Question 1

After 5 minutes of hyperventilation breathing cold air,a subject's FEV₁ falls 16% from the pre-test value.The pulmonary function technologist should conclude that: A) The subject has hyperreactive airways. B) The air was not cold enough to provoke a response. C) An additional 5 minutes of hyperventilation is required. D) Inadequate CO₂ was added to the inspired gas.

Accepted Answer

A fall of 16% in FEV1 after exposure to cold air indicates hyperreactivity of airways, which is a characteristic feature of asthma. Therefore, the pulmonary function technologist should conclude that the subject has hyperreactive airways. The other options (B, C, and D) are not relevant or plausible explanations in this scenario.

Question 2

When developing an exercise bronchoprovocation test protocol,which of the following should be included?
A) The patient should be free from respiratory infections for 1 week before the test.
B) The patient should not do vigorous exercise for 4 hours before testing.
C) The exercise time is planned for 15 to 20 minutes.
D) A cycle ergometer is used to apply the work for the exercise.

Accepted Answer

B

Question 3

A subject performing a methacholine challenge test has the following reproducible results:  The technologist should do which of the following?
A) Administer the first dose of methacholine.
B) Administer 2.50 mg/ml dose of methacholine.
C) Stop-the test is positive.
D) Administer an inhaled bronchodilator.

Accepted Answer

A

Question 4

What is the highest concentration of methacholine delivered according to the ATS dose-doubling or dose-quadrupling scheme?
A) 25 mg/ml
B) 16 mg/ml
C) 8 mg/ml
D) 4 mg/ml

Accepted Answer

The answer of What is the highest concentration of methacholine...

Question 5

A patient presents with a history of cough after playing ice hockey.Spirometry and lung volume results are normal.Which of the following tests is indicated?
A) Diffusing capacity
B) Mannitol
C) Maximum inspiratory pressure
D) Arterial blood gas

Accepted Answer

Mannitol challenge test is indicated for patients with symptoms suggestive of exercise-induced bronchoconstriction (EIB), especially when spirometry and lung volume results are normal. This test helps in diagnosing EIB, which can occur in athletes exposed to cold air, such as during ice hockey.

Question 6

When multiple methods of bronchoprovocation are ordered on the same day,how many hours after an exercise test should elapse before another test is performed?
A) 1
B) 2
C) 3
D) 4

Accepted Answer

The answer of When multiple methods of bronchoprovocation are ordered...

Question 7

Which of the following should be withheld for 48 hours before bronchial challenge testing?
A) Theophylline
B) $\beta$-Adrenergic agents
C) Anticholinergic preparations
D) Beverages containing caffeine

Accepted Answer

Theophylline should be withheld for 48 hours before bronchial challenge testing as it can affect the bronchial reactivity and make the test results unreliable.

Question 8

What is the typical inspiratory gas mixture when performing a eucapnic voluntary hyperventilation study? A) 5% CO₂,21% O₂,balance N₂ B) 10% CO₂,balance O₂ C) 5% CO₂,balance O₂ D) 10% CO₂,21% O₂,balance N₂

Accepted Answer

In a eucapnic voluntary hyperventilation study, the typical gas mixture used is 5% CO2, 21% O2, with the balance being nitrogen (N2). This mixture helps maintain normal CO2 levels while allowing for hyperventilation.

Question 9

A 15-year-old subject performs an exercise challenge test on a treadmill to a heart rate of 180 beats per minute for 5 minutes and has the following reproducible results:  The technologist should do which of the following?
A) The workload was not significant enough to elicit a response.
B) The duration was not significant enough to elicit a response.
C) The results were negative for exercise-induced bronchospasm.
D) The results were positive for exercise-induced bronchospasm.

Accepted Answer

The results of the exercise challenge test were reproducible and the heart rate reached 180 beats per minute, which is a significant workload. Therefore, the fact that the subject had exercise-induced bronchospasm is a positive result.

Question 10

A subject performing a methacholine challenge test has the following repeatable results:  The technologist should do which of the following?
A) Repeat methacholine 1.0 mg/ml dose.
B) Administer methacholine 4.0 mg/ml dose.
C) Give 10 breaths of the next dose.
D) Stop-the test is positive.

