Asthma in children Flashcards
main symptoms of asthma
reversible
Wheeze, cough and SOB
main genes that can cause asthma
ADAM33, ORMDL3
criterea for asthma diagnosis
Wheeze (with and without URTI)
SOB@rest
Parental asthma
Responds to treatment
Personal history of:
•Eczema
•Hayfever
•Food allergies
how much height can be lost due to asthma treatment in childhood
0.5-1cm
tests that can be used for asthma
spirometry- if it shows obstruction then COULD be asthma
if obstruction plus relief with asthma treatment- asthma
type of asthma cough
- Dry
- Nocturnal (just after falling asleep)
- Exertional
causes of non asthma wheeze in under 5s
- Congenital
- CF
- PCD
- Bronchitis
- Foreign body
causes of non asthma wheeze in over 5s
- Dysfunctional breathing
- Vocal cord dysfunction
- Habitual cough
- Pertussis
how to measure control in chronic asthma
SANE •Short acting beta agonist/week •Absence school/nursery •Nocturnal symptoms/week •Excertional symptoms/week
first line preventer in under 5’s
LTRA
leukotriene receptor antagonist
max dose of ICS in kids
800 microg (<12 yo)
when to start regular preventers
B2 agonists use more than two days a week
symptomatic three times a week or more, or waking one night a week.
add on preventors in kids
Long acting beta agonist (LABA) - inhaler
Leukotriene receptor antagonist (LTRA) - oral
what to do when ICS does not help control asthma
- LABA
- increase ICS dose
- LTRA
steroid form in chronic treatment
inhaled
steroid form in acute treatment
tablets
how to assess severity of acute asthma
•Respiratory rate •Work of breathing •Heart rate •Oxygen saturations• Ability to complete sentences •Confusion •Air entry
mild acute asthma treatments
SABA via spacer
SABA via spacer + pred
moderate acute asthma treatments
SABA via neb + pred
SABA + ipratropium via neb + pred
severe acute asthma treatments
IV salbutamol IV aminophylline IV magnesium (neb) IV hydrocortisone Intubate and ventilate
risk factors for asthma
Genetic predisposition Atopy Gender/Race Maternal smoking during pregnancy Recurrent chest infections/Bronchiolitis Smoking/Exposure as a child Air pollution Socioeconomic factors Obesity
Primary muscles of respiration
diaphragm
external intercostals
accessory muscles on respiration
abdominal muscles such as :
rectus abdominis,
transversus abdominis,
external and internal obliques
muscles attached to ribs including: pectoralis major and minor, latissimus dorsi, sternocleidomastoid, scalenus muscles, serratus
