Radiology needed for Asthma

Asthma case study instructions ( Essay)

 

A 6 year old female child that came to the clinic with accompanied by her mother complaining of cough since 8 weeks ago. The cough is triggered when she laugh or cry. Her cough get worse  when she is exposes to cold air, exercise, and at night. Patient past medical history of mild eczema and chronic nasal congestion. No shortness of breath, wheezing or fever reported. She is currently talking no medications. No known allergies reported. On her examination she is not in acute distress. Positive findings during examination: nasal turbinates little pale and edematous. During lungs auscultation she had end- expiratory wheezing, but no use of accessory muscle of respiration. The child was born in India moved to United Stated when she was 1 year old. Her family recently moved to a new area, since that, she is complaining of worsening nasal congestion. The house has some carpets on the floor. She also has a dog in her house. Patient has a history of mother and cousins diagnosed with asthma. The primary diagnosis is asthma based on her past history, clinical presentation and family history.

 

Introduction

Should be a paragraph that provides a brief overview of the case and main diagnosis:

1-Asthma

Differential Diagnoses

Provide EACH differential diagnosis with the rationale and supporting evidence with the REFERENCE for each one. Also explain why differentials Viral pneumonia and sinusitis) were not the main diagnosis.

  • Asthma:
  • Viral pneumonia:
  • Sinusitis:

 

Diagnostics

Identify the lab, radiology, or other tests needed for Asthma with supporting evidence.

Treatment

Include the initial treatment plan for Asthma. It should include medication names, dosages, and frequencies

Education

Patient/family education in patient with asthma

 

Follow-Up for athma

Appropriate follow up plan.

Please include when will patient follow up: 2 weeks, 1month, 3 months.

What are some follow up labs or test. Referrals

Why are they following up? What outcome do you wish to assess?

 

References 

Requirement:

APA format

Intext citation

References at least 4 high-level scholarly reference per post within the last 5 years in APA format.

EACH differential diagnostic gets 1 reference

Plagiarism free.

Turnitin receipt.

Radiology needed for Asthma

Introduction:

This case study focuses on a 6-year-old female child who presented at the clinic with a persistent cough for the past 8 weeks. The cough is triggered by laughing or crying and worsens with exposure to cold air, exercise, and at night. The patient has a past medical history of mild eczema and chronic nasal congestion. During examination, the patient exhibited pale and edematous nasal turbinates and end-expiratory wheezing on lung auscultation. The child’s family recently moved to a new area, where she experiences worsening nasal congestion. With a family history of asthma and the presenting symptoms, the primary diagnosis in this case is asthma.

Differential Diagnoses:

  1. Asthma: Asthma is the primary diagnosis in this case due to the patient’s symptoms, such as persistent cough triggered by specific factors (laughing, crying, cold air, exercise, and nighttime). Additionally, there is a family history of asthma, which further supports this diagnosis.

Reference: Global Initiative for Asthma. (2021). Global Strategy for Asthma Management and Prevention. Retrieved from https://ginasthma.org/wp-content/uploads/2021/04/GINA-Main-Report-2021-V2-WMS.pdf

  1. Viral Pneumonia: Viral pneumonia is a possible differential diagnosis due to the presence of cough and respiratory symptoms. However, in this case, the absence of fever, wheezing, or shortness of breath, along with the chronicity of symptoms, makes viral pneumonia less likely.

Reference: Jain, S., Williams, D. J., Arnold, S. R., Ampofo, K., Bramley, A. M., Reed, C., … & Grijalva, C. G. (2015). Community-acquired pneumonia requiring hospitalization among U.S. children. New England Journal of Medicine, 372(9), 835-845.

  1. Sinusitis: Sinusitis is another possible differential diagnosis, considering the patient’s chronic nasal congestion and the recent worsening after moving to a new area. However, the absence of facial pain, fever, and purulent nasal discharge makes asthma a more likely diagnosis.

Reference: Rosenfeld, R. M., Piccirillo, J. F., Chandrasekhar, S. S., Brook, I., Kumar, K. A., Kramper, M., … & Hester, D. (2015). Clinical practice guideline (update): Adult sinusitis. Otolaryngology–Head and Neck Surgery, 152(2_suppl), S1-S39.

Diagnostics:

  1. Pulmonary Function Tests (PFTs): PFTs are essential for diagnosing asthma and assessing the severity of airflow limitation. Spirometry can measure forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), providing information on airflow obstruction.

Reference: Miller, M. R., Hankinson, J., Brusasco, V., Burgos, F., Casaburi, R., Coates, A., … & MacIntyre, N. (2005). Standardisation of spirometry. European Respiratory Journal, 26(2), 319-338.

