Asthma

Question 1

Define asthma:

Answer 1

Inflammatory disease

• Hyper-responsiveness
• recurrence of (cough, wheeze, dyspnea, chest tightness)
• variable airway obstruction

Question 2

Pathophysiology of asthma

Answer 2

Allergens > Release of interlukins > release of soluble mediators

Question 3

How to diagnose child <5 years with asthma

Answer 3

Clinical diagnosis (cough, wheeze, response to dilator or steroid)

To rule out: CXR and SPAT “but not usually done to diagnose asthma”

Question 4

How to diagnose child <5 years with asthma

Answer 4

Clinical diagnosis (cough, wheeze, response to dilator or steroid) ++ SPAT in atopy and spirometry FEV1 w\bronchodilator.

Question 5

Diagnosis of asthma guidelines

Answer 5

Cough >2week - wheeze bilateral - eczema - family history of atopy - >3flare ups in 1 year

Question 6

What is the role of spirometery in children

Answer 6

Little role, because we give a trial of bronchodilator to see if there’s any improvement over 2 weeks

Question 7

LFT curve in asthma

Answer 7

Scooped in curve pre-bronchodilator
& normalized curve post-bronchodilator.

(Increase of 12% or 200 in FEV1)

Question 8

What are the reliever medications

Answer 8

• B agnosits
• ipratropium
• theophylline
• steroid

Question 9

What are the preventer medications?

Answer 9

• Steroid
• leukotriene antagnosist (monteleukast)
• steroid + LABA

Question 10

What is the proportional for MDI of b-agnoist and neubilizer?

Answer 10

B-agnoist + spacer = nebulizer

Question 11

If child <20 kg, how to prescribe salbutamol inhaler?

Answer 11

Take it 4-6 puffs with spacer

“Total dose 2.5mg”

Question 12

If child >20 kg, how to prescribe salbutamol inhaler?

Answer 12

8-10 puffs

Question 13

How to prescribe inhaled corticosteroid, and when to expect symptom releif?

Answer 13

BID and symptom relief will occur 1-2 weeks