If spirometry shows obstructive disease in smoker, what is the recommended step?

If spirometry shows obstructive disease in smoker, what is the recommended step?

• A. Administer Bronchodilator and Repeat Spirometry
• B. Perform a CT Scan
• C. Administer Antibiotics
• D. Administer Bronchodilator and Repeat Spirometry

Answer: (D)

When spirometry shows an obstructive pattern in a smoker, the next step is to give a bronchodilator and repeat spirometry. This reversal testing is essential because it shows how much of the obstruction is reversible, which helps distinguish a fixed obstructive disease (like COPD) from asthma or an asthma–COPD overlap. If FEV1 improves significantly after bronchodilator (commonly about 12% and 200 mL), it indicates reversibility and might influence specific treatment plans; if there’s little or no improvement, it supports a more fixed obstruction. Imaging like CT or treating with antibiotics aren’t the immediate next steps for confirming reversibility in this scenario, and antibiotics aren’t indicated unless there’s an infection. Repeating spirometry after bronchodilator provides a reliable baseline for diagnosis and ongoing management.

When spirometry shows an obstructive pattern in a smoker, the next step is to give a bronchodilator and repeat spirometry. This reversal testing is essential because it shows how much of the obstruction is reversible, which helps distinguish a fixed obstructive disease (like COPD) from asthma or an asthma–COPD overlap. If FEV1 improves significantly after bronchodilator (commonly about 12% and 200 mL), it indicates reversibility and might influence specific treatment plans; if there’s little or no improvement, it supports a more fixed obstruction.

Imaging like CT or treating with antibiotics aren’t the immediate next steps for confirming reversibility in this scenario, and antibiotics aren’t indicated unless there’s an infection. Repeating spirometry after bronchodilator provides a reliable baseline for diagnosis and ongoing management.