BalterMD, Alan D. Her medical history was significant for appendectomy and hemorrhoidectomy. Spirometry showed an obstructive pattern forced expiratory volume in 1 second [FEV1], 2. Airway hyperresponsiveness is usually measured using direct stimuli, such as methacholine or histamine, that act by stimulating specific receptors on the bronchial smooth muscle to cause contraction and narrowing of the airways.
Although this review focuses particularly on diagnosis, these tests can also be used to assess asthma control and as an aid in optimizing chronic therapy.
Her skin-prick test was positive for house-dust mites. The patient was transferred to the thoracic surgery ward for surgical treatment. She had wheezing and allergy symptoms in childhood, and her mother and 1 cousin have confirmed asthma. She was hospitalized for evaluation for anti-IgE therapy.
Bronchial lavage fluid was removed from the left bronchus. Uncontrolled symptoms that linger despite aggressive therapy warrant evaluation to rule out other etiologies, such as a carcinoid tumor, before selecting new treatment options.
Sara states that she has never received a diagnosis of asthma. Measurement of sputum eosinophilia has been proposed for clinical use in the diagnosis of asthma. For further evaluation, computerized tomography was performed and showed a mm nodular lesion located in the left lower lobe bronchus Fig.
The chronic inflammation of asthma is associated with airway hyperresponsiveness that leads to recurrent symptoms, yet lung function may nevertheless remain normal. However, some patients with this condition have neutrophilic inflammation, whereas, conversely, some patients without asthma have eosinophilic inflammation.
Her mother has told her that she had eczema as a baby, and she remembers having itchy, red rashes when she was younger. Her routine blood count was hematocrit, She had had a severe asthma attack at that time, during which her wheezing was not well correlated with physical exercise and had persisted for several months.
We were unable to show spirometric reversibility but were able to learn that during a previous hospitalization at another clinic, she had had a reversible airway obstruction.
Pathological examination concluded the diagnosis of typical carcinoid tumor. Computed tomography also revealed a nodular lesion at the same location. Over the past 6 months, she has noticed that because of her dyspnea, she is unable to keep up with her partner when they go salsa dancing.
She smokes a half package of cigarettes daily and has done so for 20 years. Fiberoptic bronchoscopy was performed and showed an endobronchial lesion obstructing the left lower bronchus lumen. She is otherwise well and is taking no medications. Her vitals were stable with a heart rate of 76 bpm, a temperature of Chest radiography revealed a left-sided hilar opacity.
However, because she often gets a stuffy nose, she has wondered if she has allergies. The case Sara is a year-old secretary in an autobody shop who comes to see you for evaluation of intermittent episodes of wheeze and shortness of breath that have progressed over the past 2 years.
All data about the patient seemed to indicate that she could be a candidate for anti-IgE therapy. She wakes up a couple of times a week because of coughing, but she can generally get back to sleep after she coughs up some phlegm. After surgery, her symptoms disappeared and she has had no recurrence.
KaplanMD, Meyer S. Validated questionnaires may be an option in settings where objective testing is unavailable. Her examination was normal with the exception of decreased auscultation in the left lung.
These radiological findings changed our management plan and diagnosis from asthma to a chest mass. Finally, we took into account our own clinical experience, as supported by the relevant referenced evidence.Nov 10, · The case used here focuses on the diagnosis of asthma in adults.
If spirometry results are normal but the clinician still suspects the patient has asthma (a common situation, because asthma is a variable disease), the diagnosis can be confirmed by other objective tests.
This article is the second in a 7-part case study. Case Studies on ED Management of Asthma Carlos Camargo, MD, DrPH Emergency Medicine, MGH treatment” for all patients with persistent asthma.
4 – ICS are preferred treatment for persistent asthma • Case 3 – Severe acute asthma – Use adjunct therapies for PEF. Nursing Care Study This assignment is a case study of a patient who was admitted to a respiratory ward with acute exacerbation of asthma.
This assignment will discuss nursing an adult patient with asthma, also it will aim to critically assess, plan, implement and evaluate the patients nursing needs using the Roper, Logan and Tierney nursing. Diagnosis and management of severe asthma.
Start the case study. Anne. Diagnosing and treating asthma in adults. Start the case study. Ensuring correct inhaler technique in a patient with asthma. Start the case study.
COPD. Latest Case Study Peter. REAL Respiratory Clinic, Education for Health, The Athenaeum, 10 Church Street. Patient presented with a worsening shortness of breath, chest tightness, and coughing, especially in the previous 2 weeks Described itchy, watery eyes, congestion, and drainage when around cats and also in the spring, summer, and fall.
threatening asthma and ask them which category they think the patient is in.*** Further Treatment After what hopefully is a relatively rapid initial assessment of ABC the students.Download