Bronchial Asthma inA Childhood : Case Based Learning

Question 1
A 5 year old child has had recurrent episodes of cough and wheezing since the
age of 1 year.
1. What further history would be useful in the evaluation of this child.
2. What differential diagnoses would you consider in this child.
3. Discuss the factors that would support a high probability of Asthma in
pre-school children.
4. Describe the Classical Clinical features of BA.
5. Describe the pathological changes that occur in the airways of a child
with bronchial asthma.
6. Discuss the pathophysiology of Bronchial asthma in childhood.
7. What are the common triggers for acute exacerbations in Bronchial
asthma.
8. What are some factors to consider in the prevention of Bronchial asthma
in childhood

Question 2
A 7 year old boy, who is a known case of Bronchial Asthma (BA), is brought to
the Accident and Emergency department in the early hours of the morning
with an episode of Acute Exacerbation of BA.
1. What history would you obtain from the parents to assess the severity of
the child’s AEBA.
2. What history would you obtain to assess the Level of Control of BA in
this chid.
3. Describe the assessment of the severity of his AEBA based on history
and physical examination.
4. Describe the classification of asthma control.
5. Discuss some physical examination findings of poorly controlled Chronic
asthma in this child.
The child was diagnosed to have a moderate AEBA
 6. List some immediate useful investigations that should be performed in
the child, with reasons.
7. Discuss the immediate management of this child.
8. What are some therapies that are not recommended in the
management of AEBA.
9. Discuss the criteria for admission to the ward.
The child was admitted to the ward and discharged after 1 week.
10. What would be the Goals of Long-term asthma management in this
child.
11. Discuss medication that would be considered for Chronic asthma
management in this child and devices may need to be used.
12. What would be the asthma action plan for this child.
The child was planned for Follow up in the Paediatric Clinic 2 months after
discharge.
13. What parameters should be monitored during follow up in the clinic.
14. Discuss Patient / Parent Education that should be given during follow up
in the clinic.