Asthma Differentials

Question 1

NICE Asthma Differentials:

breathlessness, dizziness, lightheadedness, and peripheral tingling; may be associated with anxiety

Answer 1

BPD
Panic Attack

Question 2

NICE Asthma Differentials:

persistent productive cough, copious sputum, recurrent lower respiratory tract infections, a history of childhood pneumonia, finger clubbing, and focal chest signs

Answer 2

Bronchiectasis

Question 3

NICE Asthma Differentials:

infants with a history of preterm delivery and symptoms present since birth

Answer 3

Chronic lung disease of prematurity/bronchopulmonary dysplasia

Question 4

NICE Asthma Differentials:

symptom-onset of more than 35 years; significant smoking history (more than 30 pack-years) or noxious exposure; and airflow obstruction on lung function testing

Answer 4

COPD

Question 5

NICE Asthma Differentials:

blocked nose, throat clearing, sneezing, itching, and associated symptoms of chronic sinusitis or allergic rhinitis

Answer 5

Chronic upper airway cough syndrome (‘post-nasal drip’)

Question 6

NICE Asthma Differentials:

cardiac murmur; cyanosis when eating; and faltering growth in a child

Answer 6

Congenital Heart Disease

Question 7

NICE Asthma Differentials:

moist cough/mucus production and gastrointestinal symptoms that are present from birth, recurrent lower respiratory tract infections, finger clubbing, and faltering growth; may have a family history

Answer 7

CF

Question 8

NICE Asthma Differentials:

predominant cough, postural and food-related symptoms, persistent vomiting, and faltering growth.

Answer 8

GORD

Question 9

NICE Asthma Differentials:

adult-onset asthma symptoms, nasal polyps, and allergic rhinitis before progression to a marked blood eosinophilia and multi-organ vasculitis

Answer 9

Eosinophilic granulomatosis with polyangiitis

Question 10

NICE Asthma Differentials:

breathlessness on exertion, orthopnoea, postural nocturnal dyspnoea, peripheral oedema, a history of heart disease, and fine lung crepitations

Answer 10

Heart failure

Question 11

NICE Asthma Differentials:

breathlessness, inspiratory wheeze (stridor); symptoms present in adolescents and young adults.

Answer 11

ILO

Question 12

NICE Asthma Differentials:

clinical features may include a dry cough and crackles; weight loss and systemic symptoms.

Answer 12

Interstitial lung disease (asbestosis, pneumoconiosis, fibrosing alveolitis, and sarcoidosis)

Question 13

NICE Asthma Differentials:

sudden-onset cough, stridor, unilateral wheeze, or reduced or diminished breath sounds;

Answer 13

Inhaled foreign body

Question 14

NICE Asthma Differentials:

persistent cough, haemoptysis, weight loss, systemic symptoms, persistent hoarseness, history of current or previous smoking.

Answer 14

Lung cancer

Question 15

NICE Asthma Differentials:

paroxysmal coughing bouts leading to vomiting, or an inspiratory whoop (especially in children, may be absent in infants). Occasionally the cough may persist for several months. Absence of lung function abnormalities.

Answer 15

Pertussis

Question 16

NICE Asthma Differentials:

recurrent lower respiratory tract infections, productive cough, chronic ear infections and/or rhinosinusitis in children; and situs inversus (in about 50% of affected children).

Answer 16

Primary ciliary dyskinesis

Question 17

NICE Asthma Differentials:

persistent cough following a respiratory infection.

Answer 17

Post-infectious cough

Question 18

NICE Asthma Differentials:

cute-onset breathlessness, pleuritic pain, haemoptysis, crackles, and sinus tachycardia.

Answer 18

PE

Question 19

NICE Asthma Differentials:

cough and coryzal symptoms for less than 10 days, asymptomatic between viral infections.

Answer 19

Recurrent viral respiratory tract infections

Question 20

NICE Asthma Differentials:

persistent productive cough, breathlessness, weight loss, haemoptysis, fatigue, fever, night sweats, and focal chest signs.

Answer 20

TB

Question 21

NICE Asthma Differentials:

may present with recurrent ‘asthma exacerbations’ without objective confirmatory evidence

Answer 21

Vocal cord dysfunction