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Sample Topic: Asthma

Asthma : Last revised in December 2013


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

  • Features that increase the probability of asthma in children include:
    • More than one of the following symptoms: wheeze, cough, difficulty breathing, chest tightness. Such symptoms particularly indicate asthma if they:
      • Are frequent and recurrent.
      • Are worse at night and in the early morning.
      • Occur in response to, or are worse after, exercise or other triggers such as exposure to pets, cold or damp air, or with emotions or laughter.
      • Occur even when the person has not got a cold (coryzal illness).
    • Personal history of another atopic disorder (hayfever, eczema).
    • 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.
      • This short video demonstrates the signs of expiratory wheeze, cough and intercostal recession associated with an acute episode of asthma in a 5 year old child.
        This short video demonstrates the signs of expiratory wheeze, cough and intercostal recession associated with an acute episode of asthma in a 5 year old child.
    • Prolonged expiration.
    • Increased respiratory rate.
This short video demonstrates the signs of increased respiratory rate (tachypnoea), intercostal recession and increased use of abdominal muscles associated with an acute episode of asthma in a 4 year old child.
This short video demonstrates the signs of increased respiratory rate (tachypnoea), intercostal recession and increased use of abdominal muscles associated with an acute episode of asthma in a 4 year old child.
  • Features that lower the probability of asthma in children include:
    • Symptoms with colds (coryzal illness) only.
    • Isolated cough in the absence of wheeze or difficulty breathing.
    • History of moist cough.
    • Prominent dizziness, light-headedness, peripheral tingling.
    • Clinical features pointing to an alternative diagnosis.
    • Repeatedly normal physical examination of the chest when symptomatic.