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Emphysema-predominant COPD physiology — SCE Respiratory MCQ

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HardRespiratory PhysiologyEmphysema-predominant COPD physiologySCE Respiratory

Three technically acceptable adult spirometry manoeuvres produce FEV1 values 2.81, 2.68 and 2.64 L and FVC values 3.90, 3.72 and 3.69 L. FVC exceeds 1 L. What is the correct quality conclusion?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — FEV1 is repeatable but FVC is not; obtain further acceptable manoeuvres

Explanation lettering: E = shown as B · B = shown as C · C = shown as D · D = shown as E

A is correct. Adult repeatability compares the highest and second-highest acceptable values, not the full three-blow range. FEV1 differs by 0.13 L and meets the 150-mL criterion; FVC differs by 0.18 L and does not. Additional acceptable manoeuvres should be attempted within the test limit. A 250-mL threshold is too permissive, the special 100-mL criterion applies when FVC is below 1 L, and the largest FEV1 and FVC need not arise from the same manoeuvre.

Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC7337892/