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Sample Topic: Asthma

Asthma : Last revised in December 2013

What features increase or decrease the probability of asthma in adults?

  • Features that increase the probability of asthma in adults include:
    • More than one of the following symptoms: wheeze, breathlessness, chest tightness, and cough, particularly if they:
      • Are worse at night and in the early morning.
      • Occur in response to exercise, allergen exposure, and cold air.
      • Occur after taking aspirin or beta-blockers.
    • History of atopic disorder.
    • Family history of asthma and/or atopic disorder.
    • Widespread wheeze (bilateral, predominantly expiratory).
      • The absence of wheeze does not rule out asthma. In severe cases, chest wall movement may be reduced on both sides, and wheeze may not be audible.
    • Prolonged expiration.
    • Increased respiratory rate.
  • Features that lower the probability of asthma in adults include:
    • Prominent dizziness, light-headedness, peripheral tingling.
    • Chronic productive cough in the absence of wheeze or breathlessness.
    • Voice disturbance.
    • Symptoms with colds only.
    • Significant smoking history (greater than 20 pack-years).
    • Cardiac disease.
    • Repeatedly normal physical examination of the chest when symptomatic.
    • Clinical features of an alternative diagnosis.