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q? - uttem - Printable Version +- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com) +-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1) +--- Forum: Step 3 (https://www.usmleforum.com/forumdisplay.php?fid=6) +--- Thread: q? - uttem (/showthread.php?tid=100210) |
q? - uttem - ArchivalUser - 07-07-2006 A 10-year-old boy is brought to the office because of a 4-month history of a non-productive cough. The mother tells you that the cough is usually worse a night when she hears him having "coughing spells" in his room. He denies any fever or chills now, but says that he did have a "cold" a few months ago, before the cough began. His gym teacher in school recommended that he "go to the doctor" when she noticed that he was coughing and was unusually short of breath after class for the past 4 months. Throughout the visit, the patient coughs and the mother says "cover your mouth." She looks at you and tells you that she is trying to teach him manners, and that he needs to cover his mouth so others do not "catch his germs." His temperature is 37.2C (99.0 F), blood pressure is 100/70 mm Hg, pulse is 70/min, and respirations are 20/min. Physical examination shows expiratory wheezes in the lower lungs. The remainder of the examination is unremarkable. He continues to cough and his mother goes over to him and puts her hand over his mouth. The most appropriate immediate step is to A. administer a beta-agonist B. measure oxygen saturation on room air C. measure peak expiratory flow D. order a chest x-ray E. tell the mother that the patient does not need to cover his mouth when he coughs 0 - ArchivalUser - 07-07-2006 i think it,s start os asthma, i,ll go with ,,,c,,, measure peak exp. flow rate.then give beta blockers.if pefr becomes better.then it,s confirmatory for asthma . 0 - ArchivalUser - 07-07-2006 measure peak expiratory flow 0 - ArchivalUser - 07-07-2006 try again. 0 - ArchivalUser - 07-07-2006 E. 0 - ArchivalUser - 07-07-2006 this is uw q its e..although i feel the answer is stupid. we usualy make dx of asthma by response to the b2 agonsit and the change in the fev1,if the pateint come in between the attacks we use the mechaline induced bronchospasm. this patient looks having s/s if they would let me asnwer the q as i like i would do respirometer for him and give him b2 agonist and see how he does. many times there is increase incidnce of asthma development in those patient who have rsv and other respiratory viral infectios. 0 - ArchivalUser - 07-07-2006 sory meant the metacholine induced bronchospasm |