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    SubjectsMedicineSingle-Breath Nitrogen Test - Closing Volume and Phase III Slope
    ClinicalMedicine

    Single-Breath Nitrogen Test - Closing Volume and Phase III Slope

    1 MCQs in Medicine for NEET PG

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    A 40-year-old woman with 20 pack-years of cigarette smoking presents with persistent cough and reduced exercise tolerance. Her spirometry is normal (FEV₁ 92% predicted, FEV₁/FVC 0.78). A single-breath nitrogen washout test is performed: after exhaling to residual volume, she inhales a vital-capacity breath of 100% oxygen to total lung capacity, then exhales slowly while a nitrogen analyzer measures expired N₂ concentration against expired volume. The resulting curve marked **C** shows four characteristic phases. The Phase III slope in this patient is 4% N₂ per liter (normal <2%), and closing volume is elevated at 22% of vital capacity (normal <10% at age 40). Which of the following best explains the abnormal Phase III slope and elevated closing volume despite normal spirometry?

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