Asthma

Question 1

What is the definition of asthma?

Answer 1

Episodic, reversible airway obstruction

Question 2

Name some causes

Answer 2

Atopy

• T1 hypersensitivity
• dust mites, pollen, food, animals, fungus

Stress

• Cold air
• Exercise
• Viral URTI
• Emotion

Toxins

• Pollution, smoking
• Drugs: NSAIDs, BB

Question 3

What are the SX?

Answer 3

• Nocturnal cough +/- sputum
• Wheeze
• Dyspnoea
• Diurnal variation w morning dipping

Question 4

Name 4 signs

Answer 4

• Tachypnoea, tachycardia
• Widespread polyphonic wheeze
• Hyperinflated chest
• Reduced air entry

Question 5

What main IX are required?

What other IX can be done?

Answer 5

All pts need spirometry with bronchodilator reversibility testing

All pts need a FeNO test

Other IX:
o Bloods
     - FBC: eisinophilia
     - High IgE
o CXR: hyperinflation
o Skin prick/ RAST: atopy

Question 6

What spirometry pattern is seen?

Answer 6

Obstructive

FEV1/FVC = <70%

Question 7

What findings are seen in reversibility testing?

Answer 7

Improvement in FEV1 of 12% of more and increase in vol. of 200ml or more

Question 8

What indicates a positive FeNO test?

Answer 8

> or = 40 ppb

Question 9

How is it MX?

Answer 9

General: TAME
- Technique for inhaler use
- Avoid allergens, smoking
- Monitor peak flow diary (2-4x/d)
- Educate
 o Liaise w specialist nurse
 o Need for RX compliance
 o Emergency action plan

***Refer to step MX for ASTHMA BTS