Asthma Questions & Answers

Updated: Oct 24, 2018
  • Author: Michael J Morris, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Questions & Answers

Overview

What is asthma, and what is the prevalence of asthma in the US?

Which signs and symptoms are associated with asthma?

What criteria is used to establish a diagnosis of asthma?

Which tests are primarily performed to establish an asthma diagnosis?

What are the goals of asthma management?

Which medications are used in the treatment of asthma and how are they managed?

How do allergens play a role in asthma management?

What is the prevalence of asthma in the US?

Which pathologic features are involved in the pathophysiology of asthma?

How is the clinical severity of asthma determined?

Which tests are performed in the initial stages of asthma diagnosis?

How is the severity of asthma classified based on physical findings?

Which control agents and relief medications are used in the management of asthma, and how are they used?

What is the anatomical structure of the airways of the lungs?

What are the cellular elements of the airways of the lungs, and which dysfunction leads to bronchial asthma?

Which features are the main components of asthma pathophysiology?

What are the categories of airway inflammation in asthma, and what physiologic features contribute to airflow obstruction?

Which types of cells are involved in airway inflammation associated with asthma?

What mechanisms are involved in airway hyperresponsiveness and bronchial hyperreactivity associated with asthma?

What is the role of chronic inflammation in asthma, and which common symptoms result from inflammation?

What is the role of Th lymphocytes in airway inflammation associated with asthma?

What is the "hygiene hypothesis" and how does it relate to asthma?

What factors contribute to the different types of airflow obstruction in asthma?

How does airway obstruction in asthma affect the ability to breathe?

What is ventilation-perfusion mismatch, and how does it manifest in the early and late stages of asthma?

What factors may contribute to asthma?

What is the triad of asthma, aspirin sensitivity, and nasal polyps?

What are the treatment options for aspirin-induced asthma?

What is the role of gastroesophageal reflux (GERD) in asthma?

What is the role of occupational factors in the development of asthma?

What are the features asthma types associated with occupational factors?

How does exposure to respiratory virus in infancy relate to the incidence and severity of childhood asthma?

How does sinusitis exacerbate symptoms of asthma?

What is exercise-induced asthma (EIA)?

What factors contribute to exercise-induced bronchoconstriction (EIB) symptoms?

Which age groups are most affected by exercise-induced bronchoconstriction (EIB)?

What role do genetics play in the susceptibility to asthma?

How do genetics and environmental factors influence a child’s susceptibility to asthma?

How is obesity associated with a child's risk of asthma?

What is the worldwide prevalence of asthma?

How do race and environmental factors play a role in the incidence of asthma?

Which countries have the highest prevalence of asthma, and what factors are thought to contribute?

Is asthma more common in males or females?

Which age groups have the highest prevalence of asthma?

What is the asthma mortality rate, and what factors contribute to asthma-related death?

What is the average annual cost of asthma due to lost productivity and healthcare expenditures?

What percentage of children diagnosed with asthma will require less or no treatment by early adulthood?

What are the negative outcomes of poorly controlled asthma?

What are the key elements of patient education about asthma?

What effect does school-based asthma education have on the course of asthma in children?

Who should be provided with patient education for asthma?

What asthma education resources are available?

Presentation

What are the key elements of a thorough assessment in suspected or diagnosed asthma?

What is the role of wheezing in the assessment of asthma?

What is the role of coughing in the assessment of asthma?

Which chronic or recurrent conditions in children are associated with asthma?

What are the typical symptoms of exercise-induced bronchoconstriction (EIB) (exercise-induced asthma [EIA])?

Which findings are essential to a diagnosis of asthma?

How are the different severities of acute asthma episodes classified?

Which physical findings are associated with an acute asthma episode?

Which physical findings are associated with a moderately severe asthma episode?

Which physical findings are associated with a severe asthma episode?

Which physical findings are associated with a child in imminent respiratory arrest?

Which respiratory and dermatologic findings may be seen between acute episodes of asthma?

Which nocturnal symptoms are associated with asthma?

When is bronchoconstriction most common in asthma?

How is the severity of asthma classified?

Which characteristics of asthma are required to diagnose severe asthma?

DDX

What is vocal cord dysfunction, and what is its relationship to asthma?

What are the similarities of airway tumors and asthma?

