A 37 y/o black female, presents to the ER with tachypnea, and acute shortness of

Question

A 37 y/o black female, presents to the ER with tachypnea, and acute shortness of breath with audible wheezing. She complained of chest tightness and a constant cough.  A physical exam revealed the following: HR 110, RR 40 with signs of accessory muscle use. Ausculation revealed decreased breath sounds with inspiratory and expiratory wheezing and pt was coughing up small amounts of white sputum. SaO2 was 93% on room air. An arterial blood gas (ABG) was ordered with the following results: pH 7.5, PaCO2 27, PaO2 75

Based on the above symptoms what other assessments, tests or procedures would the MD order or perform to help diagnosis the problem?

What results would you expect to find and why?

Based on your results what is the cause and pathology?

What are the patient’s risk factors?

Explanation / Answer

1). Your doctor may order lung function tests to determine how much air moves in and out as you breathe. These tests may include:

Additional tests includeds

2). Your doctor may rule out the result by assesing the following signs and symptoms:

The most common symptom is wheezing. This is a scratchy or whistling sound when you breathe. Other symptoms include:
•    Shortness of breath
•    Chest tightness or pain
•    Chronic coughing
•    Trouble sleeping due to coughing or wheezing

3). Pathology of asthma:

The disease starts with exposure of the individual to an allergen. The person becomes sensitized and results in the formation of IgE antibodies. These antibodies coat the mast cells. Reexposure to a similar antigen triggers the immunological response and mastcells undergo degranulation and release the cytoplasmic granules which includes histamine, essinophilic cheomotactic factor, prostaglandins and platelet activating factor which causes bronchoconstriction. Repeated similar episodes lead to remodelling of the bronchial wall with proliferation of the smooth muscle and fibroblasts.

Cause of asthma are as follows

4). A number of factors are thought to increase your chances of developing asthma. These include:

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