What are the differential diagnoses for a 26-year-old female with mild persistent asthma, presenting with increased wheezing, chest tightness, and shortness of breath after dust exposure, with partial relief from albuterol (salbutamol) inhaler use?

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Differential Diagnosis for M.K.

  • Single most likely diagnosis
    • Asthma exacerbation: This is the most likely diagnosis given M.K.'s history of mild persistent asthma, recent exposure to a known trigger (dust), and symptoms of increased wheezing, chest tightness, and shortness of breath. The partial relief from her albuterol inhaler also supports this diagnosis.
  • Other Likely diagnoses
    • Chronic obstructive pulmonary disease (COPD) exacerbation: Although less likely given M.K.'s age and lack of smoking history, COPD cannot be entirely ruled out, especially if she has been exposed to other irritants or has a family history of the disease.
    • Allergic rhinitis: M.K.'s symptoms began after cleaning her apartment, which could have stirred up allergens, leading to allergic rhinitis. However, the primary symptoms of wheezing and shortness of breath are more indicative of an asthma exacerbation.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Pneumonia: Although M.K. denies fever, chills, cough, or sputum production, pneumonia is a potentially life-threatening condition that must be considered, especially if her symptoms worsen or do not respond to treatment.
    • Pulmonary embolism: This is a less likely but potentially deadly diagnosis that must be considered, especially if M.K. has a history of deep vein thrombosis, recent surgery, or other risk factors.
  • Rare diagnoses
    • Hypersensitivity pneumonitis: This is a rare lung disease caused by an allergic reaction to inhaled substances, such as dust or mold. Although M.K.'s symptoms began after cleaning her apartment, this diagnosis is less likely given the lack of other supporting symptoms.
    • Vocal cord dysfunction: This is a rare condition that can mimic asthma symptoms, but it is less likely given M.K.'s known history of asthma and response to albuterol.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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