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Restrictive Spirometry — RACP Adult Medicine MCQ

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EasyRespiratoryRestrictive SpirometryRACP Adult Medicine

A 50-year-old man presents with worsening exertional dyspnoea and a 6-month history of dry cough. He has a history of chronic hypersensitivity pneumonitis from bird exposure. Spirometry: FVC 55% predicted, FEV₁ 52% predicted, FEV₁/FVC 0.78. DLCO 40% predicted. What is the spirometry pattern?

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Correct answer: E — Restrictive pattern

FVC and FEV₁ both reduced with preserved or elevated FEV₁/FVC ratio (≥0.70) indicates a restrictive pattern. In the context of chronic HP with pulmonary fibrosis, this is expected. The severely reduced DLCO reflects impaired gas exchange from fibrotic lung disease. Full lung volumes (TLC by plethysmography) confirm true restriction.

Reference: eTG Respiratory – 2024 – Pulmonary Function Testing; ATS/ERS 2005