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epica

04/06/07 - 09:30 PM

A 45-year-old man is evaluated because of a persistent cough. He is a lifelong nonsmoker without a history of lung disease. He has had a cough productive of clear sputum for approximately 6 months. The cough is particularly troublesome at night and toward the end of the workweek. The patient works in an automobile repair shop spray-painting cars. He has worked in his present job for 2 years. He denies a history of allergies, and there is no family history of asthma or allergies. The chest examination shows a few expiratory wheezes. Spirometry shows moderate airflow obstruction and substantial improvement after inhalation of a bronchodilator.

Which of the following is the best management option for this patient?

( A ) Measure carbon monoxide diffusing capacity
( B ) Advise him to change jobs
( C ) Prescribe an inhaled bronchodilator
( D ) Measure IgE antibody to anhydrides

new_n_lost
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04/06/07 - 09:39 PM

( B ) Advise him to change jobs wink

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salmonella
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04/06/07 - 10:17 PM

agreed

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mms
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04/06/07 - 10:36 PM

b for me too

silver
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04/08/07 - 03:21 PM

why B? what's the logic?

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rock
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04/08/07 - 04:42 PM

the spray paint must contain lead(most paints have lead) and lead dust can enter the blood via lungs and in the process cause lots of respiratory irritation and inflammation...workers are advised to wear some kinda face mask/respirator(dont know the right word for it) to avoid this...and he feels worse at night(maybe after a whole day at work) and more so at the end of the workweek...these are pointers to the prob...so my answer is B too-advise him to change jobs.

epica

04/08/07 - 05:55 PM

Guys, I don't have the ans for this Q but only one good ans is B.

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