Accepted Answer

The answer of A subject performing a methacholine challenge test...

Question 11

A patient has a eucapnic voluntary hyperventilation (EVH)test to evaluate bronchial hyperreactivity.If the subject's FEV₁ is 3.3 L and her FVC is 4.0 L,which of the following is the appropriate target ventilation for the test? A) 50 times the FEV₁ for 1 minute B) 30 times the FEV₁ for 6 minutes C) 2 times the FVC for 6 minutes D) Cannot be determined without the MVV

Accepted Answer

The appropriate target ventilation for the EVH test is 30 times the FEV1 for 6 minutes. In this case, 30 times the FEV1 of 3.3L is 99L. The test should be performed for 6 minutes at this ventilation level. Option A is incorrect because it suggests only 1 minute of hyperventilation, which is not long enough for the test. Option C suggests a target ventilation based on FVC, which is not appropriate for the EVH test. Option D is incorrect because the MVV is not necessary to calculate the appropriate target ventilation for the EVH test.

Question 12

What does the acronym PC₂₀represent? A) The repeatability has to be 20% when performing a methacholine challenge. B) The dose that yields a 20% decline in FEV₁ C) A 20% decline in specific conductance D) A 20% increase in specific resistance

Accepted Answer

The acronym PC₂₀ is not a recognized acronym in any medical or scientific literature. Therefore, none of the options provided can be verified.

Question 13

Anticholinergic agents should be withheld for 24 hours.
A) 1 and 2
B) 3 and 4
C) 1 and 3
D) 2 and 4

Accepted Answer

The answer of Anticholinergic agents should be withheld for 24...

Question 14

A subject performing a methacholine challenge test has the following reproducible results:  The technologist should do which of the following?
A) Repeat methacholine 0.25 mg/ml dose.
B) Administer methacholine 1.0 mg/ml.
C) Give 10 breaths of the next dose.
D) Stop-the test is positive.

Accepted Answer

The answer of A subject performing a methacholine challenge test...

Question 15

A mannitol challenge is performed with the following results:  What should the technologist do next?
A) Proceed to the next level.
B) Deliver a bronchodilator.
C) Terminate the test.
D) Repeat the maneuver.

Accepted Answer

The answer of A mannitol challenge is performed with the...

Question 16

An exercise bronchoprovocation test was completed on a 45-year-old male.The FEV₁ decreased 18% post-exercise.The technologist should explain that this change is related to: A) Release of mediators from inflammatory cells B) A direct response of the airway smooth muscle to exercise C) An exercise-induced increase in the number of inflammatory cells D) A decrease in water loss from the airways

Accepted Answer

The decrease in FEV1 (Forced Expiratory Volume in 1 second) post-exercise indicates bronchoconstriction, which is often related to the release of mediators from inflammatory cells in the airways, a hallmark of exercise-induced bronchoconstriction or asthma.

Question 17

When preparing methacholine dilutions for the doubling protocol from 100 mg of dry powder,which of the following would yield a dilution of 4.0 mg/ml?
A) 3 ml of 16.0 mg/ml
B) 3 ml of 8.0 mg/ml
C) 3 ml of 4.0 mg/ml
D) 3 ml of 2.0 mg/ml

Accepted Answer

To achieve a 4.0 mg/ml concentration, you can dilute a higher concentration solution. Starting with 8.0 mg/ml, diluting it by half (3 ml of 8.0 mg/ml mixed with 3 ml of diluent) will yield a 4.0 mg/ml solution.

Question 18

Which of the following is a direct bronchoprovocation test?
A) Methacholine
B) Mannitol
C) Adenosine
D) Exercise

Accepted Answer

Methacholine is a direct bronchoprovocation test because it stimulates the muscarinic receptors present on the airway smooth muscle, leading to bronchoconstriction. Mannitol and exercise are indirect bronchoprovocation tests, while adenosine is not used as a bronchoprovocation test but rather as a bronchodilator.

Quiz 9: Bronchoprovocation Testing

After 5 minutes of hyperventilation breathing cold air,a subject's FEV₁ falls 16% from the pre-test value.The pulmonary function technologist should conclude that:

When developing an exercise bronchoprovocation test protocol,which of the following should be included?

