Screening for Chronic Obstructive Pulmonary

Question: Discuss about the Screening for Chronic Obstructive Pulmonary. Answer: Introduction: Geronimo, a 12 years old boy, has been diagnosed of suffering from asthma since the age of 6 years, has recently been found to be presented with exacerbation of asthma. The probable reasons for the exacerbation of asthma in this case may be attributed to three chief causes related to the cold seasonal condition, harboring of the upper respiratory tract infection (URTI) and non-adherence to prescribed medication for asthma. The case has been reported to occur in the month of November when the weather is essentially cold. Moreover mention has been made about thunderstorms. Exposure to cold, dry air in the winter season has been found to trigger asthma and has the potential to aggravate the symptoms. Furthermore, the windy, cold air due to thunderstorms might stir up pollens and allergens in the air thereby causing severe problems for those already afflicted by respiratory disorder like asthma (Walter et al., 2008). URTI may have been possibly acquired from school by Geronimo due to sel f limited viral pathogens also contributed to deterioration of his asthma symptoms. Human rhinovirus may be the causative factor for the URTI responsible for further contagious spreading of infection through inhalation of respiratory droplets from coughing or sneezing (Gern, 2010). Additionally it has been revealed that Geronimo has run out of his prescribed medication of salbutamol comprising of 2 puffs per night in the last three days. Research has shown that non-compliance to medication in asthma like condition results in adverse outcomes thereby impacting on morbidity and mortality with more pronounced effects in case of children and adolescents (Desai Oppenheimer, 2011). Based on the history provided by Geronimo and his mother it is evident that Geronimo encounters perpetual difficulty in playing sports during his soccer games. He has been reported of wheezing and coughing while laughing. Moreover he reportedly avoided running around with his peers for preventing the symptoms of feeling breathless. Till date plethora of studies carried out on the ailment of asthma has depicted that a number of causative factors are responsible for triggering the disease. In case of the pediatric population, depending upon the type of asthma and the nature of education imparted for mitigating the condition, appropriate interventions have been suggested for tackling the situation (Coffman et al., 2008). Therefore as per the information obtained regarding the symptoms for Geronimo, the type of asthma he is suffering from may be acknowledged as exercise induced asthma. Physical exertion coupled with difficult breathing, chest tightness and coughing normally characterizes exercise induced asthma and is likely to ameliorate in absence of physical exertion or exercise. The narrowing of the airway makes it difficult for the affected person to catch up with the breath and generate wheezing and cough like symptoms. Exercise induced bronchospasm culminates in the expression of heterogeneous inflammatory response that has the capacity to get cured by potent bronchodilators through opening of the blocked respiratory passage (Parsons Mastronarde, 2009). Hence, for Geronimo, exercise induced asthma is the closest possibility as his symptoms of asthma fits nearly matches with those exhibited in the said condition and increases more from participation to physically demanding activities. For Geronimo, spirometry was conducted to assess the specific lung function parameter related to FEV1. Spirometry is considered as the cornerstone of all pulmonary function tests in which medical test is performed for the purpose of measuring the volume of air an individual inhales or exhales as a function of time. Spirometric analysis has huge clinical relevance whereby obstructive and restrictive lung disorders may be detected from the assessments. The FEV1 or Forced Expiratory Volume in the first second parameter as measured in this case depicted a value of 1.64 L (55% of predicted) under the effect of exacerbating asthma condition. This reduction in the FEV1 value is suggestive of the presence of moderate obstruction in the airway. However upon administration of anti-inflammatory and bronchodilator drug named prednisolone and salbutamol respectively, the value was found to increase to 2.2 L (74% of the predicted) thereby accounting for improvement under the effect of medication a nd lessened obstruction. FEV1 basically predicts the volume of air exhaled during the first second of the forced vital capacity (FVC) maneuver and normal range lies between 3-4.5 L (Calonge et al., 2008). The recommendation of an arterial blood gas (ABG) analyzer by a Junior Doctor for Geronimo is rationale and appropriate. ABG will likely to reveal vital information regarding severity of the asthma, extent of efficacy of the therapeutic intervention for asthma, measurements related to partial pressures of oxygen and carbon dioxide, pH of blood, oxygen content as well as oxygen saturation values (Lian, 2010). Therefore data retrieved from ABG might serve to better treat the clinical condition of asthma for Geronimo. Asthma refers to a chronic inflammatory condition in which the airway is narrowed thereby causing obstruction to breathing due to swollen airway and tightening of the respiratory muscles around the airway. Symptoms of coughing, wheezing, chest tightness or shortness of breath are common in asthma. Asthma although not curable may be controlled to a large extent following proper intervention strategy and management. Different forms of asthma medication are available however their application varies depending upon the ensuing circumstances. Long term asthma control medications are generally prescribed for daily administration and include anti-inflammatory drugs of inhaled corticosteroid, oral medications comprising of leukotriene modifiers along with bronchodilator medicines like inhaled medication of long acting beta agonist, combination inhalers and Theophylline. This type of medications helps to keep asthma under control through daily dosage regime (Chung et al., 2013). Again for the sake of providing quick, short term symptom relief in case of an asthma attack quick relief mediations are effective. These include short acting beta agonists, bronchodilators like Ipratropium and various oral as well as intravenous corticosteroids. Moreover in case of asthma triggered by allergies, certain allergy medications are found to be effective through utilization of allergy shots or immunotherapy and Omalizumab medication. Allergy shots act by gradually reducing the immune system reaction in response to specific allergens. Alteration of immune function is acted upon by Omalizumab medication for treatment of patients having severe asthma. Thus for effective control of asthma through mitigation of the symptoms is recommended by means of following a step wise approach based on the severity of the condition (Tran et al., 2014). References Calonge, N., Petitti, D. B., DeWitt, T. G., Gordis, L., Dietrich, A. J., Gregory, K. D., ... Loveland-Cherry, C. (2008). Screening for chronic obstructive pulmonary disease using spirometry. Annals of internal medicine, 148(7), 529-534. Chung, K. F., Wenzel, S. E., Brozek, J. L., Bush, A., Castro, M., Sterk, P. J., ... Boulet, L. P. (2013). 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