Inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) combinations are prescribed for which patient/s?

A patient with exercise-induced and mild persistent asthma is prescribed two puffs of albuterol 15 minutes before exercise and as needed for wheezing. She is also prescribed one puff per day of beclomethasone (Qvar). What key point/s should be included in the teaching regarding her inhaler use?

Mr. J., a 67-year-old male with a 40–pack-year smoking history and a diagnosis of moderate COPD, presents for a routine follow-up visit in early October. He reports increased exertional dyspnea but denies recent exacerbations. He has not received vaccinations in the past two years and is unsure which immunizations are recommended for patients with chronic lung disease. He is currently managed with tiotropium daily and uses albuterol as needed. He has had no recent hospitalizations. When reviewing his preventive care needs, the provider notes that COPD places him at increased risk for complications from respiratory infections, and immunizations should be updated accordingly. Based on current preventive care recommendations for patients with COPD, which vaccinations should this patient receive at this time, and what is the recommended frequency for each?

Which of the following spirometry findings is most consistent with a diagnosis of COPD?

How should patients appropriately manage asthma exacerbations in the home setting according to current evidence-based guidelines?

A 22-year-old college student presents to the campus health clinic reporting shortness of breath and wheezing approximately three times per week, especially during intramural soccer. She currently uses albuterol as needed, which provides temporary relief. She has had two urgent-care visits in the past year for asthma symptoms but no hospitalizations. She denies nighttime awakenings. Lung sounds are clear today, and spirometry shows reversible airflow obstruction.

A 72-year-old male with severe COPD presents for evaluation of worsening dyspnea. His vital signs include SpO₂ 89% on room air. After resting quietly for 10 minutes, repeat SpO₂ is 87% on room air. An arterial blood gas (ABG) drawn at rest shows a PaO₂ of 54 mmHg. Based on CMS (Medicare) qualification criteria for home oxygen therapy, does this patient qualify, and which value supports your decision?

For the 19-yo man newly diagnosed with mild persistent asthma in Q2, describe the step-by-step education you would provide him regarding proper inhaler technique to ensure medication compliance. 

Describe the history, purpose and scope of physical therapy. (Please include all three concepts in your response.)

Based upon the patient’s history and physical exam what are your top 5 differential diagnoses?   Part 1: Please list in order, with #1 being your most likely diagnosis at this time, based upon what you discovered from the patient’s history and PE.  Part 2: Justify the pros and cons for your top 5 differential diagnoses. You may use the results of your diagnostics to help justify (rule in or rule out) your differential.  Differential Diagnoses  Pros Cons 1.  2.  3. 4. 5.