Clinical features of Asthma in Children Flashcards
If you remember one thing…
No wheeze, no asthma
Key words to describe asthma?
Wheeze, Variability, Respond to treatment
What are the asthmatic similarities with adults?
Symptoms, Common, same triggers, same treatment, same pathology
What are asthmatic difference between children and adults?
Gender (most common with boys in children), severe asthma, occupational asthma uncommon.
Effect on UK population?
1 million children. 100,000 in Scotland. 5% children in inhaled steroids.
What are the main multiple ‘hits’ of asthma?
Genes, inherently abnormal lungs, early onset atopy, Later exposures (Rhinovirus, Exercise, smoking)
Inconsistencies in asthma?
Persistance, severities, age at onset, triggers
Explain ‘growing out’ of asthma.
Asthma symptoms fade as they grow up - but may come back further down the line.
Testing in Children?
asthma is a diagnosis based on symptoms supported by abnormal physiology. Tests are unproven.
What is stridor?
Inspiratory sound, similar to snoring.
What are mechanisms for wheeze?
Bronchoconstiction, airway wall thickening, Luminal secretions, HOWEVER childrens airways are smaller and more likely to be musical.
Explain shortness of breath at rest.
Significant respiratory difficulty (<30% lung function), Airway obstruction, “sucking’ in of ribs with wheeze
Features of asthmatic cough
Dry, Nocturnal, exertional
What are common triggers?
URTI (upper respiratory tract infections = rhinovirus), Exercise, Allergen, Cold air, Emotion and menstruation.
Does atopy cause Asthma?
No. It is likely that asthma causes IgE sensitisation.
What is an ideal diagnosis for asthma?
Wheeze, shortness of breath at rest, Multitrigger, atopy, parental asthma, RESPONDS TO TREATMENT.
What are differential diagnosis for asthma?
Foreign body, Cystic fibrosis, Immune deficiency, Ciliary dyskinesia, tracheo-bronchomalacia
How do you treat infrequent episodic wheeze with a cold?
With Salbutamol
When is it not asthma?
All that is chronic and paediatric and respiratory is not asthma
If you are under 18 moths is it most likely asthma or infection?
Infection
Over 5 years, is it most likely asthma or infection?
Asthma
What are features of bronchitis?
Common, Loose rattly cough, noisy breathing, chest free of wheeze, self-limiting, parent worried but child is VERY well
Describe bacterial bronchitis.
Disturbed mucociliary clearance. Infection is secondary. Following URTI, lasts 4 weeks. First winter bad then continues to improve.
Eg rhinovirus, adenovirus,RSV
how do you treat bacterial bronchitis?
You DON’T - if you give antibiotics they probably wont work and may cause diarrhoea
What is Pertussis?
‘whooping cough’
Common, vaccination reduces risk, coughing fits, vomiting, colour change, Petechiae (burst blood vessels in eye)
When its not asthma at preschool age, what could it be?
Bronchitis (peak at 2-3, wet cough), Tracheomalacia (life long), Cystic fibrosis, foregin body, ciliary dyskinesia, pertussis
When its not asthma at school child age, what could it be?
habitual cough (8-12), Dysfunctional breathing, vocal cord dysfunction, pertussis
How can you confirm an asthma diagnosis?
With inhaled corticosteroids and see if the symptoms improve
