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Asthma - chronic inflammatory disease of the airways - Coggle Diagram
Asthma - chronic inflammatory disease of the airways
Symptoms
response
exercise
allergen exposure
cold air
medication- NSAID and beta blockers
absence of URTI
worse at night and early in morning
breathlessness
Wheeze, chest tightness, coughing, SOB
widespread wheeze- bilateral, predominantly expiratory
Tests
Spirometry
Peak flow
Bronchodilator reversibility
Bronchial challenge testing
Treatment
Relief bronchodilator (SABA)
ICS at a low dose
Variable with age and severity
LAMA
LABA
Leukotrine receptor antagonist
Increase Dose of ICS
Theophylline
Treatment plan
Referral- Respiratory
Children
2 asthma attacks in 12 months
symptoms persist after treatment
consider diagnosis
Follow up
Annually
after each asthma attack
Acute exacerbations
Oral Prednisolone
SABA
Increase dose of ICS
Assess severity- moderate (PEFR 50-75%, talking in sentences) acute (PEFR 33-50% resp at least 25, pulse 110), life threatening (PEFR <33%, spO2 92%, altered consiousness)
Hospital
Emergency Rx - O2 maintain spO2 94-98%,nebulised salbutamol)
If no nebuliser MDI- 4 puffs followed by 2 puffs every 2 mins up to 10 puffs, repeat every 10-20mins)
Hospital admission
little or no response to treatment
severe asthma
life threatening asthma
Risk Factors
Fhx atopic disease
Male - prepubertal
Female - child to adult hood
exposure to tobacco smoke/dampness, flour dust, paint
obesity
low birth weight and premature birth
Respiratory infection in infancy
Complications
Impaired QOL
Respiratory complications
Death
Differentials
Cystic Fibrosis-moist cough, GI symptoms from birth, finger clubbing, failure to thrive
GORD- cough, vomitting, postural and food related symptoms
Ciliary Dyskinesia- moist cough since birt
Heart failure- orthopnoea, oedema, hx of IHD, fine creps
COPD - productive cough, dyspnoea on exertion, previous smoker, over 35 years old
Whooping cough
Bronchiectasis- copious sputum, frequent chest infections,course crepes, hx of childhood pneumonia
PE - acute onset pain, haemoptysis, crackles, sinus tachycardia,
ILD - dry cough, fine lung crepes
TB - productive cough, dyspnoea, haemoptysis
Lung Ca- wt loss, heamoptysis, hoarse voice
Covid 19- pyrexia, dyspnoea, pyrexia