Instructions
You are a medical student on placement in general practice. Your next patient is Declan Fahey, 42, back for the results of tests for breathlessness on exertion. His spirometry report is printed for you.
Take a focused history
Outline to the examiner:
- Your findings
- Your interpretation of the results
- Your most likely diagnosis and differentials
- Next steps in management, including relevant investigations
- You do not need to examine the patient; the examiner will give you any findings you ask for
- Ask the examiner for any further results you want
Spirometry and gas transfer (six weeks ago)
| Item | Value | Reference range |
|---|---|---|
| FEV1 pre-bronchodilator | 2.25 L (55% predicted) | >3.25 L |
| FEV1 post-bronchodilator | 2.35 L (58% predicted) | >3.25 L |
| FVC post-bronchodilator | 4.52 L (92% predicted) | >3.95 L |
| FEV1/FVC post-bronchodilator | 0.52 | >0.70 |
| FEV1 change after salbutamol 400 microgram | +100 mL (+4%) | - |
| DLCO (gas transfer) | 55% predicted | 75-125% |
Male, 42 years, height 178 cm, weight 80 kg. Good effort; acceptable and repeatable.