Asthma

Question 1

Anyone suspected of having asthma should be asked whether any specific triggers bring on or aggravate their respiratory symptoms

Answer 1

Symptoms can occur/worsen in presence of:

1. Allergens
   - animal dander
   - dust mites
   - pollens
   - fungi
2. Exercise
3. Viral infection
4. Smoke
5. Cold
6. Chemicals
7. Drugs (NSAIDs & Beta-blockers)

Question 2

What clinical signs are indicative of asthma?

Answer 2

• episodic symptoms & signs
• dinurinal variability
  - nocturnal/early morning
• non-productive cough, wheeze
• triggers
• associated atopy
  - Increased IgE (rhinitis, conjunctivitis, eczema)
• blood eosinophilia >3%
• responsive to steroids or beta-agonists
• family history of asthma
• wheezing due to turbulent airflow

Question 3

What tests must be carried out in order to diagnose asthma?

Answer 3

• history & examination
• diurinal variation of peak flow rate
• reduced forced expiratory ratio (FEV1/FVC <75%)
• reversibility to inh. salbutamol (>15%)
• provocation testing –> bronchospasm
  - exercise
  - histamine/ methacholine/ mannitol

Question 4

What are the 3 components that lead to the development of COPD?

Answer 4

1. Mucociliary dysfunction
2. Inflammation
3. Tissue damage

Question 5

What is COPD?

Answer 5

An ongoing disease process which leads to obstruction of airflow and symptoms of COPD e.g. breathlessness and worsening quality of life