asthma clinical features COPY Flashcards
what’s the definition of asthma?
A disease characterised by an increased responsiveness of the trachea and bronchi to various stimuli and manifested by a widespread narrowing of airways that changes in severity either spontaneously or as a result of therapy
what are the proven risk factors for asthma? (8)
genetic occupation smoking obesity diet reduced exposure to microbes/microbials products indoor pollution
In what way is genetic a risk factor for asthma?
Inherited tendency to IgE response to allergens
In what way is occupation a risk factor for asthma?
interactions with smoking and atopy
In what way does smoking increase the risk of asthma?
mum smoked during pregnancy promoting wheezy illness, airway responsiveness
Why are obese people associated with asthma?
body mass index increases asthma, wheezing and airway hyperreactivity
Are children born on farms less likely to develop asthma?
yes, there is reduced exposure to microbes
what are the sympoms of asthma?
wheeze short of breath chest tightness cough sputum
what are triggers of asthma?
exercise, cold air, smoke, perfume, pets, tree
whst sre the indications that it might not be asthma?
clubbing stridor assymetrical expansion dull percussion crepitations
How do you investigate asthma?
airflow obstruction
variability and or reversibility of airflow obstruction
full pulmonary function testing
reversibility to bronchodilator
reversibility to oral corticosteroids
how do you confirm the diagnosis of occupational asthma?
serial peak flow readings
antibodies
bronchial challenge
a condition which causes airflow obstruction which varies over time and with treatment
What could this be?
asthma
cough or wheeze in a context where asthma seems likely and other diagnoses have been excluded
note
what are key words for asthma?
wheeze, variability, respond to treatment
What are the similarities for asthma in adults?
Symptoms Common Same triggers Same treatment Same pathology
what are the difference of asthma
Gender (boys and women)
Severe asthma
Occupational asthma uncommon
which country is mostly affected
uk
is a stethoscope important in determining asthma?
no
Are allergy tests irrelevent in determing asthma?
yes
whats a must have in asthma?
wheeze
When is it not asthma?
under 18 months- most likely infection
Symptoms of bronchitis?
Loose rattly cough Noisy breathing Post-tussive vomit - “glut” Child VERY well, parent worried Chest free of wheeze/creps Self-limiting
Whats the risk of treating bacterial bronchitis?
quality of life and risk of diarrhoea
What are symptoms of pertussis?
coughing fits
vomiting, colour change
is there an asthma test?
no
How do you confirm the diagnosis?
trial of ICS
what is the aetiology of asthma?
atpoy- airway hypersensitiveness to allergen
What is pathology
what the disease does
whats the pathology of asthma?
Inflammation of airways causing obstruction
what are the symptoms of asthma?
SOB, cough, wheeze, increased resp rate
what are the signs of asthma?
trachypnoea, wheeze
what are the tests/investigations
spirometer, peak flow rate, PFT, response to bronchodilators, gas transfer is normal
how do you manage asthma?
inhaled SABA, LABA, corticosteroids, leukotriene, theophylline
how many people live with asthma in uk?
5.4 million
how often is someone potentially having a life threatning asthma attack?
every 10 seconds
what is the percentage of children getting asthma? and what gender is it more likely in
10-15%
male
what is the percentage of adults getting asthma? and what gender is it more likely in
5-10% and female
what is the most common chronic disease of childhood in the uk
asthma
if it is not asthma what else could it be?
generalised airflow obstruction-
copd
bronchiectasis
cystic fibrosis
localised airway obstruction
tumour
foreign body
cardiac
If alveoli is destroyed, what disease is it likely to be?
copd
if it does not respond to corticosteroids what disease would this be?
copd
