Dan - Urgent Care Notes on Discharge
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19-year-old Caucasian male with episodic wheezing since 13 years of age

  • Chief complaints include chest tightening and wheezing several days a month and nocturnal exacerbations 1 night every week or every other week for many years
  • Nocturnal episodes lead to sleep deprivation, interfering with the patient’s ability to arise and perform at work
  • No prior history of diagnosed asthma or significant allergies; no identified irritants
  • Short-acting ß2-agonist as needed for wheezing

After his examination, Dan’s physician sends him for pulmonary function tests. The tests measure his lung capacity in three parts: forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and forced expiratory flow in quartiles (FEF25%, FEF50%, FEF75%).

  • FVC: 85% of predicted (normal lung function)
  • FEV1: 81% of predicted (normal lung function)
  • FEF25-75%: 66% of predicted (normal lung function)
  • FVC: *83% of predicted (normal lung function)
  • FEV1: 79% of predicted (normal lung function)
  • FEF25-75%: 40% increase (indicates impaired lung function and the possibility of distal airway obstruction)
  • Mild persistent asthma with seemingly confounding results from lung function tests
  • Consult with specialist regarding treatment options