A subject performing a methacholine challenge test has the following reproducible results: The technologist should do which of the following?

What is the highest concentration of methacholine delivered according to the ATS dose-doubling or dose-quadrupling scheme?

A patient presents with a history of cough after playing ice hockey.Spirometry and lung volume results are normal.Which of the following tests is indicated?

When multiple methods of bronchoprovocation are ordered on the same day,how many hours after an exercise test should elapse before another test is performed?

Which of the following should be withheld for 48 hours before bronchial challenge testing?

What is the typical inspiratory gas mixture when performing a eucapnic voluntary hyperventilation study?

A 15-year-old subject performs an exercise challenge test on a treadmill to a heart rate of 180 beats per minute for 5 minutes and has the following reproducible results: The technologist should do which of the following?

A subject performing a methacholine challenge test has the following repeatable results: The technologist should do which of the following?

A patient has a eucapnic voluntary hyperventilation (EVH) test to evaluate bronchial hyperreactivity.If the subject's FEV₁ is 3.3 L and her FVC is 4.0 L,which of the following is the appropriate target ventilation for the test?

What does the acronym PC₂₀represent?

Anticholinergic agents should be withheld for 24 hours.

A subject performing a methacholine challenge test has the following reproducible results: The technologist should do which of the following?

A mannitol challenge is performed with the following results: What should the technologist do next?

An exercise bronchoprovocation test was completed on a 45-year-old male.The FEV₁ decreased 18% post-exercise.The technologist should explain that this change is related to:

When preparing methacholine dilutions for the doubling protocol from 100 mg of dry powder,which of the following would yield a dilution of 4.0 mg/ml?

Which of the following is a direct bronchoprovocation test?

Quiz 9: Bronchoprovocation Testing

After 5 minutes of hyperventilation breathing cold air,a subject's FEV1 falls 16% from the pre-test value.The pulmonary function technologist should conclude that:

When developing an exercise bronchoprovocation test protocol,which of the following should be included?

A subject performing a methacholine challenge test has the following reproducible results: The technologist should do which of the following?

What is the highest concentration of methacholine delivered according to the ATS dose-doubling or dose-quadrupling scheme?

A patient presents with a history of cough after playing ice hockey.Spirometry and lung volume results are normal.Which of the following tests is indicated?

When multiple methods of bronchoprovocation are ordered on the same day,how many hours after an exercise test should elapse before another test is performed?

Which of the following should be withheld for 48 hours before bronchial challenge testing?

What is the typical inspiratory gas mixture when performing a eucapnic voluntary hyperventilation study?

A 15-year-old subject performs an exercise challenge test on a treadmill to a heart rate of 180 beats per minute for 5 minutes and has the following reproducible results: The technologist should do which of the following?

A subject performing a methacholine challenge test has the following repeatable results: The technologist should do which of the following?

A patient has a eucapnic voluntary hyperventilation (EVH) test to evaluate bronchial hyperreactivity.If the subject's FEV1 is 3.3 L and her FVC is 4.0 L,which of the following is the appropriate target ventilation for the test?

What does the acronym PC20 represent?

Anticholinergic agents should be withheld for 24 hours.

A subject performing a methacholine challenge test has the following reproducible results: The technologist should do which of the following?

A mannitol challenge is performed with the following results: What should the technologist do next?

An exercise bronchoprovocation test was completed on a 45-year-old male.The FEV1 decreased 18% post-exercise.The technologist should explain that this change is related to:

When preparing methacholine dilutions for the doubling protocol from 100 mg of dry powder,which of the following would yield a dilution of 4.0 mg/ml?

Which of the following is a direct bronchoprovocation test?

After 5 minutes of hyperventilation breathing cold air,a subject's FEV₁ falls 16% from the pre-test value.The pulmonary function technologist should conclude that:

A patient has a eucapnic voluntary hyperventilation (EVH) test to evaluate bronchial hyperreactivity.If the subject's FEV₁ is 3.3 L and her FVC is 4.0 L,which of the following is the appropriate target ventilation for the test?

What does the acronym PC₂₀represent?

An exercise bronchoprovocation test was completed on a 45-year-old male.The FEV₁ decreased 18% post-exercise.The technologist should explain that this change is related to: