Correct!
5. Vocal cord dysfunction

The chest x-ray is normal. The pulmonary arteries are normal sized and there are no masses which could be arteriovenous malformations. The spirometry was interpreted by the computer as showing “moderate severe obstruction”, which although true, is only part of the story. The FEV1 is decreased but the shape of the flow-volume loop is squared indicting fixed obstruction. The squaring is caused by decreased flows during both inspiration and expiration.

What should be done to diagnose VCD in our patient? (Click on the correct answer to be directed to the sixth of seven pages)

  1. Bronchoscopy
  2. CT scan of the neck
  3. Flexible fiberoptic laryngoscopy
  4. 1 or 3
  5. Any of the above

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