Clinical Features of Asthma in children Flashcards
What does no wheeze mean?
no asthma
What is the solution to suspected asthma?
Quality of life affected- confirm diagnosis with trial of ICS (low dose inhaled steroids)
Quality of life unaffected- watch and see
Give characteristics of asthma?
chronic
WHEEZE and cough and difficulty breathing
multiple triggers predominantly rhinovirus (common cold virus)
symptoms are variable or reversible
What causes asthma?
Host (genes) response to environment
Physiology abnormal before symptoms (predisposition)
Host response to exposure important
It is a syndrome- much more variable
What percentage of asthma cases are genetics the cause>
30-80%
What are common asthma genes?
ADAM33 , ORMDL3
Does allergy cause asthma?
allergy fuels eczema/asthma etc..
When is it asthma?
Wheeze
-genuine
-URTI
-Exertional
Cough
Episodes of SOB
-sucking in of ribs
Responds to steroid Rx
What are the old wives tales of asthma?
there is a reliable test for asthma
you cant diagnose asthma <5
cough variant asthma exists in children
inhaled steroids are harmful
Which conditions cause isolated cough?
bronchitis
pertussis
habitual cough
foreign body
Give characteristics of a habitual cough?
-6-11 years
-dry
-loud
-single
-throat clearing
-strong FHx asthma
-not watching TV/ asleep
Dysfunctional breathing?
Common secondary school aged
common in sport
common in asthma
“can’t get enough air in”
management is breathing exercises
Conditions which cause noisy breathing?
bronchitis
laryngomalacia
tracheomalacia
snoring
Describe laryngomalacia?
2+ weeks
Variable noise++
Well infant+++
“Worsens” to 6 mo
“Scootery feeder”
Age related approach for onset of symptoms before 2 months?
congenital thing
Laryngomalacia
Tracheo-bronchomalacia
Rare stuff (CF/PCD)
