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Questions and Answers
What is asthma characterized by?
What is asthma characterized by?
Which of the following is a risk factor for asthma?
Which of the following is a risk factor for asthma?
What is airway hyperreactivity characterized by?
What is airway hyperreactivity characterized by?
What is the main characteristic of T2-type asthma?
What is the main characteristic of T2-type asthma?
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What is a common clinical sign of asthma?
What is a common clinical sign of asthma?
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What is the purpose of a challenge test in diagnosing asthma?
What is the purpose of a challenge test in diagnosing asthma?
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What is a characteristic of asthma with persistent/fixed airway obstruction?
What is a characteristic of asthma with persistent/fixed airway obstruction?
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At what age are most asthma cases diagnosed?
At what age are most asthma cases diagnosed?
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What is the significance of a >20% increase in PEF, 15 minutes after 2 puffs of salbutamol?
What is the significance of a >20% increase in PEF, 15 minutes after 2 puffs of salbutamol?
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How is asthma control classified?
How is asthma control classified?
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What is the step in management for symptoms less than twice a month?
What is the step in management for symptoms less than twice a month?
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Which of the following is NOT a non-pharmacological treatment for asthma?
Which of the following is NOT a non-pharmacological treatment for asthma?
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When is short course OCS may be needed?
When is short course OCS may be needed?
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What is the criteria for moderate asthma?
What is the criteria for moderate asthma?
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Study Notes
Definition and Characteristics of Asthma
- Asthma is a heterogeneous disease characterized by chronic airway inflammation and variable respiratory symptoms.
- Symptoms include wheeze, shortness of breath, chest tightness, and cough, which vary over time and intensity.
- Asthma is defined by a history of these symptoms, along with variable expiratory airflow limitation.
Risk Factors
- Allergy
- Genetic predisposition
- Smoking
- Obesity
Pathogenesis
- Airway hyperreactivity, resulting in airway narrowing as a reaction to irritants.
- Inflammation and airway remodeling, including eosinophilic inflammation.
Classification
- T2-type asthma: allergic and late onset eosinophilic asthma, exercise-induced asthma, and childhood or early adulthood onset.
- Non-T2 type asthma: obesity associated asthma, smooth muscle mediated paucigranulocytic asthma, and smoking related neutrophilic asthma.
Phenotypes
- Allergic asthma
- Non-allergic asthma
- Late-onset asthma
- Asthma with persistent/fixed airway obstruction (non-reversible)
Clinical Signs and Symptoms
- Wheezing
- Cough
- Dyspnea
- Symptoms usually worsen in mornings
- Night asthma
- Can develop in any age, but less frequent in older adults
- 75% of cases are diagnosed before age 7
Diagnosis
- Objective examination: usually normal, with wheezing (also common in respiratory infections, COPD, upper airway dysfunction, and heart failure)
- Anamnesis: symptoms change over time and intensity, worsen at night or when waking up, and can be provoked by exercise, laughter, allergens, or cold air
- Tests: spirometry, challenge test, and exercise challenge test
Control of Asthma
- Assessment based on symptoms in the past 4 weeks
- Well-controlled: no symptoms or need for reliever
- Partially controlled: 1-2 symptoms or need for reliever
- Uncontrolled: 3-4 symptoms or need for reliever
Severity Assessment
- Mild asthma: can be controlled with treatment in step 1 or 2
- Moderate asthma: can be controlled with treatment in step 3
- Severe asthma: can be controlled with treatment in step 4 or 5, or remains uncontrolled
Management
- Step 1: for symptoms less than twice a month
- Step 1/2 track 1 or step 2 track 2: for symptoms less than 4-5 days a week
- Step 3: for symptoms most days, or waking with asthma once a week or more
- Step 4: for daily symptoms or waking with asthma once a week or more, and low lung function
- Non-pharmacological treatment includes avoidance of smoke, allergens, and occupational factors, as well as physical activity, breathing techniques, weight reduction, and stress reduction.
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Description
Learn about the definition, characteristics, risk factors, and pathogenesis of asthma, a chronic disease of the airways.
