Asthma

Question 1

Define asthma?

Answer 1

Chronic inflammatory disorder of the lungs with REVERSIBLE airflow limitation and airway hyper-secretion

Question 2

Name four common symptoms experienced with asthma?

Answer 2

Cough (worse at night)
Wheeze
SOB (episodic, related to exertion)
Chest tightness

Question 3

What is characteristic about the symptoms experienced with asthma?

Answer 3

Diurnal variation throughout day - worse at NIGHT and EARLY MORNING
Set off by triggers including smoking, cold, dust, b-blockers, aspirin

Question 4

On taking a history from a patient with asthma - what 5 features would make you consider asthma?

Answer 4

Personal/FHx of atopy
Acid reflux (60%)
Widespread wheeze
Syx improve with treatment
Otherwise unexplained peripheral eosinophillia

Question 5

Describe 4 questions that should be asked within a Hx when considering asthma?

Answer 5

Diurnal variation
Sleep and quality of sleep
Exercise tolerance - quantify
Industrial asthma? - do your symptoms improve on days off?

Question 6

O/E what signs of asthma may be elicited?

Answer 6

Tachypnoea 
Widespread polyphonic wheeze
Well controlled asthma - NO signs
Severe asthma = silent chest
Chronic asthma = Harrison's sulcus and pigeon chest

Question 7

Describe the stepwise management of asthma in adults?

Answer 7

Short acting B2 agonist
Inhaled corticosteroids
Long acting B2 agonist and increase steroid dose
Montelukast and theophyline
Oral prednisalone

Question 8

Describe asthma within pregnancy?

Answer 8

12% of pregnant women are affected
1/3 get better
1/3 stay the same
1/3 get worse