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Heterogeneous emphysema for lung volume reduction — SCE Respiratory MCQ

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HardThoracic ImagingHeterogeneous emphysema for lung volume reductionSCE Respiratory

A spray painter develops work-related wheeze that improves during holidays. He remains exposed while specialist referral is arranged and maintenance treatment can be kept stable. Which serial peak-flow protocol has the best occupational diagnostic value?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — At least four evenly spaced readings daily for at least three weeks, including work and away periods

Explanation lettering: C = shown as B · E = shown as C · B = shown as D · D = shown as E

A is correct. BTS states that serial PEF for suspected occupational asthma should run for at least three weeks, ideally with four evenly spaced readings per day, several consecutive days at work and repeated periods away from exposure while maintenance medication is stable. Interpretation depends on the work–rest pattern, so one-off clinic testing or recordings confined to leave are inadequate. Exposure should not be prolonged if unsafe, but immediate job loss before objective specialist assessment can have major employment consequences and is not a substitute for a valid record.

Reference: https://thorax.bmj.com/content/77/5/433