QuestionSBA
QuestionChoice
COPD shows an obstructive rather than restrictive pattern on spirometry. This would result in a FEV1/ FVC ratio less than 0.7.
10027817
b
Chronic obstructive pulmonary disease
QuestionChoice
Pneumoconiosis (coal miner's lung) does cause a restrictive pattern on spirometry so would match this patient. However, there is no significant history of coal exposure to make that possible.
10027818
c
Pneumoconiosis
QuestionChoice
The spirometry results show a restrictive pattern as the FEV1/FEVC ratio is greater than 0.7. The smoking history alongside this makes idiopathic pulmonary fibrosis the most likely.
10027816
a
Idiopathic pulmonary fibrosis
QuestionChoice
Bronchiectasis is an obstructive lung disease so the FEV1/ FVC ratio would be reduced (less than 0.7).
10027819
d
Bronchiectasis
QuestionChoice
Lung cancer may affect the functioning of the lungs but spirometry is not usually diagnostic. There would likely be other features of underlying malignancy such as weight loss, haemoptysis and hoarseness of voice. This makes lung cancer less likely in this patient.
10027820
e
Lung cancer
Concept
Chapter
2693
3726
Spirometry
Topic
132
Respiratory
17961
A 72-year-old woman has been referred to the pulmonary clinic. She presents with progressively worsening breathlessness and a dry cough. She smokes a pack a day and has done so for 50 years. Her spirometry results are shown below:

| FEV1        | FVC           |
| ------------- |:-------------:|
| 1.57 L (50% of predicted)      |  1.63 L (40% of predicted)|

What is the most likely diagnosis?
a