Pulmonology Consultations Archive

Where are the generic inhalers?

Where are the generic inhalers?

What options are available for patients who cannot or are unwilling to pay the higher copayment for nongeneric medication?

How often should asthma be assessed?

How often should asthma be assessed?

At what point is it safe to consider stopping a steroid metered-dose inhaler?

Recurring GI symptoms following winter fever and cough

Recurring GI symptoms following winter fever and cough

A young man presents with constant periumbilical pain, extreme weakness, anorexia, nausea, constipation, and orthostasis.

Decreasing secretions following tracheostomy

A patient with a tracheostomy for severe obstructive sleep apnea has not responded to several treatments to decrease secretions from the plastic tube. What's the next step?

Could this be COPD?

A Native American man aged 40 years presents with a very tender right rib cage cystic formation that measures 2.0 x 2.0 x 0.5 cm.

Do PPIs affect calcium absorption?

Are there any studies that confirm effective calcium absorption when the patient is taking long-term proton pump inhibitors (PPIs) along with oral calcium?

Avoiding bad auscultation techniques

Are more clinicians performing auscultation through garments?

Choosing the best inflammation marker

Which serologic measure of inflammation is the most cost-effective and reliable when monitoring inflammatory disease?

Effectiveness of a sinus CT

How reliable is a CT scan of the sinuses in a patient who does not respond to an initial extended course of antimicrobial treatment for sinusitis?

What caused this nail dystrophy?

Could a woman's nail dystrophy be related to a history of mild intermittent asthma?

Cardioprotection in a complex patient

What is the best choice for cardioprotection in a woman aged 75 years with episodic symptomatic angina, MI one year earlier and a sensitivity to nitroglycerin patches and spray?

Are high-dose beta blockers safe for patients with pulmonary disease

Is it safe for a patient with chronic obstructive pulmonary disease to be on high doses (e.g., 100 mg b.i.d.) of metoprolol?

Depression treatment in an overweight recent ex-smoker

Which antidepressant would you recommend for a woman aged 47 years who presents with depressed mood, low energy, decreased motivation and hypersomnia?

Tonsillopharyngitis vs. peritonsillar abscess

What is the best way to differentiate tonsillopharyngitis from a peritonsillar abscess?

Tips for treating elevated homocysteine levels

What are the consequences of elevated homocysteine in young asymptomatic patients with and without comorbidities?

Latent tuberculosis in a patient vaccinated with BCG?

Are health care providers performing proper follow-up for patients who where previously diagnosed with BCG vaccine who have positive skin tests for tuberculosis?

Sertraline in patients with pulmonary disease

Is sertraline contraindicated in patients with asthma or chronic obstructive pulmonary disease (COPD)?

When is it appropriate to order abdominal ultrasound?

Clinician seeks guidelines for ordering abdominal ultrasound to detect asymptomatic abdominal aortic aneurysm in a smoker.

When to swab for pertussis

When should an adult with a spasmodic upper-respiratory infection be swabbed for pertussis?

How effective is BCG vaccine against TB?

Given the number of immigrants from Third World countries, why are medical providers still teaching that BCG vaccine provides lifelong protection against TB?

Immunity to day-care infections

PA questions whether a child would have better immunity to diseases if introduced to day care earlier.

Eardrum safety

Do decongestants and/or antihistamines decrease the likelihood of tympanic membrane (TM) rupture?

Is chemotherapy working?

A 67-year-old man with stage 3 non-small cell lung cancer has had two sessions of...

PROCALCITONIN IN PNEUMONIA THERAPY?

What is the significance of a procalcitonin (PCT) level in the face of questionable pneumonia? How reliable is a PCT determination in the decision to...

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