4.2. Paediatric Respiratory - Asthma Flashcards
What are the Clinical Features of Asthma?
- Wheeze - No Wheeze, No Asthma
- Cough
- Dyspnoea - “Panting”
- Multiple Triggers - URTI / Exercise / Allergen / Cold
- Variable / Reversible
- Responds to Asthma Treatment
Note - There is No Uniform Definition
In Asthma, what is the:
- Similarity with Adults?
- Difference with Adults?
- a) Symptoms
- b) Common
- c) Same Triggers / Pathology
- d) Same Treatment
- a) Gender (Boys and Women)
- b) Severe Asthma
- c) Occupational Asthma (Uncommon)
What are the Different Onsets of Asthma?
- Infant Onset
- Childhood Onset
- Adult Onset
- Excertional Asthma
- Occupational Asthma
What is the Aetiology of Asthma?
- Genes
- Inherently Abnormal Lungs
- Early Onset Atopy
- Later Exposures - Rhinovirus / Exercise / Smoking
Note - These are Multiple Hits
How is Asthma Diagnosed in Children?
- History
- Examination is Unhelpful
- No Asthma Test in Children
What must be Present in a History to indicate Asthma?
- Wheeze - Rattle / Stertor / Stridor
- Shortness of Breath at Rest - Airway Obstruction
- Cough - Dry / Nocturnal / Exertional
- > 1 Trigger - URTI / Exercise / Allergen / Cold Air
- Atopy - Eczema / Hayfever / Food Allergy
What is the Treatment of Infrequent Wheeze with a Cold?
- Salbutamol
2. Inhaled Corticosteroids
When is it not Asthma?
- Bronchitis
- Pertussus
- Habitual Cough
- Tracheomalacia
How is Control of Asthma Measured?
Closed Questions (SANE): S - Short Acting Beta-2 Agonsit / Week A - Absence from School / Nursery N - Nocturnal Symptoms / Week E - Excertional Symptoms / Week
What are the Classes of Medications used in Asthma Management?
- Short Acting Beta Agonists
- Inhaled Corticosteroids (ICS)
- Long Acting Beta Agonists
- Leukotriene Receptor Antagonists
- Theophyllines
- Oral Steroids
Note - 3. / 4. / 5. are “Add Ons”
What are the Different Steps of Asthma Management?
- Inhaled SABA as Required
- (1.) + Regular Preventer - Very Low Dose ICS if > 5 / LTRA if < 5
- (2.) + LABA (/ Increase ICS / LTRA)
- Increasing Doses / Change Add on Therapy
- Oral Steroids (Last Resort)
What are the Delivery Systems of Asthma Medication?
- Metered Dose Inhaler / Spacer
- Dry Powder Inhaler
- Nebuliser - Hospital Only
What are some Non-Pharmacological Managements of Asthma?
- Stop Tobacco Smoke Exposure
2. Remove Environmental Triggers
What is the Management of Mild Acute Asthma Exacerbation?
- SABA via Spacer
2. (1.) + Prednisolone
What is the Management of Moderate Acute Asthma Exacerbation?
- SABA via Nebuliser + Prednisolone
2. SABA + IPRA via Nebuliser + Prednisolone
