Spirometry intrepretation 

useful obstructive / restrictive / post salbutamol to look for asthmatic changes / reversersibility 

gold standard for COPD, to make definite diagnosis for restrictive @@@@

Contraindications: delirium/ severe dementia / critically unwell ( nausea, vomiting, cough) 

relate clinical details : weight and BMI ( obesity ), gender, smoker ? ex-smoker ? pack years 

FEV1 

FVC 

FEV1 / FVC < 70% - obstructive 

FEV1/ FVC > 70% - retsrictive 

Forced lung capacity , SLow lung capacity 

Post bronchodilator --> detect asthma 

The test is positive if the FEV1 increases by at least 12 percent and the FVC increases by at least 200 mL.

A negative bronchodilator response does not completely exclude the diagnosis of asthma.

asthma - clinical diagnosis - reversible disease 

acute, seasonal / triggers/ mite/ dust/ cold/ childhood 

Acute excaberation: SABA + atroven regular 4-6 puffs 4 hourly, IVI Mg 2g over 20 minutes if severe, prednisone 40mg for 5 days  

COPD - chronic inflammatory changes - not reversible 

• Acute excerbation: SABA + atroven 4 - 6 puffs 4 hourly, 24% O2 via venturi mask, SpO2 88-90 %, if evidence of infection ( sputum / pneumonia ) - amoxillin over augmentin 

• lasts stage is steroid