RESPIRATORY - BRONCHIAL ASTHMA

Question 1

How you want to diagnose BA ?

Answer 1

diagnosis is based on combination of history and presence of obstructive airflow reversibility

Question 2

From the general inspection , what do you want to see ?

Answer 2

Hands
: eczema at flexural areas
Face
: allergic rhinitis
: behind the knee
: on the neck
Use of accessory muscles
Barrel chest
Harrison sulci

Flexural areas
: inside the elbow
:behind the knee
:on the neck

Question 3

On palpation (chest expansion) , what findings did you aspect to found ?

Answer 3

Symmetrically reduced chest expansion

Question 4

On auscultation , what findings did you aspect ?

Answer 4

Reduced breath sounds
Expiratory wheezing

Question 5

What is the clinical tests for asthma ?

Answer 5

Spirometry

Question 6

What investigations you want to do to diagnose BA ?

Answer 6

1) Demonstration of airway obstruction
2) Demonstration of airway obstruction variability
3)Detection of eosinophilic inflammation or atopy

Question 7

Regarding the demonstration of airway obstruction , what is the expected findings ?

Answer 7

spirometry FEV1/FVC is less than 70% – +ve obstructive

Question 7

Regarding demonstration of airway obstruction variability , what is the expected findings ?

Answer 7

bronchodilator reversibility
- imporvement in FEV1 of 12% and 200ml

Question 8

Regarding detection of eosinophilic inflammation , what do you want to look for ?

Answer 8

Blood eosinophilic
IgE
FeNo

FeNo
- fractional exhaled nitric oxide
- measure the amount of nitric oxide in the breath
- NO helps to relax the airway

Question 9

What is the DDx of BA ?

Answer 9

COPD

Question 10

How you want to assess for BA control ?

Answer 10

usingasthma control test

Question 11

When there is AEBA , what is your first line tretament for the patient ?

If the case is emergency , then what you do ?

And what durg that you give to all patient ?

Answer 11

AEBA :inhaled B2 agonists
Emergency : SAMA + SABA
Given to all patient : corticosteroids