Asthma clinical features- children Flashcards
what is the most important feature of asthma?
wheeze
what are the three key features of asthma?
- wheeze
- variability
- responds to asthma treatment
what are the similarities between asthmatic adults and children?
Symptoms Common Same triggers Same treatment Same pathology
what are the differences between asthmatic adults and children?
Gender
Severe asthma
Occupational asthma uncommon
what are the 4 “hits” for asthma?
- genes
- inherently abnormal lungs
- early onset atopy
- later exposure (rhinovirus, exercise, smoking)
in what ways is asthma inconsistent?
Transient” vs persistent Different severities Different age at onset Heterogeneity in response Different triggers
how can asthma be described as heterogeneity in response?
there are many domains (environment, atopy and lung function) that add up to the threshold for symptoms in different ways
can peak flow and spirometry be used in children to diagnose asthma?
no
what is a wheeze?
a soft expiratory polyphonic
why is a wheeze present?
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.
what are sounds from the lungs can be mistaken for wheeze?
rattle, stertor, stridor
what is stertor?
heavy snoring or gasping
what is stridor?
high pitched sound
when is there SOB at rest?
when there is significant respiratory difficulty <30% caused by airway obstruction
what does SOB at rest look like?
sucking in of ribs with wheeze
is cough a good predictor of asthma?
not really, wheeze is much better
what sort of cough is associated with asthma?
dry
nocturnal, just after falling asleep
exertional
what personal medical history is indicative of atopy?
eczema
hayfever
food allergies
what is the treatment of asthma to use for a daignosis?
ICS for 2 months
what are the ideal symptoms to diagnose asthma?
Wheeze (with and without URTI)
SOB@rest
Parental asthma
Responds to treatment
what other conditions may cause a wheeze but wont respond to asthma treatment?
foreign body cystic fibrosis immune deficiency ciliary dyskinesia thracheo-bronchomalacia
can viral induced wheeze and asthma be treated as the same thing?
yes
below 18 months is the respiratory disease likely to be asthma?
no, but if it sounds like asthma and responds to asthma treatment then it is
above 5 years is a respirator disease likely to be asthma?
yes
what conditions can cause an isolated cough but are not asthma?
bronchitid
pertussis
habitual cough
tracheomalacia
what is bronchitis?
inflammation of the bronchi, occurs in 2-3 year olds and causes a wet cough
what is pertussis?
whooping cough, bacterial infection, affects any age causes fits vomiting and haematoma
what is a habitual cough?
nothing wrong with patient, just thinks they need to cough. afects 8-12 year olds and produces a single loud cough
what is tracheomalacia?
trachea ans bronchi are floppy, causes life long cough
what are the clinical features of bacterial bronchitis?
recurrent wet cough
‘darth vader sound
palpable fremitis (rattling chest)
what are some red flags for bacterial bronchitis?
age < 6months or >4years static weight disrupt child's life associated sob (when not coughing) acute admission
should we treat bacterial bronchitis with antibiotics?
not usually as it is self limiting and antibiotics have side effects
