resp

Question 1

adult (>16) asthma investigations

Answer 1

1st= eosinophil (raised)+ FeNo (50 or >)

2nd= Spirometry + reversible bronchodilator (salbutamol)
-10% raise FEV1 from predicted OR 12% or more increase FEV1 + increase volume 200mls or more

Spirometry not available= PEF twice daily for 2 weeks
-diagnose if 20% variability

still not confirmed:
-refer for bronchial challenge test
-diagnose asthma is hyper responsiveness present

Question 2

5- 16 year old investigations asthma

Answer 2

1st= FeNO (35 or >)

not raised/ not available= spirometry + reversible bronchodilator
-diagnose if 12% or more increase in FEV1 OR
-1-% FEV1 raise from predicted FEV1

spirometry not available= PEF twice daily for 2 weeks
-diagnose if 20% variability

still not diagnosed= Skin prick test for house mite dust or total IgE

Still not diagnosed= refer to paeds + bronchial challenge test

Question 3

investigations asthma <5 years

Answer 3

clinical