Respirology Flashcards
What do you expect to see on a PFT of an asthma patient?
Obstructive pattern with decreased: FEV1, FEV1/FVC, FEF 25-75 and increased residual volume and RV/TLC, bronchodilator responsive
What do you expect to see on a PFT of someone who is deconditioned?
Everything will be normal. No bronchodilator response.
What do you expect to see on a PFT of someone who is obese?
Restrictive pattern with normal FEV1, FEV1/FVC, FEF 25-75, and a DECREASED FRC and TLC. No bronchodilator response.
What is your DDx for an obstructive appearing PFT?
Asthma, CF, non-CF bronchiectasis, bronchiolitis obliterans
What is your DDx for a restrictive appearing PFT?
ILD, pulmonary fibrosis, end stage CF, chest wall abN (scoliosis, obesity), neuromuscular abnormalities (DMD)
What features on spirometry provide a diagnosis of asthma?
FEV1/FVC <0.8
FEV1 increase >/= 12% with bronchodilator
Methacholine: 20% fall in FEV1
Exercise: FEV1 decrease 10-15%
List the criteria for well controlled asthma.
- Daytime symptoms <2 days/wk
- Nighttime symptoms <1night/wk
- PA normal
- Mild, infrequent exacerbations
- NO absence from school/work
- <2 doses/wk of fast acting beta agonise
- FEV1 or PEF >/= 90% personal best
Name the risks for morbidity in asthma.
- Previous PICU/intubation/ventilation
- Recurrent hospitalizations or ED visits in last year
- Severe asthma
- Overuse of SABA (>2 in 1 mth)
- Poor adherence to treatment
- Failure to attend clinic appointments
- Psychiatric illness
- Substance use
- Obesity
- Stressors
- Denial of illness/illness severity
