IM pulmonology clarification.. - mahr90

[ArchivalUser]

..the flow-volume loop curve of obstructive lung dis. is to the Left, when we give bronchodilator & if the curve changes that means it's asthma.. i just want to clarify if it "changes" as in moves to the Normal curve??

Thank you.. (:

[ArchivalUser]

Yes-- but make sure when you aren't just looking at the direction it moves, because the normal curve won't always be there for comparison. Sometimes the test takers will intentionally reverse the numbers on the horizontal axis just to confuse you... because as we know, they are bast**ds. The bronchodilator will change almost any COPD curve towards normal, but it will change asthma the most. Asthma is different from other COPDs in that it's flow volume loop curve may have a "scooped out" look to it.

So, yes, "improvement," or moving to the right on flow-volume loop is usually asthma but could also be COPD. A rightward movement usually signifies lower total volumes and remember that COPDs have increased total lung capacities due to air trapping. Bronchodilator will allow passages to stay open at lower pressures and allow for air to be expired, lowering TLC and moving the curve to the right.

Other COPD such as emphysema (early) or chronic bronchitis will not improve as much, if at all, or respond better to anti-muscurinic, eg ipratropium.

[ArchivalUser]

ok so all COPD curves will change with bronchodilator? Which ones will be irrversible then?

& thank you for reminding me about the axis . (:

[ArchivalUser]

I guess for discussion, asthma is the main one that will always *markedly) improve (if treatment is effective). Early emphysema or bronchitis can also change, but if we're talking about typical patients, eg 12 year old asthmatic, and 60 year old smoker with 50 year pack history, then only the child will get better with bronchodilator. The smoker (emphysema/chronic bronchitis) will not. (Still, it's important to remember the exceptions.)

Restrictive lung diseases will not improve with bronchodilators and will remain on the "low volume" side, eg pulmonary fibrosis, interstitial lung diseases, pneumoconiasis, etc. So assuming normal curve is in the middle, and high volume is to left (COPDs), then restrictive lung diseases are to the right (low volume).

[ArchivalUser]

hmm yes b/c in vid he said that COPD will not change with bronchodilators so that must be the typical scenario as in NOT directly change compared with asthma.. alright thanks a ton !! (: