pft at ALLERGY & ASTHMA

1.) ASTHMA

Initial Evaluation:

Pre & Post-Bronchodilator Spirometry testing is useful for demonstrating airway obstruction reversibility, central in establishing an asthma diagnosis. An absence of reversibility may lead to seeking alternative explanation for wheezing, cough, or stridorus breath sounds.

For monitoring:

Spirometry, as well as measring the Fractional excretion of exhaled Nitric Oxide (FeNO) are useful for defining degree of control, exacerbation, and/or response to therapy. Consider testing with symptom changes, after changes in therapy, otherwise annually.

Consider also:

Determination of DLCO is generally considered optional but could identify COPD, or clarify a COPD component.

Methacholine Challenge Test (MCT) if PFTs are normal or nearly normal and question about diagnosis remains.

Tests in bold offered at pft at ALLERGY & ASTHMA

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2.) CHEST TIGHTNESS

Initial Evaluation:

For monitoring:

Spirometry, as well as measring the Fractional excretion of exhaled Nitric Oxide (FeNO) are useful for defining degree of control, exacerbation, and/or response to therapy. Consider testing with symptom changes, after changes in therapy, otherwise annually.

Consider also:

Determination of DLCO is generally considered optional but could identify COPD, or clarify a COPD component.

Methacholine Challenge Test (MCT) if PFTs are normal or nearly normal and question about diagnosis remains.

Tests in bold offered at pft at ALLERGY & ASTHMA

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3.) COPD

Initial Evaluation:

Pre & Post-Bronchodilator Spirometry
Lung Volumes: Residual Volume (RV) and Total Lung Capacity (TLC)
Diffusing capacity of carbon monoxide (DLCO)

For monitoring:

Spirometry

Consider also:

Arterial Blood Gas (ABG) when FEV1 <50% predicted. An algorithm for the prescription of oxygen to COPD patients is discussed in the 2018 Global Strategy for Prevention, Diagnosis and Management of COPD, which can be found at https://goldcopd.org/gold-reports/ see pages 89-90. Or, see page 26 of the 2018 Gold Pocket Guide, found at the same web location.

Tests in bold offered at pft at ALLERGY & ASTHMA

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Testing Considerations by Condition including asthma, chest tightness, COPD

1.) ASTHMA

2.) CHEST TIGHTNESS

3.) COPD

4.) CORONARY ARTERY DISEASE

5.) COUGH (chronic)

6.) DIFFUSE INTERSTITIAL CHANGES on CXR

7.) DYSPNEA (exertional)

8.) NEUROMUSCULAR DISEASE

9.) OCCUPATIONAL EXPOSURES

10.) RECURRENT BRONCHITIS or PNEUMONIA

11.) SMOKER

12.) SYSTEMIC DISEASES