A patient with asthma develops reflux

A chest X-ray reveals the cause of Norma's breathlessness

Norma is a 64-year-old accountant. She attends with a classical infective exacerbation of asthma with wheeze, productive cough and increasing shortness of breath on exertion.

She is given a seven-day course of antibiotics and three days of prednisolone with almost complete resolution of symptoms.