Medical Emergencies · patient case question

All of the following are appropriate history questions before treating her EXCEPT:

Patient case: 14-year-old with asthma and a nut allergy

Patient: 14-year-old girl attending with her mother.

Chief complaint: Her mother says she is unhappy with the appearance of her teeth.

History: Asthma managed with albuterol. Reported allergy to nuts. Otherwise healthy.

Findings: Mild crowding of the maxillary anterior teeth. No caries. No mucosal lesions at present.

Show answer and explanation

Correct answer: B. Does anyone in your family have asthma?

A. Knowing whether she uses a rescue or controller inhaler, and whether she has it with her, is directly relevant to managing an episode in the chair.
B. CORRECT — this is the exception. FAMILY HISTORY of asthma is epidemiologically interesting but changes nothing about how you manage THIS patient today. The other three each directly alter your treatment safety plan.
C. Recency and frequency of exacerbations are the best available index of her current control and therefore of her risk during treatment.
D. The nature of the nut reaction — anaphylaxis versus mild intolerance — determines your emergency preparedness and your choice of products.