1 - Paeds - Resp - Asthma - Background, Hx + Ex Flashcards
how common is asthma? important cause of ..? 3 things - how many deaths per year?
most common - 15-20% children affected
school absence, restricted activity, anxiety
20 p year
why is diagnosis difficult
~1/2 children have wheeze at some point in first 3 y
what are the 2 wheeze patterns?
transient early wheezing
persistent and recurrent wheezing
transient early wheezing - ass w? what happens? 2 features?
virsues eg cold -
small airways narrow and obstruct due to inflam and imm response to viral infection
episodic in nature, often have decreased lung function from birth
transient early wheezing - RFs ? prognosis?
maternal SMx (during and after preg), prematurity, male
usually fine after 5y
persistent and recurrent wheezing - ass w? triggered by? recurrent wheezing due to this is called?
ass w presence of IgE v common inhaled allergens eg house dust mites, pollen, pets
trig by many stimuli
recurrent wheezing due to this is called atopic asthma
atopic asthma features
atopy - ezema, food allergy, hayfever, risk increases w FHx
persistent Sx and dec lung function
when to suspect asthma? what are you looking for specifically?
wheeze on more than one occasion - wheeze - polyphonic noise due to abnormal narrowing of airways when breathing out
Key features to look for in a history?
Sx worse at night and early morning Sx could be triggered - exercise, pets, dust, cold air interval Sx personal/FHx of atopy \+ve response to asthma therapy
O/E of chest what would you expect to find if not in acute attack?
usually normal
long standing? may get hyperinflation, gen polyphonic exp wheeze, prolonged exp phase
what are harrison sulci and what may they be caused by?
depressions at base of thorax - if onset of disease in early childhood
what suggests chronic infective condition? eg?
CF/bronchiectasis
wet cough/sputum production, clubbing, poor growth
