A14-year-old girl is brought to the physician by her mother because of episodic shortness of breath and a dry cough that is worse at night. She had an upper respiratory tract infection 4 weeks ago. Lungs are clear to auscultation. Pulmonary function tests are as follows: . Which of the following would be most helpful in excluding a diagnosis of asthma in this patient?

Question

A14-year-old girl is brought to the physician by her mother because of episodic shortness of breath and a dry cough that is worse at night. She had an upper respiratory tract infection 4 weeks ago. Lungs are clear to auscultation. Pulmonary function tests are as follows:  . Which of the following would be most helpful in excluding a diagnosis of asthma in this patient?

Quizplus · Accepted Answer

Eductional Objective: Bronchial challenge testing is a highly sensitive but nonspecific measure that can help exclude a diagnosis of asthma.  A provocative stimulus (typically aerosolized methacholine) is administered at increasing concentrations to induce bronchoconstriction.  Patients with asthma are hyperresponsive to this stimulus and experience a decline in FEV1 at lower doses than nonasthmatics.

A14-Year-Old Girl Is Brought to the Physician by Her Mother