Asthma

Question 1

What are the common examination findings?

Answer 1

Inspection - O2, inhalers, SOB and using accessory musclesPlethoric

Trachea - Central but decreased distance

Expansion - reduced but hyperexanded

Percussion - Hyper resonant

TVF - Normal

Auscultation - Decreased breath sounds, widespread expiratory wheeze

Question 2

What are the investigations?

Answer 2

By the bed - History, obs, peak flow, spirometry and sputum,cardiovascular exam,

Bloods - FBC (anaemia or infection) eosinophilia in atopic, CRP for infection

Other - CXR, ECG, ABG for respiratory failure

Question 3

What are the key investigation findings?

Answer 3

Bloods - May be polycythaemic

Peak flow - Shows variability

ABG - Type 1 or type 2 respiratory failure

Spirometry - Obstructive picture with low Fev1:FVC ratio (low Fev1, low or normal FVC)

Question 4

What is the treatment?

Answer 4

Conservative - education, smoking cessation, advice on inhaler technique and to see doctor if they have increased SOB

Medical - Follow stepwise protocol so SABA/SAMA depending on symptoms