Adult Asthma Flashcards
What are the 6 clinical features typically associated with asthma in adults?
- Wheeze
- Shortness of breath
- Coughing (paroxysmal and usually dry)
- Chest tightness
- Difficulty in expiration
- Symptoms tend to be worse at the beginning or at the end of the day, at different points in the week (occupational allergens) or at different times of the year (seasonal allergens)
What is the prevalence of asthma in adults?
5-10%
Does asthma affect more males or females in adulthood?
Females
Explain the pathophysiology of asthma
- Airway inflammation is mediated by the immune system
- Widespread narrowing of the airways and increased airway reactivity
- airway narrowing (either spontaneously or in response to a stimuli)
List three proven risk factors for asthma
- Hereditary predisposition
- Smoking during pregnancy
- Occupation
What is atopy?
The body’s inherited predisposition to develop IgE antibodies in response to exposure to environmental allergens
Name the three professions that are at high risk of asthma
bakers, painters & shellfish workers
List the three unproven but possible risk factors for asthma
- Obesity
- Diet
- The hygiene hypothesis
Why is it thought that obesity and asthma are linked?
Obesity is a pro-inflammatory disorder
Explain the hygiene hypothesis
Modern children are too clean and do not have the microbial diversity that is important in reducing the risk of asthma
Can spirometry be used to diagnose asthma?
Asthma is variable so asthmatic patients may give a normal spirometry or a spirometry which shows evidence of airflow obstruction- it just depends on what kind of a state they are in when they took the test
if a suspected asthmatic gives an obstructed spirometry reading (<0.7), carry out ________________________ to exclude ________
Full pulmonary function tests
COPD
Following full pulmonary function testing, what else ca be done to help give a definitive diagnosis of asthma?
Test the reversibility of the symptoms by giving a beta2 agonist and retesting spirometry after 15 mins or give an oral steroid for 14 days then re-test spirometry
What should a clinician do if a patient is suspected to have asthma but exhibit normal spirometry in the clinic?
Ask the patient to measure their peak flow 2x daily for 14 days. Variability of >20% over the course of the 14 days can point towards asthma.
Airway response tests are also useful
Other than spirometry, what other investigations should be carried out when asthma is suspected?
- Chest Xray
- Skin prick testing to determine atopic status (looking for atopy)
- Total and specific IgE (looking for atopy)
- Full blood count (look for eosinophilia)
