K. L is a 26-year-old man with asthma. His symptoms have been well controlled with inhaled fluticasone and salmeterol. This morning he went for a short run and is now in the emergency department with an acute asthma attack that was not responsive to either of his inhalers. He is wheezing audibly, RR is 28, and O2 sats are 86% on room air.

a. What is the cause of wheezing during an asthma attack?
b. Why were the inhalers ineffective in aborting the attack?
c. Which medication should K. L. be prescribed to abort asthma attacks?
d. How should K. L. be reminded to use his inhalers on a daily basis? What are the major teaching points?

What does the sociological imagination refer to?

Insulin is a peptide therapeutic used to manage type 1 diabetes, which affects more than 20 million people worldwide according to the international diabetes federation. a significant limitation to the broad distribution and use of insulin to treat type 1 diabetes is the fact that it must be administered by injection rather than orally. why is insulin administered by injection and not orally?

A92-year-old man with a 45-year history of chronic obstructive pulmonary disease is intubated in the icu because of a bout of viral pneumonia that fails to improve after 72 hours of antibiotics. although the inspired fraction of oxygen is 100%, the patient's po2 remains at 57 mmhg. positive-end expiratory pressure (peep) is added to allow the inspired fraction of oxygen. twelve hours after the introduction of peep the patient suddenly become hypotensive. at the same time, his oxygen saturation drops from 92% to 61%. on physical examination, his bp is 80/50 mmhg and his pulse is 124/min. he has distended neck veins and distant heart sounds. which of the following would also most likely be seen on this patient's physical examination? - absence of breath sounds in the right hemithorax- high amplitude carotid artery upstroke- a pleural friction rub- pulsus alternans- splenomegaly