Pediatric Asthma - CRASH! Medical Review Series

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(Disclaimer: The medical information contained herein is intended for physician medical licensing exam review purposes only, and are not intended for diagnosis of any illness. If you think you may be suffering from any medical condition, you should consult your physician or seek immediate medical attention.)

[@woloabel]

Pediatrics: Pediatric Asthma (Hypersensitivity Reaction Type I) is a Chronic Inflammatory (Infiltration Disease Category) Disease of Idiopathic Aetiology but is known to be cause (Associations) by Environmental Triggers/Allergens and also has a genetic Component (Multigenic Association and Autoimmune Disease Proclivity). Pathophysiology is Reversible Obstruction of the Airways (COPD Differential) due to Bronchoconstriction, otherwise Bronchial Hyperreactivity. SSx: 1) Wheezing, 2) Night Cough or General Cough, 3) Dyspnea (Shortness of Breath), 4) Chest Tightness, 5) Upper Respiratory Tract Infections Association/History. Asthma Subtype Context: 1) Exercise-Induced Bronchospasms or 2) Nocturnal Asthma. Full Allergy History attending Possible Allergen Triggers (Home Environment, Pets, Seasonal Allergies, Occupational Exposures (Adult Asthma Type), Etc). Manifestations Category: 1) Intermittent/Mild Episodes, 2) Moderately Severe Episodes, marked by Accessory Muscle of Respiration (AROMs) use 3) Severe Episode where Saturation is less than 91% on Room Air. Agitation and a Tripod Position is Common. 4) Imminent Respiratory Arrest has Signs of Confusion and Exhaustion, Somnolence, Fatigue ( due to Hypoxia). Shallow and slow Respiration Rate (Apnea). Diaphoresis is indicative of Decompensation/Shock. Breathing Sounds will Decrease and Pulsus Paradoxus Decrease (20-40mmHg to Absent). Normal Vital Sign Parameters are Based on Age and such should apply. In Asthma, the Forced Expiratory Volume in One Second (FEV1) is Reduced (Below Eighty (80) and is Pathognomonic (Spirometry, Pulmonary Function Test) and severe Asthma if symptoms are below 60 (Status Asthmaticus); Forced Vital Capacity is Normal or Decreased. The Administration thereafter of a Bronchodilator a 12% Increase of FEV1 is Indicative of Asthma. A Methacholine Challenge can also be performed when Spirometry is Normal. Short Acting Beta Agonist (SABA) and Inhaled Corticosteroids (ICS) are the starting Treatment Pharmacotherapies. Long Acting Beta Agonists (LABA) and PO Corticosteroids for more Severe Manifestations of the Disease. Adjunct Therapy with Montelukast (Leukotriene Receptor Antagonists Drug Class) or Cromolyn (Mast Cell Stabilizers) for Infants for Suboptimal Delivery with ICS. Theophylline (Pediatric CI, Xanthines Drug Class), Salmeterol, a Beta 2-Adrenergic Agonist Agents, (In Infants of 4 Years or less), and Budesonide, a Glucocorticoid Drug Class (Less than 1y) are Contraindicated. PO Corticosteroids (Glucocorticoids) are useful in Subjects with Viral Respiratory Tract Exacerbation. Peak Respiratory Flow Diary is also useful to Monitor Progress and lastly Patient/Subject should be Reevaluated Periodically. Prognosis: Pediatric Patients with Mild Asthma can become Symptom Free with Age while Infants # Of Age have a Poor Course of Disease (unless Associated with Infection). There is a Mortality Rate of 5k Per Anuum in the United States (17/Million). Blacks (African American Stock) and Hispanics are more likely to die than Whites. Goodness, Asthma is indeed a dreadful Immunology. I have a girlfriend Physician who has Asthma (Exercise-Induced) as is currently heading my primary Indication well: Harmonize the Environment! She is ironically a Pulmonologist/Critical Care Specialist. Just kidding. She is a Tuber. MD Paul Bolin, es geht gut zu immer verluften Leben und Lieben. Prost!

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[@HafizahHoshni]

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[@drbabe2544]

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[@richardfriedel2248]

To cure asthma with acupressure: 1) Press lip with a finger and note how inhaling through your nose is facilitated 2) Make a habit of breathing in with lip pressure to stop asthma. A Google search for asthma pressure points shows points on lips. Asthma causes airway remodeling but this is cured in time by correct breathing. That is my experience. Medical treatment is unscientific because of the asthma paradox meaning that more drug treatment means more asthma and turning a blind eye to acupressure.