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Clinical cases part 2
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1
6 year old boy, Height: 118 cm, weight: 22kg. Personal and family history of eczema. Dry nighttime cough since the age of 2 years, improved by Ventoline. Asthma exacerbation at 3 years. Initiation of treatment with Flixotide for 3 months. Recurrence of cough when treatment is stopped, so he was treated with seretide for another 3 months. Persistence of chronic cough that was assessed over the last month: daily, rather nocturnal but became diurnal since 2-3 days. No use of ventoline. Chest discomfort with moderate effort (walking, playing). No current treatment. Normal pulmonary and cardiac auscultation.
rate a metacholine pretest asthma probability between 0 and 100%
2
5 years old girl, height 113.3 cm, weight: 18 kg. Past medical history: born at full term, no neonatal respiratory distress, had Eczema and rhinitis before the age of 2. 1st bronchiolitis at 4 months, pneumonia at the age of 1. Asthma treated with Flixotide(3 exacerbations per year). SARS-Cov2 infection at the age of 2 years with mild cough. Since then, recurrence of dry cough especially diurnal. 2 more severe episodes of cough , one at 3 years and another one at 4 years of age treated with ventoline which the parents didn't find rapidly effective. Chest discomfort during moderate effort with coughing after exercise. No current treatment. Normal pulmonary and cardiac auscultation.
rate a metacholine pretest asthma probability between 0 and 100%
3
7 years old girl, height 119 cm, weight 18 kg. Past medical history: laryngitis at the age of 21 months, hospitalized for tonsillitis at the age of 4 and an asthma exacerbation at the age of 5. Presents with Cough during episodes labeled ''laryngitis'' at the age of 6 treated with oral corticosteroids. No personal or family history of atopy, negative allergic tests(Total IgE and Phadiatop) Spirometry and chest X-ray done 4 months ago are normal. No dyspnea on effort. No current treatment. Normal pulmonary and cardiac auscultation.
rate a metacholine pretest asthma probability between 0 and 100%
4
10 years old boy, height 144.1 cm, weight 39.5 kg. Born at term no neonatal respiratory distress, no history of bronchiolitis or wheezing. Presents respiratory discomfort during exercise with abnormal inspiratory sounds, noticeable 10 minutes after running. His symptoms started 6 months ago and they are unresponsive to Ventoline treatment. He also complains of Intermittent morning cough. He does 8 hours of weekly physical activity, primarily soccer. His cardiac assessment is normal and his allergic tests are negative. No current medical treatment, both pulmonary and cardiac auscultations are normal.
rate a metacholine pretest asthma probability between 0 and 100%
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