Bronchprovacation (Mod 8)

Question 1

Types of Bronchial Provocation tests (4)

Answer 1

1. Methacholine
2. Histamine challenge
3. Eucapnic hyperventilation
4. Exercise challenge

Question 2

How does Methacholine work for Bronchial Provocational tests

Answer 2

Increases parasympathetic tone in bronchial smooth muscles

Question 3

How do Ucpanic hyperventilation tests work?

Answer 3

Causes heat and water loss from the airway, thus provoking bronchospasm

Question 4

Indications for Bronchial Provocation Testing?

Answer 4

• Normal patients with symptoms of Bronchospasm
  (Dyspnea, wheezing, chest tightness, cough)
• If asthma is the likely diagnosis and post testing has not established or eliminated the diagnosis
• Quantify severity of asthma and assess changes in in airway reactivity
• Screening for risks and hazards of a job

Question 5

Absolute contraindciations for Bronchoprovaction tests

Question 6

Relative Contraindications for Bronchoprovacation tests

Question 7

Hazards and Complicatoins for Bronchoprovacation testing?

Answer 7

Bronchoconstriction

Severe coughing

Dizziness, light-headedness and chest pain

Exposure of testing personnel to methacholine

Question 8

Guidelines for Conducting Bronchoprovacation tests?

Answer 8

• Subject must be asymptomatic prior to test (no obvious wheezing/coughs) to establish pre baseline
• Bronchodilators withheld prior to test but not corticosteroids
• To establish a control baseline, Establish FEV1 > 60-70% of their previously observed best value (make this its own card)

Question 9

If diluent is used, how is FEV1 base value affected?

• what if there isn’t one used?

Answer 9

If a diluent is used, the 20% decrease is based on the diluent FEV1 value

• If a diluent is not used, the 20% decrease is based on the baseline FEV1 value
• to be clear, its comparing the control baseline not the pre baseline

Question 10

Add everything after slide 8, images are mostly examples.