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Aquifer Family Medicine 13: 40-year-old male with a persistent cough correctly answered rated A+

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Aquifer Family Medicine 13: 40-year-old male with a persistent coughAfter you have finished obtaining the history of present illness, you begin to realize that the patient may be having episodes of wheezing, in addition to his cough. Which of the following can cause wheezing? Select all that apply. The best options are indicated below. Your selections are indicated by the shaded boxes. A. Asthma B. Chronic obstructive pulmonary disease C. Congestive heart failure D. Epiglottitis E. Foreign body aspiration F. Obstructive sleep apnea G. Persistent bronchitis H. Pneumonia I. Pulmonary embolism J. Upper airway cough syndrome K. Vocal cord dysfunction - correct answer The correct answers are A, B, C, E, G, I, J, K. Which of the following are symptoms of acute sinusitis? Select all that apply. The best options are indicated below. Your selections are indicated by the shaded boxes. A. Clear nasal drainage B. Facial Pain C. Failure to respond to decongestants D. Fever E. Gradual worsening five days after the onset of a viral upper respiratory infection F. Headaches G. Initial improvement after a viral upper respiratory infection followed by a worsening of symptoms H. Nasal congestion or obstruction for more than 12 weeks I. Toothache - correct answer The correct answers are B, C, D, F, G, I. What would your treatment plan be for the patient in this hypothetical situation? Choose the single best answer. The best option is indicated below. Your selections are indicated by the shaded boxes. A. Observation and reassurance B. Treatment with an antibiotic such as amoxicillin C. Treatment with an antibiotic such as a fluoroquinolone or amoxicillin-clavulanate - correct answer The correct answer is A. Based on what you know about the patient so far, write a one- to three-sentence summary statement to communicate your understanding of the patient to other providers. - correct answer Official answer: Mr. Dennison is a 40-year-old nonsmoker with a history of allergic rhinitis who presents with a productive cough worse at night for 2 months with associated wheezing but no chest pain, shortness of breath, or fever. Which of the following are the the top five items on your differential diagnosis? The best options are indicated below. Your selections are indicated by the shaded boxes. A. Asthma with uncontrolled allergic rhinitis and possible chronic sinusitis B. Chronic obstructive pulmonary disease C. Congestive heart failure D. Gastroesophageal reflux disease E. Nonasthmatic eosinophilic bronchitis F. Pulmonary embolism G. Vocal cord dysfunction - correct answer The correct answers are A, B, D, E, G. What is the best test you should do at this point? Choose the single best answer. The best option is indicated below. Your selections are indicated by the shaded boxes. A. Chest x-ray B. CT scan of the chest C. Methacholine challenge test D. Spirometry, both without and with bronchodilation E. Ventilation/perfusion scan - correct answer The correct answer is D What are the best medications to offer the patient at this point? Select all that apply. The best options are indicated below. Your selections are indicated by the shaded boxes. A. Cough suppressant such as codeine B. Cough suppressant such as dextromethorphan C. Inhaled bronchodilator such as albuterol D. Inhaled corticosteroid such as budesonide E. Nasal corticosteroid such as fluticasone F. Oral antihistamine such as cetirizine - correct answer The correct answers are C, E, F. Dr. Wilson opens the spirometry report on the computer and asks, "What are the findings on the spirometry test?" Choose the single best answer. A. Normal findings B. Obstructive lung disease with reversible findings (Improvement after a bronchodilator is given) C. Obstructive lung disease without reversible findings (No improvement after a bronchodilator is given) D. Restrictive lung disease with reversible findings (Improvement after a bronchodilator is given) E. Restrictive lung disease without reversible findings (No improvement after a bronchodilator is given) - correct answer The correct answer is B. Given the key findings of the case so far, which of the following is the most likely diagnosis at this point? Choose the single best answer. The best option is indicated below. Your selections are indicated by the shaded boxes. A. Asthma B. Chronic obstructive pulmonary disease (COPD) C. Gastroesophageal reflux disease D. Non-asthmatic eosinophilic bronchitis E. Vocal cord dysfunction - correct answer The correct answer is A.

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