Spirometry and peak flow

Question 1

Three factors influencing peak flow

Answer 1

Age

Sex

Height

Question 2

Indications for carrying out a PEFR

Answer 2

Checking for airflow obstruction

Monitoring asthma

Assessment in an acute asthma attack

Question 3

Limitations to using PEFR

Answer 3

Technical (dependent on person doing it right)

Does’nt reflect small airway obstruction

Cannot substitute spirometry (cannot diagnose based on this)

Potential fungal contamination of device

Question 4

Percentage PEFR for moderate, severe and life threatening attacks

Answer 4

Moderate: 50-75%

Severe: 33-50%

Life threatening: below 33%

Question 5

Below what age do spirometry and PEFR become unreliable

Answer 5

Below 5

Question 6

Obstructive lung diseases

Answer 6

Asthma

COPD

Bronchiectasis

Lung tumour

CF

Post-tuberculosis

Obliterative bronchiolitis

Question 7

Restrictive lung diseases

Answer 7

Intrapleural

Pulmonary fibrosis

Pneumoconiosis

Asbestosis

Pulmonary oedema

Lobectomy

Extrapleural

Kyphosis

Obesity

Pregnancy

Neuromuscular disorders

Rheumatoid Arthritis

Question 8

Severity of airflow obstruction

Answer 8

Mild (above 80)

Moderate (50-79)

Severe (30-49)

Very severe (below 30)

Question 9

How is asthma different from COPD

Answer 9

Diurnal variation

Waking with breathlessness at night

Age

Possible non-smoking status

Unproductive cough

Question 10

Spirometry pattern of obstructive disease in numbers

Answer 10

FEV1 less than 80%

FEV1/FVC less than 0.7

FVC can be more than 80% (normal)

FRV1 and ratio decreased in general

Question 11

Spirometry pattern of restrictive disease in numbers

Answer 11

FEV1 more than 80% (normal)

FVC less than 80%

FEV1/FVC ratio above 0.7 (normal)