What types of tracheal lesions manifest with symptoms associated with asthma?

How is foreign body aspiration presentation similar to asthma presentation?

What is pulmonary migraine and how is it associated with asthma?

How does congestive heart failure manifest with symptoms associated with asthma?

How is diffuse panbronchiolitis differentiated from asthma?

How are aortic arch anomalies differentiated from asthma?

Which symptoms of sinus disease are also associated with asthma?

What is the relationship between gastroesophageal reflux (GER) and asthma?

Which conditions may be mistaken for asthma?

Which factor distinguishes COPD from asthma?

When should alternative diagnoses be considered for patients presenting with symptoms of asthma?

What are the differential diagnoses for Asthma?

Workup

Which lab studies are indicated in the assessment and diagnosis of asthma?

What is the role of blood eosinophilia in the diagnosis of asthma?

How is sputum eosinophilia used to assess asthma control and guide therapy?

What is the role of serum immunoglobulin E levels in the diagnosis of asthma?

What is the role of arterial blood gas (ABG) measurement in the diagnosis of asthma, and when is an ABG measurement indicated?

What is the role of PCO2 measurement in the evaluation of an acute asthma episode?

What is the role of periostin measurement in the management of asthma?

What is the purpose of pulse oximetry measurements in acute asthma?

How is pulse oximetry used to determine the severity of acute asthma in children?

What is the role of chest radiography in the initial evaluation of asthma symptoms?

What is the purpose of chest radiography in patients being evaluated for asthma?

When is chest radiography indicated in patients who present with symptoms of asthma?

When is chest CT scanning used in the evaluation of asthma symptoms?

Which high-resolution CT (HRCT) findings are associated with a diagnosis of bronchial asthma?

What is the role of ECG in severe asthma symptoms?

What is the role of MRI in the workup of patients presenting with symptoms of asthma?

What is the role of nuclear imaging in the evaluation of asthma?

What is the role of allergy skin testing and treatment in the management of asthma?

What is the role of spirometry in the diagnosis of asthma?

What is single-breath counting (SBC), and when is it useful in the diagnosis of asthma?

What is the role of bronchoprovocation testing in patients with asthma symptoms?

What is the role of methacholine in the workup of patients with asthma symptoms?

What is the role of eucapnic hyperventilation as a method of bronchoprovocation in asthma?

What is the role of exercise spirometry in the diagnosis of asthma, and how is it administered?

What is the role of allergen-inhalation challenges in the assessment of asthma symptoms?

What is the role of mannitol in the assessment of patients with symptoms of asthma?

What is the role of peak expiratory flow (PEF) measurement in the evaluation of asthma symptoms?

What is the role of impulse oscillometry (IOS) in the evaluation of asthma symptoms?

How is exhaled nitric oxide analysis used in the management of asthma?

What is the role of sinus CT scanning in the evaluation of asthma symptoms?

When is 24-hour pH monitoring used in the evaluation of asthma symptoms?

Which histologic findings are characteristic of asthma?

Treatment

What are the main elements of medical care in the treatment of asthma?

What is the ultimate goal of treatment in asthma?

What type of approach is used in asthma management?

What is the role of rapid-acting beta2 agonists in the treatment of asthma?

Which drug is the controller medication of choice for children and adults in the treatment of asthma?

How often should patients with asthma be assessed for asthma control, and which factors should be evaluated?

What is the role of school-based intervention in the management of asthma in adolescents?

What is the role of environmental exposures and irritants in the management of asthma symptoms?

What is the role of allergen avoidance in the long-term management of asthma?

What steps can a patient take to avoid allergens and reduce their asthma symptoms?

What is the impact of air pollution on symptoms of asthma?

What measures can be taken to avoid dust mites to help reduce symptoms of asthma?

Which interventions are the most effective approach to dust mite avoidance in the management of allergic rhinitis?

What are the effects of animal allergens and how are they best managed to improve symptoms of asthma?

How can patients reduce cockroach allergen levels to improve their asthma symptoms?

How can patients reduce indoor mold allergens to improve their asthma symptoms?

How can patients reduce exposure to pollen allergens to improve their asthma symptoms?

When is immunotherapy indicated in the treatment of asthma?

What evidence exists to support the use of immunotherapy in the treatment of asthma?

