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Asthma - Clinical Features (Children) Flashcards

1
Q

What is the most important feature of asthma?

Why?

A

Wheeze

No wheeze, then no asthma.

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2
Q

What are common symptoms of asthma?

A

Wheeze
Cough
Shortness of breath

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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 key things in the diagnosis of asthma?

A

Wheeze
Variability
Respond to treatment

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5
Q

What are some differences between adults and children’s asthma?

A

Gender (prevalence in boys and girls)
Severe asthma
Occupational asthma uncommon in children

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6
Q

Outline what causes asthma (briefly).

4 points

A

Host response to environment/genes
Infection important
Physiology abnormal before symptoms
It is a syndrome

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7
Q

Outline five different originations of asthma (asthma syndromes).

A 
infant onset
childhood onset
adult onset
excertional onset
occupational onset
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8
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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9
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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10
Q

Does an allergy cause asthma?

A

Probably not, but an allergy may fuel asthma/eczema etc.

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11
Q

How many UK children suffer from asthma?

A

1.1 million UK children

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12
Q

How many children in Scotland suffer from asthma?

A

110, 000 in Scotland

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13
Q

What percentage of UK children are on inhaled steroids?

A

5%

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14
Q

Where is asthma most common in the world?

A

Western countries, with the highest pervalence in the UK

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15
Q

What can you say about the causes of asthma?

A

There are many, all leading to the same final common pathway to asthma

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16
Q

Why do people suffer from asthma at different stages of their lives?

A

It takes multiple hits to get above the threshold for clinical symptoms.

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17
Q

What can you say about testing for asthma in children?

A

There is no definitive test for asthma

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18
Q

What is a wheeze the result of?

A

A narrowing airway due to:

Bronchoconstriction
Airway wall thickening
Luminal secretions
- the variability in airway diameter means that the sound is polyphonic.

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19
Q

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

20
Q

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

A

Rattle, stertor, stridor

21
Q

What is stertor?

A

heavy snoring or gasping

22
Q

What is stridor?

A

high pitched sound

23
Q

When is there SOB at rest?

A
  • when there is significant respiratory difficulty: <30% lung function.
  • caused by airway obstruction
  • sucking in of the ribs when breathing
24
Q

Is cough a good predictor of asthma?

A

Not really, wheeze is much better

25
What sort of cough is associated with asthma?
Dry nocturnal, just after falling asleep Excertional
26
What personal medical history is indicative of atopy?
eczema hayfever food allergies
27
What is the treatment of asthma to use for a diagnosis?
Inhaled corticosteroids for 2 months
28
What are the ideal symptoms to diagnose asthma?
Wheeze (with and without URTI) SOB at rest Parental asthma Responds to treatment!!
29
What are some triggers of asthma?
``` Viruses (rhinovirus in 75% of cases) Exercise Allergen Cold air Emotion Menstruation ```
30
What other conditions may cause a wheeze but wont respond to asthma treatment?
``` foreign body cystic fibrosis immune deficiency ciliary dyskinesia thracheo-bronchomalacia ```
31
Can viral induced wheeze and asthma be treated as the same thing?
Yes
32
Below 18 months is the respiratory disease likely to be asthma?
No, it is more likely to be infection. But if it sounds like asthma and responds to asthma treatment then it is
33
When someone is over 5 years, what are they likely suffering from?
Asthma
34
What is something that sounds like asthma, and responds to asthma?
Asthma, regardless of age
35
What must happen after treatment for asthma?
There must be a response for it to be asthma
36
What are the differential diagnosis for asthma in children less than 5?
``` Congenital CF PCD Bronchitis Foreign body ```
37
What are the differential diagnosis for asthma in children of age 5 and older?
Dysfunctional breathing Vocal cord dysfunction Habitual cough Pertussis
38
When it is not asthma, what could it be instead?
``` Bronchitis (2-3 years old, wet cough) Pertussis (fits, vomits, haematoma) Habitual cough (8 - 12 years old, single loud cough) Tracheomalacia (lifelong loud cough) Viral induced wheeze (VIW) Foreign body Cystic fibrosis Immune deficiency Ciliary dyskinesia ```
39
What conditions can cause an isolated cough but are not asthma?
bronchitis pertussis habitual cough tracheomalacia
40
What is bronchitis?
inflammation of the bronchi, occurs in 2-3 year olds and causes a wet cough
41
What is pertussis?
Whooping cough (common), bacterial infection, affects any age causes fits vomiting and haematoma, petechiae
42
What is a habitual cough?
Nothing wrong with patient, just thinks they need to cough. | Affects 8-12 year olds and produces a single loud cough.
43
What is tracheomalacia?
Trachea and bronchi are floppy, causes life long cough.
44
What are the clinical features of bacterial bronchitis?
Recurrent wet cough 'darth vader' sound palpable fremitis (rattling chest)
45
What are some red flags associated from wheeze? What could/could not they indicate?
``` age <6months or >4years static weight disrupt child's life associated sob (when not coughing) acute admission ``` ``` Yes = bronchiectasis No = bacterial bronchitis ```
46
Should we treat bacterial bronchitis with antibiotics?
Not usually, as it is self limiting and antibiotics have side effects. Treatment - quality of life, risk of diarrhoea
47
Asthma and ____ should be treated as ______________.
VIW the same condition

Respiratory System (26 decks)

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