Let's talk technique
Lets see how people approach this case.
3-5 yo pt with history of asthma. Had an episode of RSV one month ago with residual cough up until 2 weeks ago. Currently doing well, afebrile and mild cough but not much different from his usual status. Hasn't used albuterol in over a week. Posted for BMT & adenoids at out-pt surgery center. Parents are well educated non smokers. Pt is not obese and has mild snoring habits but no real OSA. Enlarged tonsils but no symptoms of tonsillitis in the...
Let's talk technique (Source: Student Doctor Network)
Source: Student Doctor Network - March 30, 2016 Category: Universities & Medical Training Authors: Noyac Source Type: forums
Shortness of Breath in the pregnant patient: what's your approach?
So I saw this patient today and am having second thoughts (too late I know but nonetheless) and would love to hear what others are doing.
Youngish female, second trimester, short of breath x 2 days, worse lying flat, better on side. Reports feeling chest congestion, dry cough. No frank chest pain but feels tight. No runny nose, sore throat, yaddy yaddy. No leg swelling, calf pain. no fevers.
Exam noted for wheezing in lower lung base. Otherwise clear. No evidence of volume overload...
Shortness of Breath in the pregnant patient: what's your approach? (Source: Student Doctor Network)
Source: Student Doctor Network - March 27, 2016 Category: Universities & Medical Training Authors: vengaaqui Source Type: forums
MRCP part 2 question
44 year old man complians of, cough, shortness of breathing; painful joints and stiffness of the hands, for one year duration, no past history of hospitalisation or medical condition
Examination of the hands reavealed painful tender joints and swelling of metacarpophalangeal joints of both hands and reduced flextion and extension of the fingers, chest examination showed bilateral wheezing and dullness mainly on the bases, 6 month before he was working as a coalminer abroad
CXR revealed bilateral scattered nodules varying in size
What is the most likely Diagnosis ?
What investiga...
Source: Doc2Doc BMJ Cardiology - March 8, 2016 Category: Cardiology Authors: alaminium Source Type: forums
should I push for testing?
Ok, I have never done this before, but I need some advice. A little bit of history-my husband(27) had very frequent lung infections as a child. His bedsheets always had a salt residue on them from his night sweats(which he still has). They had him tested for cf, but his results were borderline, & he was never retested. The summer before we got married(he was 20 years old), he ended up in the ER for diagnosed pleurisy. From that point on, he has had a chronic cough, & allergy symptoms that don't ever go away. Fast forward to current. He is exhausted. He can't sleep at night, & his sinus infections will not go aw...
Source: Cystic Fibrosis Adults Forum - December 2, 2015 Category: Respiratory Medicine Authors: themrsstacey Tags: Adults Source Type: forums
Wwyd
So I picked up my daughter after school. She says oh I don't feel good today. Started after lunch but she said she didn't want to bother me or go to the nurse because I was at work. She said she was nauseous, had a headache and it hurt to take a deep breath. No fever. Min cough. question is; got a call to see if I could work 2 morrow(I am NOT obligated to) WWYD? This stuff comes up alot and my career suffers from it but her health comes first. (Source: Cystic Fibrosis Families Forum)
Source: Cystic Fibrosis Families Forum - October 29, 2015 Category: Respiratory Medicine Authors: Rebjane Tags: Families Source Type: forums
CFTR nonsense w-1204, nonsense w-1143
Chr7: 117,267,718 G>A
Pathogenic
Zygosity: Homozygous
dbSNP ID: rs121908764
Population Allele Frequency: 0.00%
Gene Impact: CFTR NONSENSE W-1204-* NONSENSE W-1143-*
Gene Impact: AC000111.6 INTRON
Hello all,
I'm a 42 year old male and I had all kinds of problems with my lungs all my life (Pneumonia half a dozen times, Bronchitis more times than I can count, and asthma. A few months ago I ordered an Asthma Peak Flow Meter and my air flow is much worse than it should be even when I do not have any asthma symptoms.
For the past several weeks I have had Bronchitis. I didn't bother going to the doctor because this typ...
Source: Cystic Fibrosis DNA and Mutations Forum - October 28, 2015 Category: Respiratory Medicine Authors: oaktree Tags: DNA and Mutations Source Type: forums
Could it be CF in my 14 yo?
My son is 14 years old, weighs 78 lbs and is 4'10". He has had a cough for 2 years now and asthma among other things have been ruled out. He has had pneumonia twice and bronchitis once in this time. He is currently under the care of an endocrinologist because of his growth issues. He is falling farther and farther behind. His latest labs show his FSH to be very low and his LH to be low but not out of range. His vitamin D level continues to stay low despite supplements for the last year. It is currently at 21. He has always struggled with constipation and very large BM's. As an infant he had the same cough he has now ...
Source: Cystic Fibrosis Newly Diagnosed Forum - October 21, 2015 Category: Respiratory Medicine Authors: snowborden1 Tags: Newly Diagnosed Source Type: forums
Giving newborn salt
Hello everyone, my 11 week old daughter has just been diagnosed with c.f.. The doctors told us we need to start giving her 1/8th tsp of salt everyday. The problem is they told me to give it to her straight (wet my finger, dip it in salt then put it in her mouth a few times a day) and not to mix it with any water or my expressed breast milk. I guess they don't want her to associate feedings with a negative taste. I have been following their instructions so far but she absolutely hates it and screams when I give it to her, which usually makes her cough from being so upset. Anyways, I was just wondering if any other parents o...
