Asthma

Published on 31/05/2015 by admin

Filed under Obstetrics & Gynecology

Last modified 31/05/2015

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Chapter 14 Asthma

INTRODUCTION

Description: Asthma is an intermittent or chronic obstructive tracheobronchial condition characterized by wheezing or cough. Adult-onset asthma is more common in women and poses potential problems during pregnancy.
Prevalence: Ten percent of the population.
Predominant Age: Adult ages 16 to 40 years (50% of patients are younger than age 10).
Genetics: Familial association with reactive airway disease, ectopic dermatitis, and allergic rhinitis.

ETIOLOGY AND PATHOGENESIS

Causes: Allergic factors (airborne pollens, molds, house dust, animal dander, feather pillows; a 2004 study showed that 71% had more than one allergy and 42% had more than three allergies), smoke or pollutants, viral upper-respiratory infections, aspirin or nonsteroidal antiinflammatory agents, exercise, gastrointestinal reflux.
Risk Factors: Family history, viral pneumonitis in infancy.

CLINICAL CHARACTERISTICS

Signs and Symptoms

• Shortness of breath
• Wheezing and coughing (one or both)
• Prolonged exhalation
• Decreased breath sounds, hyperresonant chest
• Periodic (especially nocturnal) attacks
• Cyanosis and tachycardia
• Pulsus paradoxus, accessory muscle use for breathing, flattened diaphragm on chest radiograph or physical examination

DIAGNOSTIC APPROACH

Differential Diagnosis

• Recurrent pneumonia
• Chronic bronchitis
• Viral or fungal infection
• Aspiration (foreign body)
• Cystic fibrosis
• Tuberculosis
• Mitral valve prolapse
• Congestive heart failure
• Chronic obstructive pulmonary disease

Associated Conditions: Reflux esophagitis, sinusitis.

Workup and Evaluation

Laboratory: Complete blood count, arterial blood gases (severe cases).
Imaging: No imaging indicated. (Chest radiograph shows hyperinflation, atelectasis, or air leak, but it is nonspecific.)
Special Tests:

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