Asthma clinical features Flashcards
Define asthma?
An increased responsiveness of the trachea and bronchi to various stimuli leading to narrowing of airways that change in severity either spontaneously or as a result of therapy
What are the common symptoms of asthma when exacerbated?
Wheeze
Cough
Shortness of breath
Is asthma worse in mornings or at night?
Generally in mornings
What are some risk factors for asthma?
Genetic - more prone for an IgE response to allergens Occupational Smoking during pregnancy Obesity Diet
What is stridor?
Wheezing heard on inspiration without a stethoscope - suggesting it originates in the upper respiratory tract
Is the airflow obstruction caused by asthma reversible?
Yes
What are symptoms of asthma?
Wheeze Shortness of breath Chest tightness Cough - paroxysmal (violent) and dry Occasional sputum
What would show it is probably NOT asthma?
Clubbing Cervical lymphadenopathy Stridor Assymetrical expansion Dull percussion note Crepitations (crackling/rattling)
What are some essential investigations for asthma?
Airflow obstruction
Variability and/or reversibility of airflow obstruction
How would you look for evidence of air flow obstruction?
Peak flow test
If the test showed obstruction, what would the follow up be?
A full pulmonary function testing to exclude COPD/emphysema
If there was obstruction, what would you test for?
The response to a bronchodilator such as salbutamol
Why would testing to see the response from a cortisteroid be helpful?
Separates COPD from Asthma
If the spirometry was normal, what would you do then?
Look for variability of airflow obstruction by doing a peak flow meter and chart, twice daily for 2 weeks
What sign MUST be present for it to be asthma?
Wheeze
Is there a specific test for asthma?
No
Is asthma a consistent or inconsistent disease?
Inconsistant
What changes are there in the airways in asthma?
Bronchoconstriction Airway wall thickening Luminal secretions
What sounds may be heard when breathing that can distinguish between asthma or another condition?
Rattle
Stridor
Stertor
Give examples of asthma triggers
URTI (commonly Rhinovirus) Exercise Allergens Cold air Emotion
5 settings of asthma?
Infant onset
Childhood onset
Adult onset
Excertional asthma Occupation asthma
What predisposing factors may make someone susceptible to developing asthma?
Genetics
Abnormal lung functions
Early onset atopy
Bacterial bronchitis is a condition that may be mistaken for asthma, what are its clinical features?
Recurrent wet cough “Darth Vader” like breathing
Palpable fremitus (lung vibrations)
- an otherwise well child
What features are present in an asthmatic cough?
Dry
Non-productive
Nocturnal
Exertional
Does atopy cause asthma?
No
What features of personal history are important in diagnosing asthma?
Allergy and family history
What factors should be present to diagnose asthma?
Wheeze (MUST HAVE) Shortness of breath at rest Multitriggers Sinusoidal Atopy Parental Asthma responds to treatment
What condition may cause an asthma-like wheeze but is not multi-trigger or sinusoidal?
A viral induced wheeze
What type of cough is not indicative of asthma?
An isolated cough
What type of cough is indicative of asthma?
A dry cough
Why would you not treat bacterial bronchitis?
Its a self limiting infection
Pertussis is a condition more commonly known as what?
Whooping cough
How can you reduce the risk and severity of pertussis?
Vaccination
Give the clinical symptoms of pertussis
Coughing fits
Vomiting
Colour change
Petichiae (small redr purple spot caused by bleeding into the skin
The diagnosis of asthma can be confirmed with a trial of what?
ICS (Inhaled Corticosteroids)
What is MAINLY going on with an asthma attack in the airways?
Inflammation
Smooth muscle contraction