Source: Cystic Fibrosis Nutrition Forum - October 16, 2015 Category: Nutrition Authors: Martina Banks Tags: Nutrition Source Type: forums
Trying to figure out how accurate the sweat test is before tomorrow
My son is 6 months old. Since he was born something has always felt a bit "off" for lack of a better word. His stools have always been bright green with mucus, he's had a chronic cough that is consistantly getting worse, he was always crying until about a month ago, he's always breathed funny, and he is always congested. I've been to several doctors, most of whom blew me off and told me it was a milk allergy or reflux. I tried reflux meds and a total elimination diet at first for months but neither helped. Finally I found a pediatritian who listens to my concerns. She sent me to a GI specialist who didn't feel li...
Source: Cystic Fibrosis Newly Diagnosed Forum - October 15, 2015 Category: Respiratory Medicine Authors: aleutenberg Tags: Newly Diagnosed Source Type: forums
Super dry cough at night
Has anyone else ever had a bad dry cough at night? It doesn't wake me up. It's when I wake up to go to the bathroom. My chest is super tight and then I start coughing until I bring something up or move the junk around which is usually really thick at night... I am also 5 mths pregnant which could be some of the problem. I also have asthma to. Any suggestions on how to help would be great thanks. (Source: Cystic Fibrosis Adults Forum)
Source: Cystic Fibrosis Adults Forum - October 12, 2015 Category: Respiratory Medicine Authors: missmary083 Tags: Adults Source Type: forums
CF or asthama?
So, DS for a couple weeks kept clearing his throat but not really coughing more and not sick...then had a nasty coughing spell after exercising (and also I realized the house was horribly dusty). Dust, vacuumed, and upped his Xopenex to 3x a day, but that's it. Cough had gone away and after the extra dose he hasn't coughed (other than a random passing one and not harsh at all), and the throat clearing has gone almost entirely too. Is that an asthama thing? Or with CF would a cough and throat clearing go away like that with nothing but just adding a Xopenex (no vest, no antibotics, etc?) (It could just be the dust whic...
Source: Cystic Fibrosis Adults Forum - September 28, 2015 Category: Respiratory Medicine Authors: Aboveallislove Tags: Adults Source Type: forums
So confused....no diagnosis...stop looking?
Looking for confirmation my 8 year old daughter doesn't have cf. Wondering what is going on. Has environmental allergies (as shown on skin tests 2x). Diagnosed with asthma 2 yrs ago due to cough...no wheeze ever. Last school year had bacterial pneumonia in Sept (x-ray at er) and bacterial pneumonia in May (2 night hosp stay). Possible pneumonia in mid June...treated but no x-ray. In past has seen GI for possible reflux and genetics b/c she didn't sweat. Sweating has slowly started and they think possible connective tissue disorder.
Recurrent pneumonias have lead to numerous tests. She's been doing really well sinc...
Source: Cystic Fibrosis Newly Diagnosed Forum - September 24, 2015 Category: Respiratory Medicine Authors: mom2girls Tags: Newly Diagnosed Source Type: forums
Asthama and PFT?
I'm hoping our resident expert (Dot the darling!) can help with this but wanted to post instead of PM in case others have similar questions but also in case others have ideas based on their clinic's handling.
DS has just figured out the spirometer and in prep for next week's quarterly I wanted to see what how things changed pre and post brochialdialtor. When he was an infant and they did the "plastic box" test he had a pretty sharp improvement after the Xopenex which they said indicated an asthmatic component. he's been on Qvar daily for a couple years when he had a cough with running. So I'm wondering if tha...
Source: Cystic Fibrosis Adults Forum - September 21, 2015 Category: Respiratory Medicine Authors: Aboveallislove Tags: Adults Source Type: forums
long term hospital stay
I was in upmc for a month had pnemonia and mucus plugs and my pfts went down by 20% culured mersa and b cepicea amd phsudo had bronc scope and had a bad reaction to it got a fever a high one that couldn't get down for couple days got confused amd really scared but it broke and they got out 2 mucus plugs out I was on fortaz iv and televansin in and another iv I forget the name but was one they always give me I got out bout 4 weeks now getting legs back was hard lost alot of wt and mucle got pft back to base but went for check up pft back down some and having short of breath and streaks of blood in mucus this just started fe...
Source: Cystic Fibrosis Adults Forum - September 19, 2015 Category: Respiratory Medicine Authors: cam Tags: Adults Source Type: forums
constant sinus drainage after lung transplant
I had a lung transplant (and liver) in late 2012. I had sinus surgery in December 2013. But I have constant mucus buildup and sinus drainage 24/7. I blow my nose several times a day and cough up stuff often that I know is from the sinus drainage. I do sinus rinses at least once a day, every day along with nasonex every day. I don't want this to cause an infection. I feel like this is getting worse and my ENT just says its CF and doesn't do anything about it (although he does clean out my sinuses when I see him). Does anyone have any remedies to decrease the amount of mucus buildup in my sinuses? (Source: Cystic Fibrosis Adults Forum)
Source: Cystic Fibrosis Adults Forum - September 14, 2015 Category: Respiratory Medicine Authors: randomgirl Tags: Adults Source Type: forums
