clinical case study: akron city hospital
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Clinical Case Study: Clinical Case Study: Akron City HospitalAkron City Hospital
By: Kristen Scalf
History 43 year old Indian Male Diagnosed with
Sarcoidosis Non Smoker
SARCOIDOSISSARCOIDOSIS
• Sarcoidosis is characterized by the formation of tiny lumps of cells in various organs in your body. Symptoms include shortness of breath and cough.
PFT TESTS:PFT TESTS: First PFT completed in October
23rd, 2008
Ordered by Dr. N. Botros MD
This was a complete PFT without a bronchodilator
Spriometry/FVL/MVVSpriometry/FVL/MVVPredicted Pre
ReportedPre %
Reported
FVC (L) 5.37 4.77 89%
FEV1 (L) 4.02 3.94 98
FEV1/FVC (%) 74.78 82.71 111
FEV3 (L) 5.21 4.54 87
FEV3/FVC (%) 97.00 95.27 98
FEF25-75% (L/s) 4.01 4.15 103
FEF50% (L/s) 5.82 5.46 94
FIF50% (L/s) 5.41
FEF50/FIF50 (%) 100.98
PEFmax (L/s) 9.58 13.76 144>
TET (sec) 6.63
FIVC (L) 4.52
EV (L) 0.17
MVV (L/min) 145.89 145.91 100
Gas Dilution Lung Gas Dilution Lung VolumesVolumes
Predicted Pre Reported
Pre % Predicted
TLC (L) 7.58 5.82 77<
VC (L) 5.37 4.33 81
RV (L) 2.21 1.49 67<
RV/TLC (%) 29.10 25.57 88
FRC N2 (L) 4.20 2.59 62<
ERV (L) 2.00 1.10 55<
IC(L) 3.37 3.23 96
N2 Time (min)
0.95
DiffusionDiffusionPredicted Pre
Reported
Pre % Predicted
Dsb
(ml/min/mmHg)
30.49 32.17 105
DsbHb
(ml/min/mmHg)
30.49 32.17 105
D/VAsb
(ml/min/mmHg)
4.02 4.82 120
VAsb (L) 7.58 6.67 88
IVC (L) 4.69
Hgb (g/dl) 14.60
BHT (sec) 11.64
PFT PFT InterpretationInterpretation
Quality of Study : Good Forced Expiration Spirometry:
This demonstrates a normal spirogram, no large airways obstructive ventilatory defect.
Respiratory Flow Volume Loop: Normal
MVV: The maximum voluntary ventilation is normal
Lung Volumes: The lung volumes show a reduced total lung capacity indication a mild restrictive ventilatory defect.
Diffusion Capacity by Single Breath CO: Normal
Impression: Mild Restrictive Ventilatory Defect
PFT TEST #2PFT TEST #2 Next PFT test was completed
on April 6th, 2009.
Ordered by Dr. A Kim MD
This was a complete PFT without a bronchodilator
Spriometry/FVL/MVVSpriometry/FVL/MVVPredicted Pre Reported Pre %
Reported
FVC (L) 5.37 4.88 91%
FEV1 (L) 4.02 3.88 97
FEV1/FVC (%) 74.78 79.48 106
FEV3 (L) 5.21 4.42 85
FEV3/FVC (%) 97.00 90.70 94
FEF25-75% (L/s) 4.01 3.62 90
FEF50% (L/s) 5.82 5.23 90
FIF50% (L/s) 8.04
FEF50/FIF50 (%) 65.13
PEFmax (L/s) 9.58 14.77 154>
TET (sec) 9.40
FIVC (L) 4.46
EV (L) 0.13
MVV (L/min) 145.89 152.77 105
Gas Dilution Lung Gas Dilution Lung VolumesVolumes
Predicted Pre Reported
Pre % Predicted
TLC (L) 7.58 5.79 76<
VC (L) 5.37 4.62 86
RV (L) 2.21 1.17 53<
RV/TLC (%) 29.10 20.23 70<
FRC N2 (L) 4.20 2.01 48<
ERV (L) 2.00 0.84 42<
IC(L) 3.37 3.78 112
N2 Time (min)
1.11
DiffusionDiffusionPredicted Pre
Reported
Pre % Predicted
Dsb
(ml/min/mmHg)
30.49 29.92 98
DsbHb
(ml/min/mmHg)
30.49 29.92 95
D/VAsb
(ml/min/mmHg)
4.02 4.61 114
VAsb (L) 7.58 6.50 86
IVC (L) 4.64
Hgb (g/dl) 14.60
BHT (sec) 11.35
PFT PFT InterpretationInterpretation
Quality of Study : Good
Forced Expiration Spirometry: This demonstrates a normal spirogram, no large airways obstructive ventilatory defect.
Respiratory Flow Volume Loop: Normal
MVV: The maximum voluntary ventilation is normal
Lung Volumes: The lung volumes show a reduced total lung capacity indication a mild restrictive ventilatory defect.
Diffusion Capacity by Single Breath CO: Normal
Impression: Mild Restrictive Ventilatory Defect
Final PFTFinal PFT
• Final PFT conducted on Oct 6, 2009
• Ordered by Dr. A. Kim MD
• This was a complete PFT with bronchodilator
Predicted Pre Reported
Pre %
Reported
Post Reported
Post % Predicted
% Change
FVC (L) 5.49 4.96 90 5.07 92 2
FEV1 (L) 4.08 4.03 99 4.26 104 6
FEV1/FVC (%) 74.20 81.25 110 89.93 113 3
FEV3 (L) 5.33 4.66 87 4.78 90 3
FEV3/FVC (%) 97.00 93.91 104 94.17 97 0
FEF25-75% (L/s) 4.01 4.17 93 5.26 131> 26
FEF50% (L/s) 5.86 5.45 6.45 110 18
FIF50% (L/s) 8.26 6.82 -17
FEF50/FIF50 (%) 66.02 94.55 46
PEFmax (L/s) 9.70 12.55 129> 13.35 138> 6
TET (sec) 7.41 8.22 11
FIVC (L) 4.45 4.76 2
EV (L) 0.15 0.19 28
MVV (L/min) 148.06 140.61 95
Spriometry/Spriometry/FVL/MVVFVL/MVV
Gas Dilution Lung VolumesGas Dilution Lung VolumesPredicted Pre
ReportedPre % Predicted
TLC (L) 7.78 6.32 81
VC (L) 5.49 4.81 87
RV (L) 2.29 1.51 66<
RV/TLC (%) 29.42 23.94 81
FRC N2 (L) 4.33 2.77 64<
ERV (L) 2.04 1.26 62<
IC(L) 3.45 3.54 103
N2 Time (min)
0.75
DiffusionDiffusionPredicted Pre
Reported
Pre % Predicted
Dsb
(ml/min/mmHg)
30.56 30.11 99
DsbHb
(ml/min/mmHg)
30.56 30.11 99
D/VAsb
(ml/min/mmHg)
3.93 4.85 123>
VAsb (L) 7.78 6.22 80<
IVC (L) 4.64
Hgb (g/dl) 14.60
BHT (sec) 11.07
PFT PFT InterpretationInterpretation
Quality of Study : Good
Forced Expiration Spirometry: This demonstrates a normal spirogram, no large airways obstructive ventilatory defect.
Respiratory Flow Volume Loop: Normal
Inhaled Bronchodilator Response: Response noted
MVV: The maximum voluntary ventilation is normal
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