Today in Parkland morning report, we discussed how to deal with an asthma patient that is not responding to optimal therapy. Dr. Vadia reminded us how important our social history is as it may demonstrate hidden allergens that your patient is being exposed to.
Remember to consider co-morbidities that are worsening their asthma symptoms including these common diseases:
- Allergic rhinitis
Then, if they still continue to be non-responders, consider alternative diagnoses that may have been mis-diagnosed as asthma and will not respond to conventional bronchodilators:
- Vocal cord dysfunction
- Allergic bronchopulmonary aspergillosis
- Bronchiolitis obliterans
There are only two good reasons to do something to a patient (or more correctly, for a patient): to make them feel better or to help them live longer. If an intervention – a drug, a device or a procedure – carries no realistic prospect of either, it’s not worth doing.
ITP is something we see with some frequency, but it can be tough to understand the pathogenesis, diagnosis and management of this dangerous condition. Take a look at this comprehensive quick reference guide by the American Society of Hematology for some help – it’s just 2 pages!
How familiar are you with the presentation, diagnosis, and treatment of the ANCA-associated vasculitides? Even if the answer is “very familiar!” there may still be something to learn from this excellemnt lecture by Dr. Evan Nair-Gill, MD, PhD.
(A note to all of the email subscribers, this post, which contains a powerpoint, is fully visible only on the actual blog website. Click the link above to access it!)