The Thorax and Lungs Case Study

CHIEF COMPLAINT: "I can't catch my breath."

History of Present Illness:

Mary is a 25-year-old telemarketer who presents to the emergency room for evaluation of shortness of breath. It started 1 week ago, right after a dust storm. She states that she starts coughing, but then she can't stop, so she feels like she can't breathe after a while. The coughing is so bad that she has vomited afterward. The cough is nonproductive. She denies fever or chills. She has noticed nasal congestion and a clear runny nose. She feels like her ears are stopped up and she has noticed increased sneezing in the past 3 days prior to the onset of the shortness of breath. She also has itchy, watery eyes. She has a childhood history of asthma, which she has outgrown. The last time she had an asthma attack, she was 15 years old.

She takes oral contraceptives, but is not on any other medication. She has never had any surgeries. When she had asthma as a child, she was never intubated.

She smokes 5 cigarettes per day and has since age 18. She drinks alcohol socially. She tried marijuana in high school, but denies any ongoing use.

Her mother has asthma and her father has high blood pressure.

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