by mtoom


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Name 5 uses of pulmonary function tests
  • 1. Diagnosis (when symptoms suggest lung disease: wheeze, cough, dyspnea)
  • 2. Detect early signs of airflow obstruction in smokers
     
  • 3. Tracking chronic disease
  • 4. Pre-operative risk assessment
  • 5. Routine health risk assessment
What 4 questions can Spirometry answer?
  • 1. Is there an airflow limitation?
  • 2. How severe is the airflow limitation?
  • 3. Is there a response to bronchodilator therapy?
  • 4. Does the airflow limitation pattern suggest obstructive or restrictive disease?
List 4 groups of Pulmonary Function Tests.
  • Spirometry
  • Subdivisions of lung volume
  • Diffusing capacity
  • Airway resistance, lung compliance, airway response, cardiopulmonary exercise testing
Lung volumes and flows vary with what factors (4)?

How are flows/volumes presented?
  • Height, age, sex, ethnicity
     
  • Presented as percent predicted
What happens to your FEV1 value if you quit smoking in middle-age?
It decreases at a slower rate than it would if smoking had continued.
What measures of lung volume do you NOT get from a Spirometry? (3)
  • RV, FRC, TLC
What specific, calculated measures of lung volume/flow do you get with Spirometry?
  • FVC
  • FEV1
  • FEV1/FVC
  • IC
  • ERV
  • PEF
  • FEF25,75
Is Spirometry effort independent?
Yes, it is relatively effort independent
What are 2 good features of Spirometry?
It is easy and reproducible
Describe 1 obstructive condition and 1 type of restrictive disease where diffusing capacity is abnormal?
  • Emphysema
  • Interstitial lung disease
What is the purpose of the airway responsiveness test that involves inhaling methacholine?
People with airway hyper-responsiveness will have a much greater fall in FEV1 from a small amount of methacholine (which is a synthetic acetylcholine).

Airway hyper-responsiveness is a hallmark of asthma. The test is also known as a bronchial challenge test.
If you give a bronchodilator to a patient after spirometry, then repeat spirometry, what findings would be suggestive of asthma?
Bronchodilator response = 15% increase of FEV1 or FVC
If patient has normal (or almost normal) lung function, what is the better test for asthma?
Airway responsiveness test

Bronchodilator test is better in patient with asthma that has impaired lung function (then you can see it improve with bronchodilator)
For % predicted, what is the "normal" range, when you interpret the figures?
+/- 20% is normal

Except FEF25-75, which has an even larger normal range.
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