Asthma

Question 1

What is the pathophysiology of Asthma

Answer 1

1) Genetic/Atopic/Environmental
2) Bronchial inflammation: oedema, cell infiltration, mucus hypersecretion
3) Bronchial hypersecretion
4) Airway narrowing
5) Symptoms

Question 2

Symptoms of Asthma

Answer 2

Polyphonic Wheeze >1 location
Cough
Dyspnoea
Tightness
Diurnal variation
Non viral triggers

Question 3

History questions for Asthma

Answer 3

How frequent are symptoms?
Tiggers?
Normal state? How often do you need to use blue?
How often have you been hospitalised/required infusion?
Interval symptoms?

Question 4

Useful investigations

Answer 4

Skin prick testing

PEFR

Question 5

Tx

Answer 5

Reliever - Bronchodilator

• SABA- Salbutamol
• LABA-Salmeterol

Preventer

• Steroid - budesonide
• Leukotriene antagonist -montelukast

SE of steroids: Reduced height velocity, thrush

Question 6

What is viral episodic asthma

Answer 6

Cause of most wheeze in preschool
Smaller airways are more likely to narrow and obstruct

RF: maternal smoking, FH asthma or allergy, male,

resolves by 5

Question 7

What is mutliple trigger wheeze

Answer 7

Frequent wheeze (preschool and school) triggered by many stimuli (not all viral)

significant proportion go on to develop asthma