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Respiratory Requisition Form v2 (pdf)

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Spirometry (Useful for)

Spirometry without or with bronchodilator

Spirometry

  • To help in diagnosis of patients who complain of dyspnea or chronic cough.
  • Differentiate between asthma and chronic obstructive pulmonary disease (COPD), and help guide treatment.
  • Gauge severity of impairment for both clinical and disability evaluations.
  • Follow serial changes in lung function when clinically warranted.


  • Flow volume loop (addition of inspiratory limb to spirometry) may also help identify evidence for:
    • Variable extrathoracic lesions:
      • Vocal cord paraylasis
      • Subglottic stenosis
      • Neoplasm
      • Goiter
    • Fixed lesions:
      • Fixed neoplasm in central airway
      • Vocal cord paralysis with fixed stenosis
      • Fibrotic stricture


Spirometry w/ Bronchodilator 

Pre and post-bronchodilator spirometry studies can identify clinically significant airway obstruction reversibility consistent with asthma.

Complete PFT (Useful For)

Spirometry, Lung Volumes, and DLCO

Full PFT

  • Includes Spirometry, Lung Volumes, and DLCO and is therefor useful in providing diagnostic information informed by each component in a synergistic fashion.


  • Spirometry
    • As above. Full PFT includes pre & post bronchodilator studies, and flow volume loop.


  • Lung Volumes
    • Can help determine whether a restrictive process, an obstructive process, or a mixture  is responsible for a decrease in FVC and FEV1. 
    • The diagnosis of a restrictive process cannot be made by PFT until a reduced total lung capacity (TLC) is documented.


  • DLCO when reduced helps in the differential diagnosis of restrictive lung disease identified by reduced Lung Volumes (total lung capacity (TLC) and vital capacity (VC)):
    • Causes of a decreased DLCO:
      • Decreased area for diffusion:
      1. Emphysema
      2. Lung/lobe resection
      3. Bronchial obstruction, (e.g tumor)
      4. Multiple pulmonary emboli
      5. Anemia
      • Increased thickness of alveolar-capillary membrane:
      1. Idiopathic pulmonary fibrosis
      2. Congestive heart failure
      3. Asbestosis
      4. Sarcoidosis, involving parenchyma
      5. Collagen vascular disease- scleroderma, SLE
      6. Drug-induced alveolitis or fibrosis- amiodarone, bleomycin, nitrofurantoin, methotrexate
      7. Hypersensitivity pneumonitis, including farmer's lung
      8. Histiocytosis X (eosinophilic granuloma)
      9. Alveolar proteinosis

  • DLCO when reduced is also useful for early detection of interstitial lung disease in high risk patients including those with:
    • Chest irradiation or cancer chemotherapy
    • Hypersensitivity pneumonitis
    • Rheumatic disease (e.g. systemic sclerosis)
    • Sarcoidosis
    • Use of drugs known to have pulmonary toxicity (e.g. amiodarone, bleomycin, nitrofurantoin, methotrexate).


  •  An increased DLCO near or above the upper limit of normal may be seen with the following:
    • Asthma
    • Obesity
    • High altitude
    • Polycythemia
    • Pulmonary hemorrhage
    • Left-to-right intracardial shunting
    • Mild left heart failure

PFT without DLCO

PFT with Lung Volumes (but no DLCO)

  • Can help determine whether a restrictive process, an obstructive process, or a mixture  is responsible for a decrease in FVC and FEV1. 
  • The diagnosis of a restrictive process cannot be made by PFT until a reduced total lung capacity (TLC) is documented.

PFT without Lung Volumes

PFT with DLCO (but no Lung Volumes)

  • Absent the context of lung volumes, DLCO may still allow early detection of interstitial lung disease in high risk patients, including those with:
    • Chest irradiation or cancer chemotherapy
    • Hypersensitivity pneumonitis
    • Rheumatic disease (e.g. systemic sclerosis)
    • Sarcoidosis
    • Use of drugs known to have pulmonary toxicity (e.g. amiodarone, bleomycin, nitrofurantoin, methotrexate).
  • Sensitivity of DLCO testing is improved by comparing follow-up test results to pre-treatment baseline.

FeNO (Useful For)

Fractional exhaled Nitric Oxide (FeNO) 

  •  From ATS Guidelines, "FeNO offers added advantages for patient care including, but not limited to:
    1.  detecting of eosinophilic airway inflammation, 
    2. determining the likelihood of corticosteroid responsiveness, 
    3. monitoring of airway inflammation to determine the potential need for corticosteroid, and 
    4. unmasking of otherwise unsuspected non-adherence to corticosteroid therapy."

Get It Done

Call or Fax to Schedule Testing

You Fax it - We schedule it


Fax requisition to:
Fax:  (406) 582-1112

pft at ALLERGY & ASTHMA CONSULTANTS OF MONTANA

1188 North 15th Avenue, Suite 3, Bozeman, MT 59715

Hours

Monday - Friday: 8AM–5PM