Resp

Question 1

What is the preferred Ix for 5-16yo with history suggestive of asthma and what would positive result be? eNO level indicating asthma

Answer 1

FeNO level 35ppb+

Question 2

Re asthma: if FeNO testing is unavailable or <35ppb, what test should be performed next and what is a positive result?

Further testing if this not available?

Answer 2

Bronchodilator reversibility (BDR) spirometry

FEV1/FVC < 70% i.e. obstructive disease
BDR demonstrated by improvement in FEV1 > 12%

Further testing:
- Variable PEF (+ve result = >20% PEF variability after monitoring 2x/d for 2w)
- Skin prick testing to house dust mites
- Total IgE (raised) + blood eosinophil (> 0.5 x10^9/L)