Station - Instructions for candidate
You are a final-year medical student on placement in a general practice in Perth.
Thanh Nguyen, a 62-year-old lawyer, attends a results appointment. Spirometry arranged by the GP two weeks ago has now been reported. You have the print-out in front of you; Mr Nguyen does not.
Spirometry (post-bronchodilator, performed in the practice)
| Item | Value | Reference range |
|---|---|---|
| FEV1 | 2.05 L | 2.56-3.84 L (80-120% predicted) |
| FVC | 3.40 L | 3.28-4.92 L (80-120% predicted) |
| FEV1/FVC ratio | 0.60 | >0.70 (LLN 0.66) |
| FEV1 % predicted | 64% | >=80% |
| Post-bronchodilator change in FEV1 | +40 mL (+2.0%) after 400 mcg salbutamol | <12% and <200 mL |
Test quality grade A (ATS/ERS). Predicted values from GLI equations for a male aged 62, height 178 cm. Pre-bronchodilator FEV1 2.00 L.
Your tasks are to:
- Interpret the spirometry results provided.
- Explain what the results show to Mr Nguyen.
- Tell Mr Nguyen your most likely diagnosis.
- Discuss the initial management with Mr Nguyen.
- You do not need to examine Mr Nguyen in this station.
- You do NOT need to summarise your findings to the examiner.
- The full spirometry report is printed on this sheet; Mr Nguyen does not have a copy.
This is a 10-minute station, with 2 minutes of reading time.