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Questions and Answers
What is the minimum increase in FEV1 to consider a positive bronchodilator test for adult patients?
What is the minimum increase in FEV1 to consider a positive bronchodilator test for adult patients?
- A rise of at least 10% and 150 ml
- A rise of at least 12% and 200 ml (correct)
- A rise of at least 15% and 300 ml
- A rise of at least 20% and 500 ml
When should changes be measured after administering salbutamol for the bronchodilator test?
When should changes be measured after administering salbutamol for the bronchodilator test?
- 30-45 minutes after administration
- 1 hour after administration
- 10-15 minutes after administration (correct)
- Immediately after administration
What is the required increase in PEF for a positive bronchodilator test in adults?
What is the required increase in PEF for a positive bronchodilator test in adults?
- An increase of at least 10%
- An increase of at least 15%
- An increase of at least 20% (correct)
- An increase of 25% or more
Which test indicates excessive variability that confirms expiratory airflow limitation when measured over two weeks?
Which test indicates excessive variability that confirms expiratory airflow limitation when measured over two weeks?
What is the positive bronchodilator test finding for children based on FEV1?
What is the positive bronchodilator test finding for children based on FEV1?
What is the criteria for excessive diurnal PEF variability in adults over two weeks?
What is the criteria for excessive diurnal PEF variability in adults over two weeks?
At what percentage increase in FEV1 and FVC is lung function considered improved in adults after 4 weeks of treatment?
At what percentage increase in FEV1 and FVC is lung function considered improved in adults after 4 weeks of treatment?
What constitutes a positive bronchial challenge test result in adults using mannitol or hypertonic saline?
What constitutes a positive bronchial challenge test result in adults using mannitol or hypertonic saline?
In children, what indicates excessive variation in lung function between visits?
In children, what indicates excessive variation in lung function between visits?
What is the diagnosis criterion for a positive bronchial challenge test in adults using standardized exercise?
What is the diagnosis criterion for a positive bronchial challenge test in adults using standardized exercise?
What percentage of PEF variability indicates a positive result for children over two weeks?
What percentage of PEF variability indicates a positive result for children over two weeks?
What is the minimum acceptable fall in FEV1 for adults during a methacholine challenge to be considered positive?
What is the minimum acceptable fall in FEV1 for adults during a methacholine challenge to be considered positive?
What parameter indicates a positive bronchial challenge result in children during a standardized exercise challenge?
What parameter indicates a positive bronchial challenge result in children during a standardized exercise challenge?
Which test confirms excessive variability in twice daily PEF over a two-week period?
Which test confirms excessive variability in twice daily PEF over a two-week period?
What is the spirometry criterion for a positive bronchodilator test in children?
What is the spirometry criterion for a positive bronchodilator test in children?
At what concentration of salbutamol should the bronchodilator test changes be measured?
At what concentration of salbutamol should the bronchodilator test changes be measured?
What is the criteria for a positive PEF finding in adults after a bronchodilator test?
What is the criteria for a positive PEF finding in adults after a bronchodilator test?
Which of the following is an acceptable metric for considering positive bronchodilator responsiveness in spirometry for adults?
Which of the following is an acceptable metric for considering positive bronchodilator responsiveness in spirometry for adults?
What is the required average daily diurnal PEF variability to indicate excessive variability in children over 2 weeks?
What is the required average daily diurnal PEF variability to indicate excessive variability in children over 2 weeks?
Which of the following indicates a positive bronchial challenge test in adults using hyperventilation?
Which of the following indicates a positive bronchial challenge test in adults using hyperventilation?
What indicates a positive excessive variation in lung function between visits in adults?
What indicates a positive excessive variation in lung function between visits in adults?
What is the criterion for a positive bronchial challenge test in children using standardized exercise?
What is the criterion for a positive bronchial challenge test in children using standardized exercise?
What constitutes a positive response for lung function improvement in children after 4 weeks of treatment?
What constitutes a positive response for lung function improvement in children after 4 weeks of treatment?
Which criterion indicates a positive bronchial challenge test with standard exercise in adults?
Which criterion indicates a positive bronchial challenge test with standard exercise in adults?
What is the typical increase in lung function indicators after 4 weeks of treatment in adults?
What is the typical increase in lung function indicators after 4 weeks of treatment in adults?
What is the increase in lung function after 4 weeks of treatment for children based on predictions?
What is the increase in lung function after 4 weeks of treatment for children based on predictions?
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Study Notes
Tests to Confirm Variable Expiratory Airflow Limitation
- Positive Bronchodilator responsiveness test using spirometry or Peak Expiratory Flow (PEF).
- Excessive variability in twice daily PEF measured over two weeks.
- Significant increase in lung function after four weeks of treatment.
- Positive response to Bronchial challenge test.
- Notable variation in lung function between clinical visits.
FEV1
- Measures the volume of air exhaled in one second as a percentage of predicted values.
FVC
- Represents the total air volume exhaled forcefully in one breath; measured in percentage of milliliters.
Spirometry Finding for Positive Bronchodilator Test in Adults
- FEV1 and FVC should both show improvement of at least 12% and 200 ml, with increased confidence if ≥15% and ≥400 ml.
