Chronic Asthma

Question 1

Different types of asthma

Answer 1

Infrequent episodic well between >6 weeks between
Freq episodic attacks are more freq than 6 weeks well between
Persistent. Not well between and then flares

Question 2

Children <5 years dd asthma and viral induced wheeze

Answer 2

30% of children <5years wheeze
10 % have asthma 
Viral induced wheeze 
No symptoms between episodes 
Child well between 
2-3 episodes per year 
Cough wheeze sob <10days associated with URTI
If recurrent Viral IW can trail LTRA

ASTHMA
Symptoms can last >10days
>3 episodes per year 
Between episodes child may have symptoms 
Atopy and family history of asthma

Question 3

Assessing asthma control mostly based on history

Answer 3

Daytime symptoms
Night time symptoms waking at night due to asthma
Reliever use >2x per week
Limitation of ADL cant go to school etc

Question 4

Exercise induced wheeze

Answer 4

Warming up
Before exercise use of SABD
LTRA good evidence

Question 5

DD of asthma

Answer 5

1 conditions causing a cough pertussis/CF/trachiomalacia/ Bronchiectasis
2 conditions associated with a wheeze FB inhaled
3 conditions associated with SOB eg anxiety /hyperventilation

Question 6

Spirometery can be done from 6 years

Answer 6

FEVa/FVC >80%

Question 7

Achalasia

Answer 7

Can produce a chronic cough esp at night
Failure of the sm fibers to relax in the LOS
Symptoms trouble with swallowing dysphasia nocturnal cough
Diagnosis ba swollow or endoscopy