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Pulmonary function testsPulmonary function tests are a group of tests that measure how well the lungs take

in and release air and how well they move gases such as oxygen from the atmosphere into the body's circulation. Pulmonary function tests are done to: Diagnose certain types of lung disease (especially asthma, bronchitis, and emphysema) Find the cause of shortness of breath Measure whether exposure to contaminants at work affects lung function

FEV1/FVC: The ratio of FEV1 to FVC. Again, for the math. challenged like me divide one into the other and - do you care? FEF 25 - 75%: Forced Expiratory Flow from 25 to 75% is what you are blowing in the middle of the test. (Don't they have anything better to do with their time than this???) SVC: Slow Vital Capacity: Is the volume of gas measured....after or before an inspiration. This is a direct quote and I would like someone to explain to me how I can exhale before I inhale!! See why I say, don't pay much attention. FRC or TGV: Measures volume of gas remaining in lungs after exhale - also called RV - or residual volume. TLC: I like this much better in its familiar form and we all need heaps of it, but in testing format it means Total Lung Capacity - which means how much you can breathe in. (the important part of this is you should always practice breathing that's what is vital)

It also can be done to: Assess the effect of medication Measure progress in disease treatment

Spirometry measures airflow. By measuring how much air you exhale, and how quickly, spirometry can evaluate a broad range of lung diseases.Lung volume measures the amount of air in the lungs without forcibly blowing out. Some lung diseases (such as emphysema and chronic bronchitis) can make the lungs contain too much air. Other lung diseases (such as fibrosis of the lungs and asbestosis) make the lungs scarred and smaller so that they contain too little air.Testing the diffusion capacity (also called the DLCO) allows the doctor to estimate how well the lungs move oxygen from the air into the bloodstream. Normal Results

What Abnormal Results Mean


Abnormal results usually mean that you may have some chest or lung disease.

Mantoux Test
The Mantoux skin test is given by using a needle and syringe to inject 0.1 ml of 5 tuberculin units of liquid tuberculin between the layers of the skin (intradermally), usually on the forearm (Figure 1). A tuberculin unit is a standard strength of tuberculin.The tuberculin used in the Mantoux skin test is also known as purified protein derivative, or PPD. For this reason, the tuberculin skin test is sometimes called a PPD skin test.With the Mantoux skin test, the patient's arm is examined 48 to 72 hours after the tuberculin is injected. Most people with TB infection have a positive reaction to the tuberculin. The reaction is an area of induration (swelling that can be felt) around the site of the injection. The diameter of the indurated area is measured across the forearm (Figure 2); erythema (redness) around the indurated area is not measured, because the presence of erythema does not indicate that a person has TB infection.

Normal values are based upon your age, height, ethnicity, and sex. Normal results are expressed as a percentage. A value is usually considered abnormal if it is less than 80% of your predicted value.

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results. Normal: 80% or greater than predicted - does that make sense? See above Predicted Values: Numbers based on "normal" person of equivalent age, height, weight, and in some cases, (depending on computer) race. Measured Value: What is your % of the Predicted: For all math challenged - you divide one into the other - for instance your Significant Other weighs 100 pounds and you weigh 50, you are 50% of his weight (or hers). What good does to know this is more than I understand, but somebody designed the program!! Forced Vital Capacity: The amount of air you blow out. Forced Expiratory Volume 1: The amount of air you blow out in one second from the beginning of the test.

Sites of TB Disease TB disease can occur in different places in the body. Pulmonary TB is TB that occurs in the lungs. About 85% of TB cases are pulmonary. Most patients with pulmonary TB have a cough and an abnormal chest x-ray, and they should be considered infectious until they meet certain criteria. Extrapulmonary TB occurs in places other than the lungs, such as the larynx, the lymph nodes, the pleura (the membrane surrounding each lung), the brain, the kidneys, or the bones and joints. Extrapulmonary TB occurs more often in people who are infected with HIV than in people who are not infected with HIV. In HIV-infected people, Extrapulmonary TB is often accompanied by pulmonary TB. Most types of Extrapulmonary TB are not considered infectious- Miliary TB occurs when tubercle bacilli enter the bloodstream and are carried to all parts of the body, where they cause disease in multiple sites. This condition, which is rare but serious, is called Miliary TB because the chest x-ray has the appearance of millet seeds scattered throughout the lung.

Classifying the Tuberculin Skin Test Reaction

5 or more millimeters An induration of 5 or more millimeters is considered positive for People with HIV infection Close contacts People who have had TB disease before People who inject illicit drugs and whose HIV status is unknown

10 or more millimeters An induration of 10 or more millimeters is considered positive for Foreign-born persons HIV-negative persons who inject illicit drugs Low-income groups People who live in residential facilities People with certain medical conditions Children younger than 4 years old People in other groups as identified by local public health officials

15 or more millimeters An induration of 15 or more millimeters is considered positive for People with no risk factors for TB

False-Positive and False-Negative Reactions to the Tuberculin Skin Test

Type of Reaction False-positive

Possible Cause Nontuberculous mycobacteria

People at Risk People infected with nontuberculous mycobacteria

Action to Take* Evaluate for TB disease if person has TB symptoms

BCG vaccination People vaccinated with BCG Assess likelihood of true TB infection (see five factors in text) May do anergy testing

False-negative

Anergy

HIV-infected people, other people with weakened immune systems People infected with M. tuberculosis within the past 10 weeks Children younger than 6 months old

Recent TB infection

Retest 10 weeks after exposure to TB ended Retest when child is 6 months old and 10 weeks after exposure to TB ended

Very young age

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