At what step should Angela begin therapy? (a 7 y/o African-A…

At what step should Angela begin therapy? (a 7 y/o African-American female is brought into the emergency department complaining of shortness of breath.  While interviewing the patient, the mother informs the RCP her daughter has been awakened approximately two times per week due to her asthma symptoms.  Upon further questioning she mentions the school nurse called yesterday because Angela has been in her office for her quick relief medication everyday in the past week.  Her last FEV1/FVC ratio was 72%.)

A 5 year old with “trouble breathing”.  Initial impression f…

A 5 year old with “trouble breathing”.  Initial impression finds a child lethargic, no abnormal sounds, with pale, mottled skin.  Primary assessment is A: clear, B: RR 36/min, mild retractions, nasal flaring, crackles at the lung bases, SpO2 93%, C: HR 140, weak peripheral pulses, delayed capillary refill, BP 74/54, D: Lethargic, E: Afebrile, no rashes. Which of the following is most accurate?

The following real question was posted on an equine list ser…

The following real question was posted on an equine list serve: On 2/21/2020 11:29 AM cuttin_guy01 wrote:> Took my mare to the breeding farm last Sunday after we palpated her the first time and found a 22 mm follicle. By Monday she had a 30 mm follicle and was showing signs of estrus and we thought she would be ready to breed soon – continued with a 33 follicle on Wednesday until Friday at which time they called and said the follicle regressed and she now only had a 25 mm follicle. Can anyone explain to me what is going on? 1) Provide “cuttin guy01” with some advice as to what this ‘problem’ is (consider time of year, behavior and what the breeder is finding on the ovary) and 2) provide him with a brief, simple recommendation on what he should do with his mare over the next few weeks in order to avoid additional frustration and breed at the current time.