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Respiratory system > Asthma clinical features- children > Flashcards

Asthma clinical features- children Flashcards

1
Q

what is the most important feature of asthma?

A

wheeze

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2
Q

what are the three key features of asthma?

A
  • wheeze
  • variability
  • responds to asthma treatment
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3
Q

what are the similarities between asthmatic adults and children?

A 
Symptoms
Common
Same triggers
Same treatment
Same pathology
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4
Q

what are the differences between asthmatic adults and children?

A

Gender
Severe asthma
Occupational asthma uncommon

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5
Q

what are the 4 “hits” for asthma?

A
  1. genes
  2. inherently abnormal lungs
  3. early onset atopy
  4. later exposure (rhinovirus, exercise, smoking)
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6
Q

in what ways is asthma inconsistent?

A 
Transient” vs persistent 
Different severities
Different age at onset
Heterogeneity in response
Different triggers
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7
Q

how can asthma be described as heterogeneity in response?

A

there are many domains (environment, atopy and lung function) that add up to the threshold for symptoms in different ways

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8
Q

can peak flow and spirometry be used in children to diagnose asthma?

A

no

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9
Q

what is a wheeze?

A

a soft expiratory polyphonic

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10
Q

why is a wheeze present?

A

airways are constricted, there walls are thickened and have increases luminal secretions.
This means they are not a wide and when air passes through them a tone is produced, the variability in airway diameter means that the sound is polyphonic.

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11
Q

what are sounds from the lungs can be mistaken for wheeze?

A

rattle, stertor, stridor

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12
Q

what is stertor?

A

heavy snoring or gasping

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13
Q

what is stridor?

A

high pitched sound

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14
Q

when is there SOB at rest?

A

when there is significant respiratory difficulty <30% caused by airway obstruction

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15
Q

what does SOB at rest look like?

A

sucking in of ribs with wheeze

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16
Q

is cough a good predictor of asthma?

A

not really, wheeze is much better

17
Q

what sort of cough is associated with asthma?

A

dry
nocturnal, just after falling asleep
exertional

18
Q

what personal medical history is indicative of atopy?

A

eczema
hayfever
food allergies

19
Q

what is the treatment of asthma to use for a daignosis?

A

ICS for 2 months

20
Q

what are the ideal symptoms to diagnose asthma?

A

Wheeze (with and without URTI)
SOB@rest
Parental asthma
Responds to treatment

21
Q

what other conditions may cause a wheeze but wont respond to asthma treatment?

A 
foreign body
cystic fibrosis
immune deficiency
ciliary dyskinesia
thracheo-bronchomalacia
22
Q

can viral induced wheeze and asthma be treated as the same thing?

A

yes

23
Q

below 18 months is the respiratory disease likely to be asthma?

A

no, but if it sounds like asthma and responds to asthma treatment then it is

24
Q

above 5 years is a respirator disease likely to be asthma?

A

yes

25
Q

what conditions can cause an isolated cough but are not asthma?

A

bronchitid
pertussis
habitual cough
tracheomalacia

26
Q

what is bronchitis?

A

inflammation of the bronchi, occurs in 2-3 year olds and causes a wet cough

27
Q

what is pertussis?

A

whooping cough, bacterial infection, affects any age causes fits vomiting and haematoma

28
Q

what is a habitual cough?

A

nothing wrong with patient, just thinks they need to cough. afects 8-12 year olds and produces a single loud cough

29
Q

what is tracheomalacia?

A

trachea ans bronchi are floppy, causes life long cough

30
Q

what are the clinical features of bacterial bronchitis?

A

recurrent wet cough
‘darth vader sound
palpable fremitis (rattling chest)

31
Q

what are some red flags for bacterial bronchitis?

A 
age < 6months or >4years
static weight
disrupt child's life
associated sob (when not coughing)
acute admission
32
Q

should we treat bacterial bronchitis with antibiotics?

A

not usually as it is self limiting and antibiotics have side effects

Respiratory system (38 decks)

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