1. Treatment for ankle sprain: RICE
-Rest for 72 hours after injury, then begin gentle stretching. Do not be immobile for too long, it increases risk for chronic pain/instability/loss of ROM
-Ice for 10 minutes several times a day
-Compression: tape, ACE bandage, semi-rigid ankle support. The latter was purported to be the best by this Cochrane review, which was later withdrawn... for mysterious reasons.
-Elevation
2. Treatment for ankle sprain: preventing re-injury: 
-practice ankle strengthening exercises every day
-avoid sandals or flip flops
-protective ankle device when returning to sports
3. Causes of wheezing:
-Asthma
-COPD
-Persistent bronchitis
-Foreign body
-PE
-CHF
-Vocal cord dysfunction
-Upper airway cough syndrome
4. Comorbid conditions that may exacerbate asthma or render it more resistant to treatment:
-GERD
-Allergic rhinitis, sinusitis
-Anxiety/depression
-OSA, obesity
-Aspirin allergy: 21% of adults have aspirin-induced asthma and should avoid NSAIDs
5. Acute sinusitis: 
-Mucopurulent/opaque nasal discharge
-URI symptoms for at least 7-10 days before onset of sinusitis symptoms (pain in head, face, teeth; fever, congestion that doesn't respond to decongestants, pressure or fullness, loss of smell)
-Chronic sinusitis: same sx, for 12 weeks.
-Viral vs bacterial: consider bacterial if the symptoms don't resolve within 10 days or worsen.
6. Diagnosing asthma/RAD:
-Spirometry before and after bronchodilation
-FEV1 improvement >12% or FEV1 predicted improvement>10% after albuterol = diagnostic of asthma.
-Methacholine challenge only if the spirometry is normal-- trained administrators only
7. DDx asthma:
-COPD: sx will respond to albuterol, but spirometry findings will not change with albuterol.
-Vocal cord dysfunction: doesn't improve with albuterol, is associated with a flattening of inspiratory loop on spirometry
-Nonasthmatic eosinophilic bronchitis: spirometry and CXR normal, respond well to inhaled steroids. Dx with eosinophils on BAL or sputum.
-Silent GERD + aspiration: consider if they do not improve on asthma meds.
8. Asthma action plan
-Sample plan here
-Green: no symptoms, take controller meds daily and albuterol PRN before exercise
-Yellow: mild to moderate symptoms (night cough, SOB, wheeze) or exposure to known trigger (onset of viral illness, change in weather etc), mild loss of function. Controller meds plus rescue meds (i.e. albuterol 2 puffs q4-6) and call PCP.
-Red: severe symptoms: really struggling to breathe, struggling to walk/talk, rescue inhaler not working like normal, turning blue/dusky: rescue meds (i.e 4 puffs of rescue inhaler q 15 minutes for an hour) and go to the hospital.
9. Peak flows: 
-Based on age, sex, and height. Measure standing up, after a full breath; best of 3 trials.
-Determine someone's personal best peak flow by taking the best score during a 2 week period of doing peak flows BID (AM and afternoon/evening), during which asthma symptoms were optimally controlled.
-Correspondence to asthma action plan:
Green= peak flow >80% of personal best
Yellow= peak flow 50%-80% of personal best
Red = peak flow <50% of personal best.
10. Chronic sinusitis treatment:
-Aggressively manage allergic rhinitis with systemic antihistamines
-Nasal steroids
-Nasal saline irrigation
-Antibiotics do not help