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Old 03-07-2012
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ObGyn Pulmonary Fucntion Tests in Asthmatic Pregnant!

A 17-year-old woman, gravida 1, para 0, has come to the outpatient office for a routine prenatal visit. She is currently at 25 weeks’ gestation with a singleton pregnancy. She has a 10-year history of asthma but is not requiring any pharmacologic bronchodilator therapy. She is not currently having respiratory complaints or symptoms. An obstetric sonogram performed 3 weeks ago showed a female fetus with grossly normal anatomic findings and appropriate size for gestational age. The patient is scheduled to undergo pulmonary evaluation and spirometry testing today.
Which of the following statements regarding her current spirometry findings are most likely to be true when compared with her last pulmonary assessment prior to pregnancy?

(A) Respiratory rate is increased
(B) Vital capacity is decreased
(C) Minute ventilation is increased
(D) Function residual capacity remains unchanged
(E) Tidal volume is decreased
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Old 03-07-2012
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it is a restrictive condition...

so most volumes are decreased...

including VITAL CAPACITY AND FRC
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Old 03-07-2012
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minute venti = tidal vol * R.R

if min venti increases r.r increases...

both cant be correct so i eliminate both as the right ans..

I cant explain y not tidal vol... but i think tidal vol remains same coz its an extrapulmo restrictive condition

so i guess ans is

Decreased Vital capacity (...??)
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Old 03-07-2012
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i would choose (C) Minute ventilation is increased.
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Old 03-07-2012
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Guys quoting FA here

" R.R and Vital capacity unchanged

Tidal Vol... increases by30-40%

there fore,
Respi min. ventilation also INCREASES(and is the ans: E)

expiratory reserve vol .. Gradual decrease

sam is rite
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Old 03-07-2012
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(C) Minute ventilation is increased.
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Old 03-08-2012
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Respiratory rate also increases during pregnancy bcos of hyperventilation. so if minute ventilation increases then resp. rate will increase as well as tidal vol. Am i right?
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Old 03-08-2012
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From uptodate:

A relative hyperventilation occurs in the first trimester of pregnancy, with the minute ventilation rising by almost 50 percent at term. The increase in minute ventilation is primarily due to a large (up to 40 percent) increase in tidal volume (figure 1)*[9,11,12]; the respiratory rate does not change. Pregnant women with normal respiratory rates often complain of dyspnea, which is usually the result of these respiratory adaptations. The evaluation of dyspnea during pregnancy is discussed elsewhere. (See "Dyspnea during pregnancy".)
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Old 03-08-2012
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So in summary:

Increase tidal volume
No change in resp rate
Increased minute ventilation
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