Asthma Diagnosis Flashcards
Symptoms of asthma
Wheeze
Sob
Tightness
Cough which vary
Reversible is lost during
Exacerbation
Viral infection
Long standing asthma
Diagnostic criteria of asthma
Symptoms
Documented variable exporatory airflow
Positive bd reversiblity
Adults
Children
12 and 200
Greater confidence if 15 and 400
Children 12
What is excessive variability in pef
Adults 10
Children 13
What is significant increase in lung function after using ics for 4 weeks
Same as bd
Pefr 20 from baseline
Criteria for positive exercise challenge test
Fall in 10 or 200ml
Child- 12
Methacholime criteria
Hyperventilation/mannitol
Fev1 20
15
Excessive variation between visits
Same as bd
What to ask in history
Atopic
Eczema
Allergies
Asthma history
Physical exam if asthma
Expiratory wheeze on forced exp
Silent chest
Conditions where methacholine test positive
Copd
Cf
Allergic rhinitis
Other tests to diagnose asthma
Feno
Allergy tests- skin pick, ige
If already on controller treatment
Variable symptoms n AL - CONFIRM if symp plus and no AL limitation- more than 70 - step down If <70 - step up for 3 mon If few symp , no AL - WITHHOLD Of symp emerge- asthma If no - stop and followup
Assess
Adjust
Review for step down
If r/f for exacerbation plus don’t stop
Suitable time, Give plan
Adjust- how to dec , stop extra controller
Review after 2- 4 wks with spiro