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For the following 2 questions, please rate your level of confidence in your ability for each category.
1. Diagnose severe asthma and identify biomarkers
2. Develop personalized treatment plans for severe asthma
3. Your patient, Greg, is a 51-year-old male with a 7-year history of severe asthma. He has daily asthma symptoms requiring a recue inhaler and has had four exacerbations in the past year, despite high-dose inhaled corticosteroid/long-acting beta antagonist treatment. He also reports peripheral neuropathy and a purpuric rash. His lab results reveal WBC=6000 cells/µL; EOS=640 cells/µL; ESR=30; CRP=6, and BMP is normal. What should be your next step?
4. You decide to repeat his labs and order a chest x-ray, as well as a skin biopsy. These labs show WBC=6200; EOS=680/µL; ANCA=pANCA+, 1:160; pulmonary infiltrates; and cutaneous eosinophilic infiltrates. Based on these results, what is his diagnosis?