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The Curbsiders Internal Medicine Podcast

Supercharge your learning as these board-certified Internists interview the experts to bring you clinical pearls, practice changing knowledge, and a healthy dose of humor. 

Dec 4, 2017

Knock the wind out of asthma with tips from Dr Denitza Blagev, a pulmonologist and intensivist who currently serves as Director for the Schmidt Chest Clinic at Intermountain Medical Center in Murray, Utah. We simplify the approach to diagnosis, spirometry, patient counseling, choice of agent, stepwise therapy, and, a little myth busting. Special thanks to Dr Cyrus Askin for writing and producing this episode and to Dr Bryan Brown for his wonderful infographics.

Full show notes available at

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Time Stamps

  • 00:00 Disclaimer
  • 00:32 Intro
  • 01:44 Picks of the week
  • 04:38 Guest bio
  • 06:20 Getting to know our guest
  • 11:50 Clinical case and approach to the patient with dyspnea
  • 16:38 How to explain asthma to a patient
  • 17:22 Are PFTs needed for diagnosis and management of asthma?
  • 18:44 Methacholine challenge and who needs one
  • 21:15 Is imaging needed?
  • 22:09 Typical PFT patterns in asthma
  • 24:23 Utility and use of peak expiratory flows
  • 25:45 Cough variant asthma
  • 26:34 Physical exam in patient with asthma
  • 27:45 Lab workup
  • 29:07 Initial treatment and inhaler teaching
  • 33:10 Stepwise therapy for asthma
  • 37:27 De-escalation of therapy
  • 39:18 Levalbuterol versus albuterol
  • 40:20 Asthma action plans
  • 43:06 Who needs a sputum sample
  • 45:25 How to treat asthma exacerbations
  • 48:05 Asthma therapy for hospitalized patients
  • 51:10 Azithromycin and asthma
  • 53:40 Who needs a referral
  • 55:24 Are beta blockers safe in asthma?
  • 56:08 Anticholinergic therapy and asthma
  • 57:26 Take home points
  • 58:58 Paul tells a story about asthma
  • 59:55 Outro 

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