Asthma- clinical features in children Flashcards

1
Q

What is the pathophysiology of Asthma

A

Obstructive lung disease
Chronic inflammatory condition
Episodic bronchoconstriction via smooth muscle of airway

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2
Q

What is asthma (characteristics)

A

Literally “panting”
Chronic
Wheeze, cough, SOB and chest tightness
Multiple triggers
Variable/reversible
Responds to asthma Rx

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3
Q

What causes asthma

A

Host response to environment
Response to infection
Physiology abnormal before symptoms
Syndrome (multiple symptoms occur at the same time)

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4
Q

What makes asthma so difficult to diagnose

A

So many inconsistencies

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5
Q

What are some of these inconsistencies

A

“Transient” vs persistent
VIW versus asthma/MTW
Different severities
Different age at onset
Heterogeneity (diversity) in response
Different triggers

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6
Q

What % of asthma is linked to hereditory explanations

A

30-80%
around 10 genetic variants

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7
Q

Can allergies cause asthma

A

Probably not
Skin abnormality can cause eczema
Allergy enters immune system
Fuels Asthma

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8
Q

what is the epidemiology of asthma in the UK

A

1.1 million UK children
110, 000 in Scotland
5% of UK children on inhaled steroids!

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9
Q

How can early life affect your life expectancy

A

Lower maximum lung capacity early in life can cause accelerated decrease in max lung capacity later in life, causing lower life expectancy

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10
Q

Are asthma tests useful

A

Useful for excluding diseases
Not for diagnosing

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11
Q

What is the importance of wheeze in asthma

A

Must have in order to have asthma
(Not just by itself tho)

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12
Q

WHat is a common mistake when checking if its wheeze

A

Might be a rattle

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13
Q

What are some charcteristics of SOB

A

Significant resp difficulty
<30% lung function
Sooking in of ribs
Airway obstruction

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14
Q

What else might be a cause of asthma

A

Parental Hx asthma
Personal history

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15
Q

How would you diagnose a patient using response to treatment for Asthma

A

ICS for 2 months
take break from ICS to rule out false positive
See if symptoms come back
(if symptoms return have asthma)

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16
Q

What are the ideal symptoms for asthma

A

Wheeze
SOB
Parental asthma
Responds to treatment

17
Q

How would you approach wheeze

A
18
Q

Differential diagnosis for children under 5s

A

Congenital (something present from birth)
CF
PCD (Primary ciliary dyskinesia)
Bronchitis
Foreign body

19
Q

Differential diagnosis for children over 5s

A

Dysfunctional breathing
Vocal cord dysfunction
Habitual cough
Pertussis

20
Q

What would be the approach to preschool cough

A
21
Q

What are some presentations which indicated different diagnosis

A

Wheeze related to coughs and colds suggestive of VIW
Isolated or productive cough
No response to treatment
Unilateral wheeze -> focal lesion or infection.