PEF Finding for Positive Bronchodilator Test in Adults
- A minimum increase of 20% in Peak Expiratory Flow is required.
Spirometry Finding for Positive Bronchodilator Test in Children
- Increase in FEV1 must be at least 12% predicted from baseline.
PEF Finding for Positive Bronchodilator Test in Children
- PEF must improve by at least 15%.
Timing for Measuring Bronchodilator Test Changes
- Changes should be assessed 10-15 minutes after administering 200-400 mcg of salbutamol.
Withholding Bronchodilators Before Testing
- Short-acting bronchodilators (SABA) should be withheld for at least 4 hours.
- Long-acting bronchodilators must be withheld for 24-48 hours prior to testing.
Excessive Variability in Diurnal PEF
- For adults, diurnal PEF variability should exceed 10%.
- For children, it should be greater than 13%.
Lung Function Increase After 4 Weeks of Treatment
- In adults, FEV1 and FVC must rise by ≥12% and ≥200 ml or PEF ≥20%.
- In children, FEV1 and FVC should increase by ≥12% predicted or PEF ≥15%.
Administration on Positive Bronchial Challenge Test
- Testing involves the use of Methacholine, Mannitol, or Hypertonic Saline to evaluate lung reactivity.
Purpose of Bronchial Challenge Testing
- The Methacholine challenge test evaluates how reactive or responsive the lungs are to stimuli.
Positive Bronchial Challenge Test Results in Adults
- With Methacholine: FEV1 must drop from baseline by ≥20%.
- With Hyperventilation: FEV1 falls by ≥15%.
- With Hypertonic Saline or Mannitol: FEV1 decreases by ≥10%.
- With Standardized Exercise: FEV1 decrease must be >200 ml.
Positive Bronchial Challenge Test Results in Children
- FEV1 must show a decrease of >12% predicted or PEF must drop by >15% during a standardized exercise challenge.
Excessive Variation in Lung Function Between Visits
- In adults: Spirometry indicates an FEV1 change of ≥12% and ≥200 ml; PEF changes ≥20%.
- In children: Spirometry must show FEV1 ≥12% and PEF ≥15% between visits.
Tests to Confirm Variable Expiratory Airflow Limitation
- Positive Bronchodilator responsiveness test using spirometry or Peak Expiratory Flow (PEF).
- Excessive variability in twice daily PEF measured over two weeks.
- Significant increase in lung function after four weeks of treatment.
- Positive response to Bronchial challenge test.
- Notable variation in lung function between clinical visits.
FEV1
- Measures the volume of air exhaled in one second as a percentage of predicted values.
FVC
- Represents the total air volume exhaled forcefully in one breath; measured in percentage of milliliters.
Spirometry Finding for Positive Bronchodilator Test in Adults
- FEV1 and FVC should both show improvement of at least 12% and 200 ml, with increased confidence if ≥15% and ≥400 ml.
PEF Finding for Positive Bronchodilator Test in Adults
- A minimum increase of 20% in Peak Expiratory Flow is required.
Spirometry Finding for Positive Bronchodilator Test in Children
- Increase in FEV1 must be at least 12% predicted from baseline.
PEF Finding for Positive Bronchodilator Test in Children
- PEF must improve by at least 15%.
Timing for Measuring Bronchodilator Test Changes
- Changes should be assessed 10-15 minutes after administering 200-400 mcg of salbutamol.
Withholding Bronchodilators Before Testing
- Short-acting bronchodilators (SABA) should be withheld for at least 4 hours.
- Long-acting bronchodilators must be withheld for 24-48 hours prior to testing.
Excessive Variability in Diurnal PEF
- For adults, diurnal PEF variability should exceed 10%.
- For children, it should be greater than 13%.
Lung Function Increase After 4 Weeks of Treatment
- In adults, FEV1 and FVC must rise by ≥12% and ≥200 ml or PEF ≥20%.
- In children, FEV1 and FVC should increase by ≥12% predicted or PEF ≥15%.
Administration on Positive Bronchial Challenge Test
- Testing involves the use of Methacholine, Mannitol, or Hypertonic Saline to evaluate lung reactivity.
Purpose of Bronchial Challenge Testing
- The Methacholine challenge test evaluates how reactive or responsive the lungs are to stimuli.
Positive Bronchial Challenge Test Results in Adults
- With Methacholine: FEV1 must drop from baseline by ≥20%.
- With Hyperventilation: FEV1 falls by ≥15%.
- With Hypertonic Saline or Mannitol: FEV1 decreases by ≥10%.
- With Standardized Exercise: FEV1 decrease must be >200 ml.
Positive Bronchial Challenge Test Results in Children
- FEV1 must show a decrease of >12% predicted or PEF must drop by >15% during a standardized exercise challenge.
Excessive Variation in Lung Function Between Visits
- In adults: Spirometry indicates an FEV1 change of ≥12% and ≥200 ml; PEF changes ≥20%.
- In children: Spirometry must show FEV1 ≥12% and PEF ≥15% between visits.
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