(Peri-Op & Anaesthesia) (GP)

Overview

• Chronic inflammatory disease of the respiratory system characterized by bronchial hyperresponsiveness, episodic acute asthma exacerbations, and reversible airflow obstruction
• Allergic Asthma → most common type of asthma, begins with symptoms in childhood and is usually associated with atopy (eg. eczema, allergic rhinitis)
• M>F in patients <18 years
• Risk Factors → FH of asthma, exposure to allergens (dust mites, pets), history of atopic diseases (eczema and allergic rhinitis), low socioeconomic status
• Pathophysiology of Allergic Asthma ⇒ IgE-mediated type 1 hypersensitivity leading to mast cell degranulation and release of histamine. 3 main pathological processes include bronchial hyperresponsiveness, bronchial inflammation and endobronchial obstruction

Making Diagnosis

Clinical Features:

• Persistent, dry cough → worse at night, with exercise, or on exposure to irritants (eg. cold air, allergens, smoke)

• End-Expiratory Wheeze

• SOB (Dyspnoea)

• Chest Tightness

• Symptoms may worsen after NSAID use

• O/E → prolonged expiratory phase on auscultation, hyperresonance to lung percussion

  <aside> 💡 Key in Hx ⇒ Comes and goes in response to triggers

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• Moderate vs Severe vs Life Threatening Acute Attack