Asthma

1. Describe the elements of history which would support the presence of asthma in a patient presenting with wheezing.

2. "All that wheezes is not asthma." List the differential diagnosis of a wheezing patient.

3. Describe those features of the physical examination, peak flow testing and arterial blood gas that characterize mild and severe asthma.

4. List non-pharmacologic measures which may be useful in the management of asthma.

5. In the outpatient management of asthma:

A. Describe, in general, the indications and side effects associated with beta-adrenergic agonist, theophylline, cromolyn, corticosteriods and atropine.

B. List the therapeutic options and precautions which are taken to reduce the side effects of the above drugs.

C. Which medications should be avoided in asthma patients?

6. Describe the differences in the approach to asthma in children and adults.

7. When is allergy testing appropriate in the evaluation of asthma?

8. Describe an approach to treating exercise induced asthma.

Sources:

Family Medicine:  Ambulatory Care and Prevention, Chapter 65, Pages 396-400; Chapter 68, Pages 415-423

Essentials of Family Medicine, Chapter 49, Pages 745-768

Reading Resources:

"Asthma Update: Part I - Diagnosis, Monitoring and Prevention of Disease Progression" Matthew Mintz, M.D., The George Washington University School of Medicine and Health Sciences, Washington, DC., American Family Physician, September 1, 2004.

"Asthma Update: Part II - Medical Management" Matthew Mintz, M.D., The George Washington University School of Medicine and Health Sciences, Washington, DC., American Family Physician, September 15, 2004.

"Childhood Asthma: Treatment Update" A. Ursulla Courtney, M.D., Daniel F. McCarter, M.D. and Susan M. Pollart, M.D., University of Virginia Health System, Charlottesville, VA, American Family Physician, May 15, 2005.