Asthma- clinical features in children Flashcards
What is the pathophysiology of Asthma
Obstructive lung disease
Chronic inflammatory condition
Episodic bronchoconstriction via smooth muscle of airway
What is asthma
Literally “panting”
Chronic
Wheeze, cough, SOB and chest tightness
Multiple triggers
Variable/reversible
Responds to asthma Rx
What causes asthma
Host response to environment
Response to infection
Physiology abnormal before symptoms
Syndrome (multiple symptoms occur at the same time)
What makes asthma so difficult to diagnose
So many inconsistencies
What are some of these inconsistencies
“Transient” vs persistent
VIW versus asthma/MTW
Different severities
Different age at onset
Heterogeneity (diversity) in response
Different triggers
What % of asthma is linked to hereditory explanations
30-80%
around 10 genetic variants
Can allergies cause asthma
Probably not
Skin abnormality can cause eczema
Allergy enters immune system
Fuels Asthma
what is the epidemiology of asthma in the UK
1.1 million UK children
110, 000 in Scotland
5% of UK children on inhaled steroids!
How can early life affect your life expectancy
Lower maximum lung capacity early in life can cause accelerated decrease in max lung capacity later in life, causing lower life expectancy
Are asthma tests useful
Useful for excluding diseases
Not for diagnosing
What is the importance of wheeze in asthma
Must have in order to have asthma
(Not just by itself tho)
WHat is a common mistake when checking if its wheeze
Might be a rattle
What are some charcteristics of SOB
Significant resp difficulty
<30% lung function
Sooking in of ribs
Airway obstruction
What else might be a cause of asthma
Parental Hx asthma
Personal history
How would you diagnose a patient using response to treatment for Asthma
ICS for 2 months
take break from ICS to rule out false positive
See if symptoms come back
(if symptoms return have asthma)
What are the ideal symptoms for asthma
Wheeze
SOB
Parental asthma
Responds to treatment
How would you approach wheeze
Differential diagnosis for children under 5s
Congenital (something present from birth)
CF
PCD (Primary ciliary dyskinesia)
Bronchitis
Foreign body
Differential diagnosis for children over 5s
Dysfunctional breathing
Vocal cord dysfunction
Habitual cough
Pertussis
What would be the approach to preschool cough
What are some presentations which indicated different diagnosis
Wheeze related to coughs and colds suggestive of VIW
Isolated or productive cough
No response to treatment
Unilateral wheeze -> focal lesion or infection.
