Case Study 2
- Matron
- Dec 3, 2024
- 2 min read
Let me introduce you to Leanne.
As you can see, she is absolutely delighted to meet you! š
Leanne is 17 years old and and is suspected of having asthma due to recent onset breathlessness, cough, chest tightness and wheeze (the wheeze has not yet been confirmed by a clinician)
Leanne has a history of eczema as a baby and does suffer with hay-fever during summer months
Leanne tells you that whenever she visits her grandparents house her symptoms worsen, and she blames this on their 3 cats
Leanne's mother does not believe her and is convinced that she is using this as an excuse to get out of visiting her grandparents on Sunday's
Leanne rolls her eyes at her mother and says "Whatever!"
She is here today for a diagnostic assessment
The thing is, she might well be using it as an excuse to get out of visiting her grandparents BUT she might not!
Lets have a look at what her spirometry test results show:
The first thing to look at here is the LLN for Leanne's FEV/FVC ratio as it is this that will help us decide if there is any evidence of obstruction.
Remember, the younger we are the higher our LLN FEV/FVC ratio will be!
Leanne's LLN FEV/FVC ratio is 0.78, meaning that if her actual/measured FEV/FVC ratio is less than 0.78, it is indicative of the presence of airway obstruction.
Leanne's actual/measured FEV/FVC ratio is 0.74 which is less than her LLN indicating the presence of airway obstruction.
An exhaled nitric oxide test (FeNO) result of 78 ppb confirms a diagnosis of asthma.
Important Point:
Using a fixed FEV/FVC ratio of 0.70 and above as measure of normality could have resulted in Leanne's asthma going undiagnosed and therefore untreated putting her at risk of future adverse events such as asthma attack and developing chronic asthma with fixed airflow obstruction.
Comments