In: Anatomy and Physiology
A patient has recently been diagnosed with asthma. The patient is unsure whether the medication regimen prescribed is actually helping. The physician orders pulmonary function testing. What information might testing provide that will aid in the patient’s treatment regimen? close to 1 page explaination
Asthma is the form of obstructive pulmonary disease i.e., the small airways are in some way reduced in caliber. It results in bronchoconstriction and consequent reduction in bulk gas movement through the small airways. This can lead to both reduced oxygen delivery and carbon dioxide elimilation. Pulmonary function testing of the forced expiratory volume in 1 second, FEV1, is useful to asses maximal gas flow through the airways. Peak flow is also a useful measure but requires a history of pulmonary function testing for comparison. The two most common pulmonary function tests for asthma are spirometry and methacholine challenge tests.
Spirometry : This test for asthma is a simple breathing test that measures how much air can be blown out of the lungs and how quickly. It is often used to determine the amount of airway obstruction patient has. The test can be done before and after patient inhales a short acting medication called a bronchodilator, such as albuterol. The bronchodilator causes airways to expand allowing for air to pass through freely. This test confirms the presence of airway obstructions that improves with treatment, which is very characteristic of asthma and can accurately measure the degree of lung function impairment.This test also monitors response to asthma medications and is recommended for adults and children over age 5. This test might also be done at future doctor visits to check the progress and to help the doctor determine if and how to adjust the treatment plan. FEV1 can be measured by spirometry.
Methacholine challenge test : It is more commonly used in adults than children. It can be performed if the symptoms and the screening spirometry do not convincingly establish the diagnosis of asthma. Methacholine is an agent that when inhaled causes the airways to spasm ( contract involuntarily) and narrow if asthma is present. During this test, patient inhales increasing amount of methacholine aerosol mist before and after spirometry. The methacholine test is considered positive, meaning asthma is present, if the lung function drops by atleast 20%. A bronchodilator is always given at the end of the test to reverse the effects of methacholine.