A patient has a decreased DLCO but a normal DLCO/VA ratio. The patient most likely has:
a. emphysema.
b. pulmonary fibrosis.
c. a small lung (low total lung capacity).
d. secondary polycythemia.
ANS: C
The diffusing capacity of the lung to effective total lung capacity ratio (DLCO/VA) differentiates between diffusion abnormalities caused by having a small lung volume compared with diffusion abnormalities caused by alveolar-capillary membrane pathologies. Patients whose only problem is small lungs will have a decreased DLCO, but their DLCO/VA ratio will be normal. Patients with pulmonary emphysema or fibrosis will have a decreased DLCO and a decreased DLCO/VA ratio.
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