Asthma in children

Question 1

main symptoms of asthma

Answer 1

reversible

Wheeze, cough and SOB

Question 2

main genes that can cause asthma

Answer 2

ADAM33, ORMDL3

Question 3

criterea for asthma diagnosis

Answer 3

Wheeze (with and without URTI)
SOB@rest
Parental asthma
Responds to treatment

Personal history of:
•Eczema
•Hayfever
•Food allergies

Question 4

how much height can be lost due to asthma treatment in childhood

Answer 4

0.5-1cm

Question 5

tests that can be used for asthma

Answer 5

spirometry- if it shows obstruction then COULD be asthma

if obstruction plus relief with asthma treatment- asthma

Question 6

type of asthma cough

Answer 6

• Dry
• Nocturnal (just after falling asleep)
• Exertional

Question 7

causes of non asthma wheeze in under 5s

Answer 7

• Congenital
• CF
• PCD
• Bronchitis
• Foreign body

Question 8

causes of non asthma wheeze in over 5s

Answer 8

• Dysfunctional breathing
• Vocal cord dysfunction
• Habitual cough
• Pertussis

Question 9

how to measure control in chronic asthma

Answer 9

SANE
•Short acting beta agonist/week
•Absence school/nursery
•Nocturnal symptoms/week
•Excertional symptoms/week

Question 10

first line preventer in under 5’s

Answer 10

LTRA

leukotriene receptor antagonist

Question 11

max dose of ICS in kids

Answer 11

800 microg (<12 yo)

Question 12

when to start regular preventers

Answer 12

B2 agonists use more than two days a week

symptomatic three times a week or more, or waking one night a week.

Question 13

add on preventors in kids

Answer 13

Long acting beta agonist (LABA) - inhaler

Leukotriene receptor antagonist (LTRA) - oral

Question 14

what to do when ICS does not help control asthma

Answer 14

1. LABA
2. increase ICS dose
3. LTRA

Question 15

steroid form in chronic treatment

Answer 15

inhaled

Question 16

steroid form in acute treatment

Answer 16

tablets

Question 17

how to assess severity of acute asthma

Answer 17

•Respiratory  rate
•Work of breathing
•Heart rate
•Oxygen saturations•
Ability  to complete sentences
•Confusion
•Air entry

Question 18

mild acute asthma treatments

Answer 18

SABA via spacer

SABA via spacer + pred

Question 19

moderate acute asthma treatments

Answer 19

SABA via neb + pred

SABA + ipratropium via neb + pred

Question 20

severe acute asthma treatments

Answer 20

IV salbutamol
IV aminophylline
IV magnesium (neb)
IV hydrocortisone
Intubate and ventilate

Question 21

risk factors for asthma

Answer 21

Genetic predisposition
Atopy
Gender/Race
Maternal smoking during pregnancy
Recurrent chest infections/Bronchiolitis
Smoking/Exposure as a child
Air pollution
Socioeconomic factors
Obesity

Question 22

Primary muscles of respiration

Answer 22

diaphragm

external intercostals

Question 23

accessory muscles on respiration

Answer 23

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