Please attempt to answer the quiz yourself before reading the answers!

Case 1. An 18 year old girl with cough and wheeze waking her at night.

PEF 345 (550) FEV1 2.1 (3.2) FVC 4.2 (4.4) FEV1/FVC 50%

 a) Your interpretation ?

 b) Likely diagnosis ?

 c) How would you confirm diagnosis ?

Click here for the answers to case 1.

Case 2. A 64 year old male with a 60 pack year history now has 2 years of cough and sputum with increasing breathlessness on exercise.

 PEF 260 (355) FEV1 1.0 (2.8) FVC 3.6 (4.0) FEV1/FVC 28%

 a) Your interpretation ?

b) Likely diagnosis ?

c) How would you confirm diagnosis ?

Answers to case 2

Case 3. A 60 year old male with a 30 year pack history attends with prolonged cough and sputum. You suspect COPD.

PEF 340 (380) FEV1 2.1 (2.4) FVC 3.0 (3.6) FEV1/FVC 75%

a) Your interpretation ?

b) Likely diagnosis ?

Answers to case 3

Answers are pasted below -

1. a. airflow obstruction (moderately severe)

b. asthma

c. confirm diagnosis by:

demonstrating variability of PEF >15%

sputum eosinophils

raised IGE

blood eosinophilia

response to bronchodilator >15%

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On to case 2

2. a. severe airflow obstruction

b. COPD

c. confirm diagnosis by:

no response to steroid trial,

<15% variability in PEF or FEV1

no bronchodilator response

Back to case 2

On to case 3

3. a. within normal limits

b. chronic bronchitis not COPD

Back to case 3