Asthma in children

Question 1

three main symptoms of asthma

Answer 1

wheeze
cough
SOB

Question 2

Asthma definition

Answer 2

condition which causes airflow obstruction which caries over time and with treatment

Question 3

Similarities with adult and child asthma

Answer 3

symptoms 
common 
same triggers
same treatment 
same pathology

Question 4

Children in the UK with asthma is

Answer 4

1 million

100,000 in Scotland

Question 5

Multiple aetiology such as

Answer 5

genes

inherently abnormal lungs

early onset atopy

late exposure (rhinovirus, 
exercise, smoking)

Question 6

How to examine for asthma?

Answer 6

ALL IN THE HISTORY

Examination is unhelpful! (stethoscope never important, probably not wheezing at the time)

No asthma tests in children

Question 7

No wheeze

Answer 7

no asthma

Question 8

SOB at rest

Answer 8

<30% lung function

Question 9

Common URTI associated with child asthma

Answer 9

rhinovirus

75% of children with asthma

Question 10

Ideally - in diagnosing asthma a child would have..

Answer 10

wheeze (with and without URTI)

SOB at rest

Parental Asthma

RESPONDS TO TREATMENT

Question 11

When is it not asthma?

Answer 11

under 18 months (usually infection)

BUT if it sounds like asthma and responds it IS ASTHMA regardless of age

Question 12

Clinical feature of bacterial bronchitis

Answer 12

recurrent wet cough
Darth vader
very well child
first born

Question 13

Pertussis

Answer 13

whooping cough

very common
Vaccine reduces risk

Question 14

Proven risk factors for asthma

Answer 14

Inherited tendency to TgE response to allergens

Asthma, eczema, hay fever, food allergy

Question 15

Immune response genes

Answer 15

IL-4
IL-5
IgE

Question 16

Airway Genes

Answer 16

ADAM33

Question 17

Use of corticosteroid separates asthma from

Answer 17

COPD

Question 18

Useful investigation

Answer 18

CXR (hyper inflated, hyper lucent)

Skin prick testing (atopic status)

Total and specific IgE

FBC (eosinophilia - level of eosinophils to measure allergy)

Question 19

Asthma is shown by reversibility to

Answer 19

bronchodilator and corticosteroids

Question 20

S
A
N
E

How to measure the control of the asthma

Answer 20

short acting beta agonist

absence (from school/nursery)

nocturnal symptoms

exertion symptoms

Question 21

in general- managing asthma - you always give the patient…

then review after 2 months to monitor progress

Answer 21

low dose inhaled corticosteroids

Question 22

Classes of medications to treat asthma

Answer 22

short acting beta agonists (SABA)

inhaled corticosteroids (ICS)

long acting beta agonist (LABA)

leukotriene receptor antagonists (LTRA)

theophyllines

oral steroids

Question 23

Step one in managing asthma would be to give a

Answer 23

short acting beta agonist

SABA

Question 24

Step two in managing asthma may be to give a

Answer 24

inhaled B2 agonist three times a week

with very low dose ICS

Question 25

Step three in managing asthma may be to add on a preventer

Answer 25

add a LABA

add an LTRA

increase ICS dose

Question 26

LABA cannot be used without

Answer 26

ICS

Question 27

LABA is used as a fixedD

Answer 27

Dose inhaler

Question 28

Chronic maintenance treatment you would use

Answer 28

inhaled steroids

Question 29

acute treatment you would use

Answer 29

oral steroids

Question 30

asthma treatments given to children by

Answer 30

inhaler spacer

nebuliser

dry powder