Lectures

Diagnosing for Lung Disease

by Jeremy Brown, PhD
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    The subject of this lecture are the investigations that we use for assessing patients who are presenting with potential lung disease. And I’m going to concentrate this lecture on the interpretation of how we use lung-function tests to assess patients with respiratory problems. Why do we use diagnostic tests? Well, in effect we don’t use diagnostic tests if it’s only mild disease and the clinical assessment makes it clear what the problem might be. But with more complex disease, more severe disease we will need diagnostic tests. And we need those for different reasons. One is to confirm the suspected diagnosis. Two is to make sure we’re not missing an alternative diagnosis we hadn’t thought about. The third is to assess how severe that diagnostic is, how badly affected the patient might be by that disease. And fourthly, we use diagnostic testing to establish the baseline data so we can monitor the progression of the disease over time. There are some important things that a clinician needs to understand about diagnostic testing before using them. The first is that you need, in your own mind, to define the question that you’re asking the test to answer. So, for example, somebody presenting with pneumonia – well I think it’s clinically pneumonia. I do a chest x-ray to see whether there is consolidation present and therefore confirm that they have pneumonia. And the choice of which test you do is clearly going to be dictated by the clinical scenario. So patients presenting with suspected airways disease, it’s the lung-function tests which are important. But if somebody’s got cancer or potential cancer, it comes down to imaging and obtaining a biopsy of the abnormal area to see whether there is a cancer or not. The third factor we need to remember is that...

    About the Lecture

    The lecture Diagnosing for Lung Disease by Jeremy Brown, PhD is from the course Introduction to the Respiratory System. It contains the following chapters:

    • Diagnostic tests
    • Pulmonary function tests - spirometry
    • Pulmonary function tests - others
    • Bronchoscopy
    • Chest X-ray and CT scan
    • Chronic dyspnoea and cancer

    Included Quiz Questions

    1. Sensitivity is the proportion of people with tuberculosis in whom the test is positive.
    2. Specificity is the proportion of people with tuberculosis in whom the test is positive.
    3. Specificity is the proportion of people with a negative test who have tuberculosis.
    4. Sensitivity is the proportion of people with a positive test who have tuberculosis.
    1. Peak flow rate is measured in L / minute.
    2. Peak flow rate is measured in L / second.
    3. FEV1 is measured in L / minute.
    4. FVC is measured in L / second.
    1. Total lung capacity is increased in COPD.
    2. Residual volume is reduced during a severe asthma attack.
    3. Transfer factor is independent of haemoglobin concentration.
    4. Chest wall disease causes an obstructive spirometry defect.
    1. PaO2 7.5 PaCO2 8.4 pH 7.15
    2. PaO2 12.5 PaCO2 3.4 pH 7.15
    3. PaO2 9.5 PaCO2 5.0 pH 7.38
    4. PaO2 6.5 PaCO2 5.3 pH 7.38
    1. Community acquired pneumonia
    2. Haemoptysis
    3. Lobar collapse in a smoker
    4. Suspected sarcoidosis
    1. The patient lies down for a CT scan and stands up for a chest X ray.
    2. Defines mediastinal anatomy.
    3. Can identify pulmonary emboli.
    4. Defines interstitial lung disease.

    Author of lecture Diagnosing for Lung Disease

     Jeremy Brown, PhD

    Jeremy Brown, PhD


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