Wheeze

Question 1

What should you consider before a diagnosis of asthma in a child under 5-years old?

Answer 1

Pre-school wheeze

Question 2

What should you ask about in a history of wheeze in a child?

Answer 2

1. When? Diurnal variation? Cough? Triggers?
2. Interval symptoms?
3. Offer peak flow diary

Question 3

What would make you suspect a diagnosis of an episodic viral wheeze instead of asthma?

Answer 3

Wheezing with a viral URTI, symptom free in between episodes, lack of atopy family history.

Question 4

What is the difference in blood results between episodic viral wheeze and asthma?

Answer 4

1. Episodic viral wheeze - neutrophilic picture

2. Asthma - eosinophilic picture

Question 5

What is the treatment for episodic viral wheeze?

Answer 5

SABA/SAMA via a spacer, add on intermittent ICS/LTRA.

Question 6

What is a multiple trigger wheeze and what is the treatment for it?

Answer 6

1. Many triggers produce symptoms (URTI, smoke, exercise, allergens)
2. LTRA/ICS