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  #1  
Old 07-27-2012
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Lungs Wheezing at Menses!

A 24-year-old graduate student presents to the university health clinic because of complaints of intermittent nonproductive cough and wheezing. She usually has these symptoms around the time of her menses and has no other pulmonary symptoms between episodes. The symptoms usually last 3 or 4 days and gradually resolve spontaneously. She has no other past medical history and smokes only at dinner parties, approximately once every few months. She is on no medications, except for ibuprofen for severe premenstrual cramping. On physical examination, she appears comfortable but is mildly tachypneic. On lung examination, there are high-pitched expiratory wheezes in both lung fields and a moderately impaired air movement; the flow is measured at 90 L/min (normal, >250 L/min). A chest x-ray film is normal. Which of the following mechanisms best explains this patient's bronchospasm?

A. Decreased leukotriene production
B. Increased cyclooxygenase expression
C. Increased leukotriene production
D. Increased production of prostaglandins
E. Increased prostacyclin production
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  #2  
Old 07-27-2012
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C. Increased leukotriene production
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Old 07-28-2012
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can you explain to me what is the diagnosis is it asthma? allergy?
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Old 07-28-2012
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I think it's non atopic asthma, which is also called intrinsic, may aggregates due to stress, like menses, but answer should b increased vagal stimulation,,,,,?i am not very sure if anybody corrects me, because history doesn't show features of atopic asthma, or allergic, pt has no history of wheezing other than menstruation days
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Old 07-28-2012
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This is called Aspirin (or NSAIDs) induced asthma. This patient takes ibuprofen with each menses which triggers her bronchospasm.

The pathogenesis believed to be increased leukotrienes as the other Prostoglandins pathway inhibited by NSAIDs which blocks the Cyclooxygenase enzyme.
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Old 07-28-2012
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its c...
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  #7  
Old 07-28-2012
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Ya c.

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