Patient F


The following is based on a description of a patient that was presented in the New England Journal of Medicine, 2013, volume 369, pages 549-557.

A 20 year-old college student with a history of asthma and allergic rhinitis, which was diagnosed in childhood, presents with cough and tightness of the chest that interfere with his sleep three or four times per month. He requires albuterol two or three times per week. He enjoys playing tennis but generally wheezes after a match. Last year, during the pollen season, he sought treatment in an emergency department for acute asthma but was not admitted to the hospital. His forced respiratory volume in 1 second (FEV1) is 93% of the predicted value....




QUESTION: Is it common for an asthmatic to have mild symptoms like this?

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QUESTION: What is albuterol?

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QUESTION: The FEV1 was normal during the spirometry testing. Thus, it would not have been possible to test for reversibility with an inhaled beta agonist, which is expected with asthma (as opposed to COPD). Is there nonetheless a way in this patient to test for a tendency for asthma in spirometry?

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QUESTION: Does it look like his medication is adequate?

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QUESTION: What would be the next step to bring his asthma under control?

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QUESTION: What would be done if his asthma moved up to moderate persistent?

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