Questions and Discussion

1. Explain the basis of Josh’s chest tightness and radiographic findings. Due to his asthma Josh’s airways can become inflamed and the smooth muscle constricted, this can resulting in negative pressure in the airways during inspiration and positive pressure during expiration causing a narrowing of the airways. Air can become trapped in the lungs due to the narrowing of the airways resulting in an increased residual lung volume at the end of expiration. A high residual lung volume causes the muscles to work harder and therefore chest tightness can be felt. The high residual lung volume can also account for the hyperinflation of lungs which was seen on Josh’s radiograph, the peribronchial inflammation in asthma causes bronical marking around the airways, which occurs when excess mucus builds up in the small airway passages of the lungs.

2. Explain the failure of Josh’s asthma to improve despite frequent use of bronchodilators, and his response to steroid therapy. Bronchodilators simply cause the smooth tissue to relax, allow the airways in the lungs to open up, but in severe/ chronic cases of allergic asthma there are multiple symptoms other than constriction of the smooth muscles. Patients with chronic allergic asthma also experience production of excess mucus and …show more content…
If Josh becomes exposed to a Rabbit he would possibly develop an IgE antibody resulting in an allergenic response every time he subsequently became exposed to the animal. An initial skin sensitivity test is can be can be carried out, but it would probably give a negative result, this negative skin test for Josh would possibly only suggest that he has no expose to the allergen yet. It would be advised that josh not get a