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ASTHMA - Coggle Diagram

- - - - CATS
- - - - IF HIGH THEN TREAT
        
        REVIEW IN 8W TO 3M
      - INTERMEDIATE
        
        SPIROMETRY
        
        OBSTX WITH REVERSIBILITY
        
        TRIAL TREATMENT
      - LOW
        
        SERIAL PEAK FLOWS
        
        DIURNAL VARIATION
        
        FENO
      - HIGH = RECURRENT EPISODES, WHEEZE HEARD BY DR, HISTORICAL RECORD OF VARIABLITY, HX OF ATOPY + NO OTHER ALTERNATIVE DDX
        
        MEDIUM = SOME BUT NOT ALL FEATURES OF ASTHMA, NO RESPONSE TO INITIAL TREATMENT
        
        LOW = NO TYPICAL FEATURES, ALTERNATIVE DDX LIKELY
  - - - NO TESTING, JUST TREAT
        
        TEST LATER IDEALLY
    - - FENO
        
        SPIRO/REVERS
        
        SERIAL PEAK FLOW VARIABILITY
        
        FEV1 < 80%. FEV1/FVC ratio <70%
        
        post bronchodilator reversibility = FEV1 increases by 12% predicted
        
        40 ppb is diagnostic, or 35 in younger <17. 25-35 + positive challenge test is ddx. if normal but other tests positive, still ddx i.e. peak flows and reversibility
      - FENO - MARKER OF INFLAMMATION
        
        VASODILATOR, BROCHODILATOR, INFLAMM MEDIATOR, NEUROTRANSMITTER
        
        OPEN UP AIRWAYS
        
        TEST PRIOR TO TX
        
        SMOKING ALSO REDUCED FENO
    - - SPIROMETRY
        
        THEN, FENO
        
        THEN, SERIAL PEAK FLOWS
      - BRONCHODILATOR REVERSIBILITY