When is allergen immunotherapy indicated for the treatment of asthma?

Which referral is required to initiate allergen immunotherapy?

What precautions are taken during the administration of allergen immunotherapy in asthma?

How is dosing of an allergen extract measured in the treatment of asthma?

Is sublingual immunotherapy (SLIT) proven to improve symptoms of asthma?

What is the role of omalizumab in the treatment of asthma?

What are the outcomes of omalizumab therapy in the treatment of asthma?

What are the potential adverse effects of omalizumab therapy in the treatment of asthma?

What are the protocols and costs associated with omalizumab therapy in the treatment of asthma?

What are the benefits of omalizumab therapy in the treatment of asthma?

What is the mechanism of action of mepolizumab, and when is it indicated for the treatment of asthma?

What is the mechanism of action of reslizumab, and when is it indicated for the treatment of asthma?

What is the mechanism of action of benralizumab and dupilumab, and when are they indicated for the treatment of asthma?

What is bronchial thermoplasty?

Which short-term results and long-term outcomes are associated with bronchial thermoplasty in the treatment of asthma?

What is the role of inhaled corticosteroids in the treatment of acute asthma?

How is albuterol administered to patients with asthma?

Which side effects are associated with albuterol in the treatment of asthma?

Which alternative treatments are available for patients who respond poorly to inhaled beta-agonist therapy in the treatment of asthma?

When is ipratropium indicated in the treatment of acute asthma?

Which method of nebulizer therapy is recommended for severe exacerbations of asthma?

Have nebulizers been shown to be more effective than metered dose inhalers (MDIs) in the management of acute asthma?

Which adverse effects are associated with corticosteroid treatment in children with asthma?

Which complications are associated with long-term corticosteroid use in asthma?

What is the role of heliox in the treatment of asthma?

How is heliox administered to a patient in the treatment of asthma?

When is endotracheal intubation indicated in the treatment of severe asthma exacerbations?

When is hospitalization indicated for treatment of a patient with asthma?

When should a patient with asthma be admitted to the ICU?

When is an acute asthmatic episode considered an emergency?

How is asthma managed during pregnancy?

How is GERD managed in patients with asthma?

How is sinusitis treated in the setting of asthma?

How is nocturnal asthma managed?

What is the role of long-term monitoring in the management of asthma?

Which assessments can be used to determine a patient’s response to treatment for asthma?

Which assessments should be included in a preoperative workup for asthma?

What are the general recommendations regarding activity for patients with asthma?

What is the relationship between obesity and asthma?

Which dietary restrictions may be recommended for patients with asthma?

When should patients with asthma be referred for additional consultations?

How can patients manage factors that contribute to their asthma symptoms?

Guidelines

What are the classification guidelines of asthma?

What is the difference between severe asthma and uncontrolled asthma according to the guidelines?

What are the overall goals of asthma management according to the guidelines?

What are the features of each step in a stepwise approach to pharmacotherapy in the treatment of asthma according to the guidelines?

What are recommended treatment guidelines for severe asthma?

What are recommended treatment guidelines for exercise-induced bronchoconstriction (EIB) (exercise-induced asthma)?

Medications

How are asthma medications categorized?

What randomized, controlled trials have been conducted on the use of inhaled corticosteroids in the treatment of asthma?

Which medications in the drug class Beta2-adrenergic agonist agents are used in the treatment of Asthma?

Which medications in the drug class Anticholinergic Agents are used in the treatment of Asthma?

Which medications in the drug class Anticholinergic agent combinations are used in the treatment of Asthma?

Which medications in the drug class Corticosteroid, oral are used in the treatment of Asthma?

Which medications in the drug class Long-acting beta2 agonists are used in the treatment of Asthma?

Which medications in the drug class Beta2-Agonist/Corticosteroid Combinations are used in the treatment of Asthma?

Which medications in the drug class Methylxanthines are used in the treatment of Asthma?

Which medications in the drug class Mast cell stabilizers are used in the treatment of Asthma?

Which medications in the drug class Corticosteroid, Inhalant are used in the treatment of Asthma?

Which medications in the drug class Leukotriene Receptor Antagonist are used in the treatment of Asthma?

Which medications in the drug class Monoclonal Antibodies, Anti-asthmatics are used in the treatment of Asthma?