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afya Spirometry

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20160425222514 Ben  
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''Measures airflow obstruction''
FVC - full insp to full exp - dec in restrictive disease or obstructive disease with air trapping
FEV1 - % of FVC expelled in 1st second - normal in restrictive, dec in obstructive (<80% predicted ))
FEF25-75 - average exp flow in middle of exp - sensitive for mid/low airways but not as reproducible as FEV1 - normal in restrictive
FEV1/FVC <0.7
compares values to normal for age, height and sex (different range for elderly and black)

Poor predictor of disability or quality of life
Good predictor of prognosis and severity assessment
''asthma'' - responds to steroids or bronchodilators and has diurnal variability of peak flow
''Restrictive'' picture - low/normal FEV1. low FVC, inc FEV1/FVC

''COPD'' (FEV1/FVC) - Stage 1 - >0.8, stage 2 - 0.5-0.79, stage 3 - 0.3-0.49, stage 4 - 0.3.

||Obstructive lung disease|	Restrictive lung disease|
|FEV1|significantly reduced|reduced|
|FVC|reduced or normal |significantly reduced|
|FEV1% (FEV1/FVC)|reduced|normal or increased|
||Asthma, COPD, Bronchiectasis, Bronchiolitis obliterans|Pulmonary fibrosis, Asbestosis, Sarcoidosis, ARDS, Infant RDS, Kyphoscoliosis, Neuromuscular disorders|

''Graph''
|Restrictive|goes up as fast ? higher, then drops faster to zero before normal|goes up with predicted line but reaches lower overall level|
|Obstructive|Goes up less high, drops more slowly but out to end of normal|goes up slower but eventually reaches predicted level|