Respiratory

Question 1

Age after which spirometry may be considered for diagnosis of asthma

Answer 1

Generally 6y, sometimes older. Depends on how compliant child is with instructions

Question 2

How to identify an obstructive airway disease on spirometry

Answer 2

FEV1/FVC ratio less than age accepted standard

• less than 0.85 (up to 19 years)
• less than 0.80 (20–39 years)
• less than 0.75 (40–59 years)
• less than 0.70 (60 years and older)

Question 3

Definition of reversibility on spirometry

Answer 3

FEV1 improvement of at least 200mLs/12% following bronchodilator

Just look at the percentage for children

Question 4

Indications to commence asthma management immediately on a preventer

Answer 4

• Symptoms 2+ times per week
• Symptoms at night once a month
• Steroid used for a flare in the last year
• Previous ICU admission for asthma
• Severely uncontrolled or troublesome symptoms

Question 5

Assessing control of asthma in children

Answer 5

Asthma score <20 = poor control
ALSO in kids:
- if symptoms last more than a few minutes OR are not relieved by bronchodilators = poor control

Question 6

When to reassess asthma control

Answer 6

Follow up after a flare
Follow up 1-3 months after beginning or changing preventer treatment
At scheduled asthma review visits
Opportunistically at non-asthma visits
Every 4-6 weeks during pregnancy