Hi, this is Tom, and in this episode I'm going to go through asthma in children,

and you can find notes at 0.0.5.com or in the 0 to Finals Pediatrics book,

and you can find flashcards and questions to train your knowledge at members.0tofin5.com. And if you stick around at the end of

the episode, we'll go through some questions to test yourself on what you just heard. So let's jump

straight in. Asthma is a chronic inflammatory airway disease that leads to variable airway obstruction.

The smooth muscle in the airways is hypersensitive and it responds to stimuli by constricting,

which narrows the space for air to flow through.

This bronco-constriction is reversible with bronchodilators such as inhaled salbutamol.

Asthma is one of the atopic conditions which also include exmer, allergic rhinitis or hay fever,

and food allergies.

Patients who have one of these atopic conditions are more likely to have others.

Atopic conditions characteristically run in families, so you may find a family history where their mother or father or grandfather or someone else in the family is also affected.

Acute asthma exacerbations involve rapidly worsening symptoms that can become quickly life-threatening.

Let's go through the presentation.

The symptoms of asthma are episodic, which means that there are periods where

the symptoms are worse and periods where the symptoms are better. There is diurnal variation,

meaning that the symptoms fluctuate at different times of the day, typically worse at night.

Typical symptoms are shortness of breath, chest tightness, dry cough and wheeze.

The symptoms should improve with bronchodilators like salbutamol.

No response to bronchodilators reduces the probability that this is asthma, and an alternative

diagnosis should be considered.

Examination is generally normal when the patient is well.

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