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Old 06-06-2012
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Default occupation asthma diagnosis ?

A 42-year-old man is evaluated in the office after a recent visit to the emergency department because of a 4-week history of steadily progressive shortness of breath and wheezing. New-onset asthma was diagnosed, an albuterol inhaler was prescribed, and he was advised to follow-up with his physician. His medical history prior to this diagnosis was negative for asthma, urticaria, eczema, aspirin sensitivity, and allergies. The work history includes a job as a spray painter in an automobile body shop that began 4 months ago. The patient indicates that his symptoms are worse while he is at work, beginning as soon as he starts painting, and that he feels better on the weekends. The albuterol inhaler provides some relief of his symptoms.

On physical examination, vital signs are normal. Only occasional wheezing is heard on auscultation of the lungs.

Which of the following is the most appropriate next diagnostic test in evaluating this patient's asthma?

A Bronchoprovocation testing with isocyanate
B Bronchoprovocation testing with methacholine
C Peak expiratory flow rate measurements at work and at home
D Radioallergosorbent test for IgE antibodies to isocyanate
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  #2  
Old 06-06-2012
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i will go with C since its the most like (i think) to show if the work environment is responsible for his sx
B also dx, but its used mainly to diagnose asthma reaction, regardless if its allergic or occupational
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Old 06-06-2012
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C Peak expiratory flow rate measurements at work and at home
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