Asthma: Diagnosing and Treatment

Question 1

FEV1, FVC, and FEV1/FVC ratio

Intermittent
Mild
Moderate
Severe

Answer 1

Intermittent: normal between episodes, FEV1 >80%, FEV1/FVC > 85%

Mild: FEV1 > 80%, FEV1/FVC > 80%

Moderate: FEV1 60-80%, FEV1/FVC = 75-80%

Severe: FEV1 < 60%, FEV1/FVC < 75%

Question 2

Symptom occurrence

Intermittent
Mild
Moderate
Severe

Answer 2

Intermittent: < 2x/week

Mild: > 2x/week but not daily

Moderate: daily

Severe: throughout the day

Question 3

Nighttime awakenings

Intermittent
Mild
Moderate
Severe

Answer 3

Intermittent: < 2x/month

Mild: 3-4x/month

Moderate: > 1x/week, but not nightly

Severe: 7/week

Question 4

SABA use for symptom control

Intermittent
Mild
Moderate
Severe

Answer 4

Intermittent: < 2 days/week

Mild: >2 days/week, but not daily

Moderate: daily

Severe: several times a day

Question 5

What is the definition of airflow obstruction using FEV1 and FVC?

Answer 5

defined as:

1. FEV1 < 80% predicted (0.80)

and/or

2. FEV1/FVC ratio < 85% predicted (0.85)

Question 6

Significant reversibility with use of a short-acting bronchodilator during spirometry is indicated by an increase in FEV1 of how much?

Answer 6

> 12% from baseline

Question 7

What diagnostic testing should be utilized next if worried about asthma but spirometry findings are normal and there is no apparent change with bronchodilators?

Answer 7

BRONCHOPROVOCATION –> methacholine, cold air, or exercise

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