Asthma Handbook

Question 1

Findings that require investigation in children: Persistent cough, not associated with wheeze/breathlessness or systemic disease

Answer 1

Unlikely to be asthma

Question 2

Findings that require investigation in children: Onset of signs from birth or very early in life

Answer 2

Cystic fibrosis
Chronic lung disease of prematurity
Primary ciliary dyskinesia
Bronchopulmonary dysplasia
Congenital abnormality

Question 3

Findings that require investigation in children: FHx of unusual chest disease

Answer 3

Should be enquired about before attributing all the signs and sx to asthma

Question 4

Findings that require investigation in children: Severe upper respiratory tract disease - severe rhinitis, enlarged tonsils/adenoids or nasal polyps

Answer 4

Specialist assessment should be considered

Question 5

Findings that require investigation in children: crepitations on chest auscultation that do not clear on coughing

Answer 5

Suggests a serious lower respiratory tract condition: pneumonia, atelectasis, bronchiectasis

Question 6

Findings that require investigation in children: Unilateral wheeze

Answer 6

inhaled foreign body

Question 7

Findings that require investigation in children: Systemic sx (fever, weight loss, failure to thrive)

Answer 7

Suggest an alternative systemic disorder

Question 8

Findings that require investigation in children: Feeding difficulties, including choking/vomiting

Answer 8

Aspiration - specialist assessment should be considered

Question 9

Findings that require investigation in children: Inspiratory upper airway noise (stridor, snoring)

Answer 9

Acute stridor suggests tracheobronchitis (croup)

Question 10

Findings that require investigation in children: Persistent voice abnormality

Answer 10

Suggests upper airway disorder

Question 11

Findings that require investigation in children: Finger clubbing

Answer 11

Cystic fibrosis, Bronchiectasis

Question 12

Findings that require investigation in children: Chronic (>4 weeks) wet or productive cough

Answer 12

Cystic fibrosis
Bronchiectasis
Chronic bronchitis
Recurrent aspiration
Immune abnormality
Ciliary dyskinesia

Question 13

Findings that require investigation in children: Focal (localised) lung signs

Answer 13

Pneumonia

Question 14

Findings that require investigation in children: Nasal polyps in child < 5 years

Answer 14

Cystic fibrosis

Question 15

Findings that require investigation in children: Severe chest deformity

Answer 15

Harrison’s Sulcus and Pectus carniatum can be due to uncontrolled asthma, but severe deformity suggests an alternative diagnosis

Question 16

Findings that require investigation in children: Obvious breathing difficulty, especially at rest or at night

Answer 16

Specialist assessment should be considered

Question 17

Findings that require investigation in children: Recurrent pneumonia

Answer 17

Specialist assessment should be considered