  1. Allergy Testing: Considering the patient’s history of eczema, chronic nasal congestion, and exposure to potential allergens (e.g., carpets and dog), allergy testing can help identify specific triggers and guide management strategies.

Reference: Arasi, S., Passalacqua, G., Caminiti, L., Compalati, E., Crisafulli, G., Frew, A., … & Canonica, G. W. (2019). Asthma, allergy and the pediatric lung. Pediatric Allergy and Immunology, 30(Suppl 23), 3-5.

Treatment:

The initial treatment plan for asthma may include the following:

  1. Short-acting Beta2-Agonist (SABA): Albuterol 90 mcg inhaler, 2 puffs as needed for cough or wheezing symptoms.
  2. Inhaled Corticosteroid (ICS): Fluticasone propionate 44 mcg inhaler, 2 puffs twice daily for long-term control of asthma symptoms.
  3. Patient Education: Provide asthma education to the patient and her family, including information on triggers, proper inhaler technique, and the importance of adherence to the prescribed medications.

Reference: National Heart, Lung, and Blood Institute. (2020). Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Retrieved from https://www.nhlbi.nih.gov/health-topics/guidelines-for-diagnosis-management-of-asthma

Education:

Patient/Family Education for Asthma:

  1. Triggers: Educate the patient and her family about common asthma triggers, such as cold air, exercise, allergens, and emotional factors. Advise them on minimizing exposure to these triggers.
  2. Inhaler Technique: Demonstrate and ensure proper inhaler technique to the patient and her family. Emphasize the importance of using a spacer device for optimal medication delivery.
  3. Medication Adherence: Explain the necessity of regular medication use, especially the inhaled corticosteroid, for long-term control of asthma symptoms. Address any concerns or misconceptions about the medications.
  4. Asthma Action Plan: Provide an individualized asthma action plan that outlines steps to be taken in different situations (e.g., symptom worsening, exacerbations, or emergencies). Ensure the family understands how to follow the plan.

Follow-Up for Asthma:

The patient should have follow-up appointments at the following intervals:

  1. 2 Weeks: A short-term follow-up is necessary to assess the response to the initial treatment plan, evaluate symptom improvement, and reinforce proper inhaler technique.
  2. 1 Month: A one-month follow-up allows for further assessment of asthma control and adjustments in medication if needed. It also provides an opportunity to address any additional concerns or questions.
  3. 3 Months: A three-month follow-up helps monitor long-term asthma control and assess the effectiveness of the treatment plan. It allows for further adjustments if required and ensures ongoing management.

Follow-Up Labs or Tests:

No specific follow-up labs or tests are mentioned in the case study. However, depending on the patient’s response to treatment and clinical presentation, additional tests such as allergy testing or spirometry may be considered in the future to optimize asthma management.

Referrals:

Referral to an allergist or pulmonologist may be considered for further evaluation and management of the patient’s asthma, especially if symptoms persist or if additional diagnostic tests or specialized care are needed.

References:

  • Global Initiative for Asthma. (2021). Global Strategy for Asthma Management and Prevention. Retrieved from https://ginasthma.org/wp-content/uploads/2021/04/GINA-Main-Report-2021-V2-WMS.pdf
  • Jain, S., Williams, D. J., Arnold, S. R., Ampofo, K., Bramley, A. M., Reed, C., … & Grijalva, C. G. (2015). Community-acquired pneumonia requiring hospitalization among U.S. children. New England Journal of Medicine, 372(9), 835-845.
  • Rosenfeld, R. M., Piccirillo, J. F., Chandrasekhar, S. S., Brook, I., Kumar, K. A., Kramper, M., … & Hester, D. (2015). Clinical practice guideline (update): Adult sinusitis. Otolaryngology–Head and Neck Surgery, 152(2_suppl), S1-S39.
  • Miller, M. R., Hankinson, J., Brusasco, V., Burgos, F., Casaburi, R., Coates, A., … & MacIntyre, N. (2005). Standardisation of spirometry. European Respiratory Journal, 26(2), 319-338.
  • Arasi, S., Passalacqua, G., Caminiti, L., Compalati, E., Crisafulli, G., Frew, A., … & Canonica, G. W. (2019). Asthma, allergy and the pediatric lung. Pediatric Allergy and Immunology, 30(Suppl 23), 3-5.
  • National Heart, Lung, and Blood Institute. (2020). Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Retrieved from https://www.nhlbi.nih.gov/health-topics/guidelines-for-diagnosis-management-of-asthma
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