A 27-year-old Caucasian female is seen for a follow-up of allergic rhinitis and asthma. She is on immunotherapy (grasses, trees, ragweed, weeds, cat, dust mite), started one year ago for seasonal allergies. She is using Advair to treat her asthma, which are partially relieved by a rescue inhaler use. She has had no nighttime symptoms and no emergency room visits in the past year. She reports symptoms of allergic rhinitis, although since she started immunotherapy, the symptoms are mostly seasonal, limited to runny nose in the fall, which we treat with Fluticasone nasal spray.
Physical examination
Well-developed, well nourished in no apparent distress. Vital signs: Temperature 98.5, pulse 81, respiratory rate 12, blood pressure 120/60. Skin: No rash. Ears: Normal. Nose: Boggy, paleturbinates. Ears: Normal. Chest: Clear to auscultation bilaterally. Cardiovascular: Clear S1, S2. Extremities: No edema or clubbing.
Patient Medical History
Asthma, allergic rhinitis
Medications
She receives the immunotherapy every week. Fluticasone, nasal spray. She stopped using Advair (fluticasone/salmeterol) 6 months ago.
Procedures
Spirometry shows FVC of 100%, FEV1 of 89% and FEV1/FVC of 0.79. Her ACT score is 18/25.