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Respiratory System DO > Asthma Clinical Features In Children > Flashcards

Asthma Clinical Features In Children Flashcards

(51 cards)

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1
Q

What is the number 1 rule in asthma

A

No wheeze = No asthma!

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2
Q

Name 6 features of asthma

A 
Panting
It is chronic not acute
Wheeze, cough and SOB
Multiple triggers
It is variable/reversible
Responds to asthma treatment
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3
Q

Name the triggers of asthma

A 
URTI (rhinovirus in 75%)
Exercise (football and trampolining)
Allergen
Cold air
Other (Emotion, menstruation)
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4
Q

What are 3 key words associated with asthma

A

Wheeze
Variability
Respond to treatment

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5
Q

Is asthma a diagnosis of exclusion

A

No

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6
Q

Name 5 similarities of childhood asthma and adult asthma

A 
Symptoms
Common
Same triggers
Same treatment
Same pathology
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7
Q

What is the reticular basement membrane (RBM) in children and adults with asthma

A

About the same

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8
Q

Name 3 differences between pediatric and adult asthma

A

Affects more boys in children and women in adults
Severe asthma in children tends to resolve
Occupational asthma in children is uncommon

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9
Q

How many children in the UK are affected with asthma

A

1 million

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10
Q

How many children in Scotland are affected with asthma

A

100,000

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11
Q

How much of the UK children affected with asthma take inhaled steriods

A

5%

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12
Q

Has the prevalence of asthma been increasing or decreasing

A

Decreasing since 2004

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13
Q

Has the prevalence of wheeze been increasing or decreasing

A

Decreasing since 1999

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14
Q

Can asthma be caused by a single gene

A

No it is a disease of multiple hits

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15
Q

Name the type of hits which can cause asthma to develop

A

Genes
Inherently abnormal lungs
Early onset atopy
Later exposures (e.g. rhinovirus, exercise, smoking)

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16
Q

State the inconsistencies which can occur in asthma

A 
"Transient” vs persistent 
Different severities
Different age at onset
Heterogeneity in response
Different triggers
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17
Q

Why is asthma able to produce so many inconsistencies

A

Everyone is affected by the environment, atopy and lung function
The above contributions will add up to cause asthma however every individual’s exposure is different and therefore cause ‘inconsistences’ in asthma

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18
Q

What is the most important aspect of diagnosing asthma in children

A

History

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19
Q

What is the history of a child with asthma most likely to look like

A

Cough
Wheeze
Shortness of breath Upper respiratory tract infections

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20
Q

Should a child be examined when trying to diagnose asthma

A

No as they are unlikely to be wheezing

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21
Q

Why is there no asthma test for children

Study These Flashcards
A

The peak flow generates random numbers
Allergy tests are irrelevant
Spirometry lacks specificity
Exhaled nitric oxide is unproven

22
Q

What causes wheeze

Study These Flashcards
A

Bronchoconstriction, airway wall thickening and luminal secretions

23
Q

Why does wheezing in children tend to sound more musical

Study These Flashcards
A

Because they have smaller airways

24
Q

How much of reported wheeze in children tends to be rattle, stertor or stridor

25
How much wheeze in children aged 2 is not genuine in Aberdeen
75%
26
What does shortness of breath at rest indicate
Severe airway obstruction | Can be seen as the ‘snooking’ in of ribs with wheeze
27
When does a cough indicate asthma in children
When it is dry, nocturnal and exertional
28
Does atopy 'cause' asthma
No
29
Which two types of history are important in diagnosing asthma
Familiy and personal (eczema, hayfever, food allergies)
30
What is the treatment for asthma in children
Inhaled corticosteroids for 2 months
31
What does taking breaks ('holidays') from treatment ensure
Ensures that the diagnosis is not a false positive
32
What are the ideal conditions when making a diagnosis of asthma in a child
Wheeze (with and without URTI) SOB @ rest Parental asthma Responds to treatment
33
Out of all of the ideal conditions when making a diagnosis of asthma in a child which is the most important and why
Response to treatment as any other illness is unlikely to respond to it if it is not asthma
34
What is the best way to approach wheeze in a child
Watch and see or the trial of treatment
35
What should be done if the trial of treatment does not work
Watch and see
36
What is viral induced wheeze
Another form of asthma
37
What can be other causes of wheeze
``` Foreign body (FB causes noise) Cystic fibrosis Immune deficiency Ciliary dyskinesia Aspiration (maybe Gastro-oesophageal reflux) Tracheo-bronchomalacia ```
38
What causes noise (wheeze) in cystic fibrosis, immune deficiency and ciliary dyskinesia
Secretions
39
How many preschoolers tend to have viral induced wheeze
99%
40
How can viral induced wheeze be treated
Only with salbutamol
41
Why does salbutamol work on viral induced wheeze
Because it works on all types of wheeze
42
When is it unlikely that a child has asthma
If they are under 18 months | They most likely have an infection
43
What could an isolated cough be
Bronchitis in 2-3-year olds with a wet cough Pertussis at any age including symptoms of fits, vomiting and haematoma Habitual cough in 8-12-year olds which presents as a single loud cough Tracheomalacia (a lifelong cough)
44
What are the clinical features of bacterial bronchitis
Recurrent wet cough Darth Vader/tractor like sounds Palpable fremitus (rattling chest) Follows from an URTI
45
Describe the progression of bacterial bronchitis
Tends to last about 4 weeks 60-80% of children respond to treatment First winter is usually bad, second better and by the third they are fine
46
Name 6 red flags of bacterial bronchitis
``` If the child is under 6 months or over 4 years Static or losing weight Disruption of the child’s life Associated SOB when not coughing Acute admission Other co-morbidities (neuro/gastro) ```
47
Why bacterial bronchitis best left untreated
It is a self limiting condition | Treatment could reduce quality of life and causes a risk of diarrhoea
48
What is the best treatment for bacterial bronchitis (sounds contradictory doesn't it)
Honey!
49
How is vaccination useful in pertussis
It reduces the risk of infection | Reduces the severity of disease
50
What are the symptoms of pertussis
Coughing fits Vomiting Perechiae
51
Is the pertussis vaccine effective and why
No | Out of 64 children in Oxford with whooping cough, 55 of them had been vaccinated

Respiratory System DO (33 decks)

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