A 32-Year-Old Woman Comes to the Office for Follow-Up of Asthma

question 131

Multiple Choice

A 32-year-old woman comes to the office for follow-up of asthma.  The patient reports that her asthma seems to be getting worse and describes increasingly frequent episodes of chest tightness and wheezing over the past several months.  She says, "I find myself reaching for my inhaler more often than I used to, and I wonder if I should try a stronger medication."  The patient has an 8-year history of intermittent asthma managed with an albuterol inhaler.  She smoked marijuana in her 20s for several years and started smoking cigarettes over the past year.  When asked about her tobacco use the patient says, "I'm smoking only half a pack a day or less and I really enjoy it, especially with my morning coffee."  Which of the following is the most appropriate response to the patient?

• A)"I am concerned that you do not fully understand the negative effects of smoking on your asthma."
• B)"I can understand that you may not want to stop completely, but even just decreasing will help."
• C)"I understand that smoking gives you pleasure, but it is also making your asthma worse."
• D)"We can consider a stronger medication, but it is unlikely to help much if you continue to smoke."
• E)"Would you like to know more about how smoking affects your asthma?"

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Definitions:

P Value

A statistical measure that indicates the probability of obtaining the observed results of a study by chance alone, often used to test hypotheses.

Correlational Study

A research method that examines the relationship between two or more variables to determine whether and how they change together.

Standard Deviation

An indicator of how much the values in a set differ or spread out.

Normal Distribution

The normal distribution, often called the Gaussian distribution, is a bell-shaped curve that describes the spread of a characteristic throughout a population where most occurrences take place around the average value.