Obstructive Lung Diseases 2

(Originally posted on: November 1, 2015
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, and tram-track appearance of some bronchial walls, and visible peripheral airways.

Based on these findings, what additional tests do you order?

When doing your review of systems, she tells you her cough and sputum persist. She also continues to have abdominal pain, and is unsure whether it is related to the type of foods she eats. A gluten-free diet has not improved her abdominal symptoms at all. She also tells you she has been taking a medication for her severe acne and uses oral contraceptives.

What medication may be a risk factor (although no clear association has been established)?  What other history do you want to know?Chapter 4 ERM

How do approach treating her cough and sputum?BA ERM

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