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Restrictive lung physiology — SCE Respiratory MCQ

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EasyRespiratory PhysiologyRestrictive lung physiologySCE Respiratory

A 63-year-old man has exertional dyspnoea. Spirometry shows FEV1 2.8 L (82% predicted), FVC 3.0 L (70% predicted), FEV1/FVC 0.93 and TLCO 45% predicted. HRCT later shows basal reticulation. What is the most likely physiological pattern?

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Correct answer: C — Restrictive ventilatory defect with impaired gas transfer

Reduced FVC with preserved or high FEV1/FVC and low TLCO suggests restriction with impaired gas transfer, consistent with ILD. Obstruction would show a reduced FEV1/FVC ratio. Upper-airway obstruction requires characteristic flow-volume loop flattening rather than this volume and gas-transfer pattern.

Reference: ARTP Pulmonary Function Testing Standards; ERS/ATS PFT Interpretation Standards