Spirometry — Patterns and Interpretation

A 52-year-old male smoker with a 30 pack-year history presents with progressive dyspnea and chronic cough. Spirometry shows FEV₁/FVC ratio of 0.68 with FEV₁ at 45% predicted. Which investigation is most appropriate to confirm the diagnosis and assess disease severity?

A 52-year-old male smoker with chronic cough presents for pulmonary function testing. His spirometry shows FEV₁/FVC ratio of 0.68 (predicted 0.80), FEV₁ 62% of predicted, and a normal inspiratory flow curve. Which of the following is NOT consistent with an obstructive pattern on spirometry?

A 68-year-old woman with idiopathic pulmonary fibrosis undergoes spirometry. Her results show FEV₁ 70% predicted, FVC 65% predicted, FEV₁/FVC ratio 0.82, TLC 60% predicted, and normal inspiratory and expiratory flow curves. Which of the following is NOT a characteristic feature of the restrictive pattern seen in this patient?

A 52-year-old male smoker with a 30 pack-year history presents with progressive dyspnea and chronic cough. Spirometry shows FEV₁/FVC ratio of 0.68 (predicted 0.75), FEV₁ 58% predicted, and a normal inspiratory flow curve. Flow-volume loop demonstrates a characteristic 'scooped out' expiratory limb. What is the most appropriate next step in management?

A 38-year-old woman with a history of allergic rhinitis and childhood asthma (remitted for 10 years) presents with a 3-month history of exertional dyspnea and dry cough. Spirometry is normal (FEV₁ 92% predicted, FEV₁/FVC 0.82). She denies current wheeze or night-time symptoms. What is the most appropriate next step in management?