Patient 2 is a five foot six inch, 130-lb 12-year old male who complains of occa
ID: 3511498 • Letter: P
Question
Patient 2 is a five foot six inch, 130-lb 12-year old male who complains of occasional periodic shortness of breath. He has never had an asthma attack and has no known allergies, but sometimes feels "like he is suffocating", and his mother wonders if he may have asthma. He had a respiratory infection a couple of months ago, but suffered no asthma-like symptoms during that time. It is also noted during the patient interview that his parents have recently gone through a divorce Patient 2 Test results: %of Expected Value 104% Respiratory Volume or Expected ValueTest Results Capacity 5000 ml Forced Vital Capacity FVC Forced Expiratory Volume after 1 second 5200 4300 ml 4400 102% FEV1 FEV1/FVO 86.3% 84.6% 98% 1. In regard to Patient 2, what do the tests results for Vital Capacity indicate? 2. What do the test results for FEV1/FVC indicate? 3. What would you expect the doctor's preliminary diagnosis to be for Patient 2? 4. What additional tests might be ordered for further assessment?Explanation / Answer
BMI of the patient is 20.98, so he is a healthy boy not over weight.
1. In patient 2 both the FEV1 ans FVC increased and also the FEV1/ FVC value is not bellow 80%. So there is no obstructive or restrictive lung disease. So the patient do not have asthma or COPD. It indicates that the boy have stronger respiratory muscle than average population, or the boy may be a athelete or lastly the spirometry test was not done correctly.
2. The FEV1/FVC ratio shows that the boy has neithere obstructive ( asthma, copd) nor restrictive disease ( fibrosis of lung). In obstructive disease this ratio is reduced, in restrictive disease this ratio may remain normal or above 80% but FEV1 and FVC both are reduced than normal.
3. Doctor's primary diagnosis will be hyperventilation due to psychological disorder due his parents recent divorce.
4. As pulmonary functions are okay, we need to rule out the cardiac cause of shortness of breath. So we should order, ECG, ECHOCARDIOGRAPHY and chest Xray to exclude cardiac cause of shortness of breath.