Integrated respiratory cases

Question 1

what is the difference between asthma and COPD

Answer 1

asthma 
- Childhood or Adult Onset
With/Without Smoking History
- Variable Symptoms
- Variable Lung Function
- Bronchodilator Reversibility
- Bronchial Hyper-reactivity
- normal gas transfer as asthma is an airway problem not a transfer problem whereas COPD is 

COPD 
- have to inhaled something toxic into the airways in order to get COPD 
- > 20 pack year smoking history 
- Chronic Symptoms
Fixed Obstructive Spirometry
- Emphysema with impaired gas transfer

• there can be overlap and can be hard to pick the two apart this is asthma COPD overlap symptom where people have a bit of both

Question 2

when should peak flow diary look like

Answer 2

• should be coming up and down
• higher in the morning and lower in the afternoon
• airway obstruction decreases during the day

Question 3

what should the ICS do to the PEF

Answer 3

• reduce PEF variability

- improve PEF

Question 4

what does feNO do

Answer 4

• breath in and out in the lungs and measures the amount of inflammation in the lungs
• it is fractional exhaled nitric oxide (feNO)

Question 5

what biomarker can be used in an asthma diagnosis

Answer 5

eosinophils

Question 6

lung cancer guidelines

Answer 6

• ## offer chest x ray to assess for lung cancer in people over the aged of 40 if they have two or more fo unexplained symptoms or if they have ever smoked and have 1 or more of the following

Question 7

what do PET scans look for

Answer 7

• metabolically active tissue

- good for picking up nodes