Question

Initial History:

15 yo girl complaining of chest tightness and dyspnea

Mowing lawn when symptoms develop

Prodrome of rhinorrhea and tearing along with chest symptoms

Felt no better after going outside

Now one hour later

Additional information:

Hx of asthma since childhood, mother and brother have asthma

Allergic to grass, ragweed and cats

Productive cough clear phlegm

Uses a “blue” inhaler for past six months, BID

No other hx

Physical examination:

Alert, anxious, T=37, P=105, RR=30, BP=115/68, skin flushed and pink, diaphoretic, prolonged expository wheezes throughout all lung fields.

What studies would you initiate?

Answer 1

The studies which can be initiated in the patient are

• Chest xray can be done to rule out the cause of wheezing ,difficulty in breathing .This is evident when there is exacerbation of asthma, COPD ,etc.,
• CBC can be done to rule out any infection because ig pneumonia ,bronchitis, etc.,
• Pulmonary function test can enable to identify the level 9f oxygen during inspiration and expiration