Your 25-year-old female patient with a history of asthma returns to clinic again after you sent additional testing. Her FEV1/FVC of 70% and FEV1 60% predicted are unimproved despite your inhaler therapy. How did you classify her asthma? You performed HRCT of the chest which revealed multiple areas of bronchoarterial ratio >1, thickened bronchial walls, […]
Author: Geneva Tatem
Management of Lung Nodule – Part 2
Your 54-year-old male patient is undergoing evaluation for dyspnea. He is a lifelong nonsmoker. A CT scan was performed by his primary care physician and a 2.5cm RUL lesion with spiculated border is noted, with a 1.4cm satellite nodule in the same lobe of the lung. There is a 7mm subcarinal lymph node seen, but […]
Obstructive Airway Disorders – Part 1
You’re seeing a 25-year-old female patient with a history of asthma for a new patient evaluation. She is a lifelong nonsmoker, and gives a history of 1-2 tablespoons of sputum production daily. On review of systems she has a history of intermittent crampy abdominal pain that hasn’t been formally evaluated yet. Results of in-office spirometry […]
Management of Lung Nodule – part 1
Your 54-year-old male patient is undergoing evaluation for dyspnea. He is a lifelong nonsmoker. A CT scan was performed by his primary care physician and a 2.5cm RUL lesion with spiculated border is noted, with a 1.4cm satellite nodule in the same lobe of the lung. There is a 7mm subcarinal lymph node seen, but […]
Outpatient Curriculum – COPD
You have a 58 yo male patient who is evaluated because of worsening dyspnea, chronic productive cough, and increasing sputum production. He has a 30 pack-year smoking history. Spirometry shows a FEV1/FVC ratio <0.7. FEV1 is 60% of predicted. He enjoys daily walks with his neighbors, but has to walk slower than others because of […]
First Post on Outpatient Curriculum – Asthma
For the first clinic discussion of the week, the topic is asthma. I have a clinical scenario for you: Your 23-year-old female patient is evaluated because of a 4-week history of cough, wheezing, and chest tightness. She reports daytime symptoms more than twice weekly, but not daily; she has had nighttime symptoms 3-4 times during […]