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Dr. Pamela Alip
Dr. Ritu Lamichhane
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a chronic inflammatory condition of thelung airways resulting in
episodic airflow
obstruction.
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Cause is unknown Contemporary research implicates a
combination ofenvironmental exposuresand inherent biological and
geneticvulnerabilities
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Parental asthma allergy
Atopicdermatitis
Allergic rhinitis
Food allergy
Lower respiratorytract infection
Male gender
Low birthweight
Environmentaltobacco smoke
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Intermittent dry coughing and/or expiratory wheezing arethe most
common chronic symptoms of asthma.
Older children and adults will report associated shortnessof
breath and chest tightness;
Younger children are more likely to report intermittent,nonfocal
chest pain.
Respiratory symptoms can be worse at night
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Others include:
self-imposed limitation of physical activities,
general fatigue (possibly due to sleep disturbance),
and difficulty keeping up with peers in physicalactivities.
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The presence of risk factors, such as a historyof other allergic
conditions, parental asthma,and/or symptoms apart from colds,
supports
the diagnosis of asthma.
The chest examination is often normal.
In clinic, quick resolution (within 10 min) orconvincing
improvement in symptoms andsigns of asthma with administration of
ashort-acting inhaled beta-agonist (SABA) issupportive of the
diagnosis of asthma.
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Pulmonary Function Tests
Spirometry measures airflow limitation
Generally, an FEV1/FVC ratio
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Chest Radiographs
(posteroanterior and lateral views) in children
with asthma often appear to be normal, asidefrom subtle and
nonspecific findings of
hyperinflation (flattening of the diaphragms)
and peribronchial thickening.
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ELIMINATE OR REDUCE PROBLEMATICENVIRONMENTAL EXPOSURES
Environmental tobacco smoke elimination or reduction
In home and automobiles
Allergen exposure elimination or reduction in
sensitizedasthmatics
Animal danders Pets (cats, dogs, rodents, birds)
Pests (mice, rats)
Dust mites Cockroaches Molds Other airway irritants Wood-
or coal-burning smoke Strong chemical odors and perfumes(e.g.,
household cleaners) Dusts TREAT CO-MORBIDCONDITIONS Rhinitis
Sinusitis Gastroesophageal refluxANNUAL INFLUENZA VACCINATION
(UNLESS EGG-ALLERGIC
