|
Case1: Male, 60 years old, life long smoker, increasing breathlessness. Spirometry Predicted Observed Pre * %Predicted Observed Post * %Predicted FVC L
3.61 2.15 59 2.61 72 FEV1 L
2.87 0.70 24 0.87 30 FEV1/FVC
% 76 32 42 33 43 PEFR
L/S 7.71 2.28 29 2.20 28 FEF25-75L/S 3.32 0.22 6 0.32 9 Lung
Volumes RV L 2.25 5.00 222 TLC L
6.11 7.07 115 RV/TLC
% 37 71 191 Diffusions DLCO 24.9 11.5 46 Va 5.2 4.47 85 KCO 4.09 2.57 62 * Note: Observerd Pre =
Pre bronchodilator
Questions: 1. How would you describe the flow volume curve?
2. Do the test results support your impression?
3. Give a summary report on this patient.
Case 2: 32 years old, female, normally fit. Some breathlessness following an RTA 2 years previously but never admitted and no abnormalities found. Attributed to 'stress'. Admitted when 38 weeks pregnant for caesarian section and medical opinion sought as patient a little 'wheezy'. Spirometry Observed Pre Predicted %Predicted Observed Post %Predicted FVC L 3.14 3.22 102 3.31 105 FEV1
L 2.72 2.58 100 2.48 91 FEV1/FVC
% 83 83 100 75 90 PEFR
L/S 3.77 2.77 73 2.16 57 FEF25-75
L/S 6.45 3.6 55 3.03 46
Questions: 1. How would you describe the flow volume curve?
2. Are the spirometric results compatible with your interpretation?
3. What investigation would you carry out next?
Case 3 : 44 years old, female. Brittle asthma for 6 years requiring continuous oral steroids. Cushingoid. Attack of asthma when attending clinic. Immediate flow-volume curve obtained but with difficulty ('not optimal effort'). See image below table for flow volume loop. Spirometry Predicted Observed Pre %Predicted Observed Post %Predicted FVC L
2.83 1.52 53 1.6 56 FEV1
L 2.48 1.37 56 1.38 57 FEV1/FVC
% 81 90 111 86 106 PEFR L/S
3.36 3.19 94 2.19 65 FEF25-75
L/S 6.09 4.05 66 3.04 49 O2 saturation at rest on air: 98%
Questions: 1. Are the results compatible with a diagnosis of acute asthma?
2. What sort of abnormality is shown in the flow-volume curve?
3. Can you offer a diagnosis?
All concepts, information and graphics contained within this internet site are the sole copyright(©) of M,A&A (©M,A&A) |
