Asthma Clinical Features in Children

Question 1

No wheeze

Answer 1

No asthma

Question 2

What is the primary physiological manifestation of this hyperresponsiveness?

Answer 2

Variable airway obstruction

Question 3

What percentage of UK children are asthmatic?

Answer 3

1 million, 5% of which are on inhaled steroids

Question 4

What are the 5 aetiology settings?

Answer 4

Infant onset Childhood onset Adult onset Excertional asthma Occupational asthma

Question 5

Is stethoscope useful in examination for asthma?

Answer 5

NO

Question 6

Is there a test for asthma?

Answer 6

NO Peak flow random number generator Allergy tests irrelevant Spirometry lacks specificity Exhaled nitric oxide unproven

Question 7

Does a cough variant asthma exist in kids?

Answer 7

NO Cough predominant asthma not uncommon in adults (I THINK)

Question 8

What are the mechanisms for wheeze?

Answer 8

Bronchoconstriction Airway wall thickening Luminal secretions

Question 9

What is stertor?

Answer 9

Respiratory sound characterized by heavy snoring or gasping

Question 10

What is stridor?

Answer 10

A harsh vibrating noise when breathing, caused by obstruction of the windpipe or larynx

Question 11

What can wheeze be confused for?

Answer 11

rattle/stertor/stridor

Question 12

What is SOB at rest indicative of?

Answer 12

Significant resp difficulty (<30% lung function) Airway obstruction Sooking in of ribs with wheeze

Question 13

What triggers exist for asthma?

Answer 13

URTI (rhinovirus in 75%) Exercise Allergen Cold air Other (emotion, menstruation)

Question 14

What are the features of a child which best suggests asthma?

Answer 14

Wheeze SOB @ rest Multitriggered Variable Atopy Parental asthma RESPONDS TO TREATMENT

Question 15

What conditions can asthma be confused for?

Answer 15

Viral induced wheeze Foreign body Cystic fibrosis Immune deficiency Ciliary dyskinesia Tracheo-brochomalacia Aspiration Gastro-oesophageal reflux

Question 16

What is treatment of infrequent episodic wheeze with a cold?

Answer 16

Salbutamol NO (Steroids at hospital or home) NO (leukotrine receptor agonist) ICS?

Question 17

What is the flow chart for wheeze?

Answer 17

Question 18

If under 18 months what is asthma most likely to be confused for?

Answer 18

Chest infection

Over 5 years it is most likely to be asthma

Question 19

If the child has a cough what can it be indicative of?

Answer 19

–Bronchitis (2-3 year old, wet cough)

–Pertussis (any age, fits, vomit, haematoma)

–Habitual cough (8-12 year old, single loud cough)

–Tracheomalacia (life long loud cough

–Small print as per wheeze

•CF, FB, ID, PCD

Question 20

How is Bronchitis symptoms different to asthma symptoms?

Answer 20

Loose rattly cough

No wheeze/creps

Also self-limiting

Question 21

How does bacterial bronchitis affect cilia?

Answer 21

Disturbed mucociliary clearance caused by –RSV/adenovirus/rhinovirus

Question 22

What are the considerations when deciding treatment for bacterial bronchitis?

Answer 22

Self limiting (without treatment)

Quality of life and diarhoea (with treatment)

Question 23

What is different between pertussis and asthma?

Answer 23

Coughing fits

Vomiting, colour change and petechiae

Question 24

What is the approach to preschool cough?

Answer 24

Question 25

A wee poem

Answer 25