Respiratory System

CASE STUDY Scenario Geronimo is a 12-year-old boy lives in" rel="nofollow">in Melbourne, with asthma diagnosed at age 6. For the last 10 days Geronimo has been experiencin" rel="nofollow">ing an upper respiratory tract in" rel="nofollow">infection with unresolved cough and breathlessness. He has been takin" rel="nofollow">ing cough syrup but this has not improved his symptoms. He also had run out of his usual asthma medication salbutamol (2 puffs per night) for three days. It was late November and There was a huge thunderstorm two days ago. Geronimo presented to hospital with an exacerbation of asthma. On presentation, he was speakin" rel="nofollow">ing in" rel="nofollow">in phrases, his heart rate was 130 beats/min" rel="nofollow">inute, respiratory rate (RR) was 25 breaths per min" rel="nofollow">inute. His SpO2 was 94% on room air and he had an audible wheeze. His FEV1 was 1.64 L (55% of predicted). Geronimo was admin" rel="nofollow">inistered salbutamol 100 µg 10 puffs via a pressurised metered dose in" rel="nofollow">inhaler and spacer and oral prednisolone 0.5mg/kg. He responded relatively quickly to the treatment; his RR decreased to 21 breaths/min" rel="nofollow">inute and he could talk in" rel="nofollow">in paragraphs. He remain" rel="nofollow">ined tachycardic but his FEV1 improved to 2.2 L (74% of predicted value), demonstratin" rel="nofollow">ing a significant bronchodilator response of 34%. His mother who was also present provided a history of Geronimo’s asthma. Both Geronimo and his mother in" rel="nofollow">initially reported that Geronimo was well until he caught a cold. However, when probin" rel="nofollow">ing specifically about his asthma symptoms and overall control Geronimo acknowledged that he had difficultly playin" rel="nofollow">ing sport especially durin" rel="nofollow">ing his soccer games on Saturdays; he wheezed and coughed when laughin" rel="nofollow">ing, he avoided runnin" rel="nofollow">ing around with his mates to prevent symptoms. His mother reported that while he might have missed about 10 days of school in" rel="nofollow">in the last 12 months, due to a bad cough when he had colds, he was otherwise well apart from the normal cough he gets. Answer Below all four questions correctly with correct references: Word count is 250 words for each question. Total = 1000 words (Excludin" rel="nofollow">ing References). 1. Describe the probable reasons for Geronimo’s acute exacerbation of asthma. 2. Based on the history provided by Geronimo and his mother, determin" rel="nofollow">ine which classification of asthma Geronimo’s asthma fits. 3. Explain" rel="nofollow">in the results of his spirometry test. An arterial blood gas (ABG) testin" rel="nofollow">ing is recommend by a junior doctor for Geronimo, do you agree with this suggestion? 4. Describe the different forms of asthma medication and when each should be used.