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25min module
Diagnosis of Asthma
with Dr Stephen Gaduzo
This module provides an overview of the diagnosis of asthma, including:
- diagnostic algorithms for asthma,
- spirometry and airflow obstruction, and
- challenge and FeNO testing
No advice given in this module is intended to be a substitute for your own professional judgment in the clinical management of your patients.
Let's get started
Click to play. You can also expand the video to full screen. When prompted, click Next to continue.
In adults with a history suggestive of asthma, the guidelines suggest diagnostic tests are performed in which order?
Blood eosinophils/FeNO - Spirometry with bronchodilator reversibility; Peak flow variability; Bronchial challenge tests
Blood eosinophils/FeNO - Spirometry with bronchodilator reversibility; Peak flow variability; Trial of treatment
Correct!
That’s correct! You’ve got the order for diagnostic testing spot on.
Incorrect!
Not quite. Trial of treatment is not one of the steps in the order of diagnostic tests set out in the guidelines.
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Now thinking about children 5 – 16, the guidelines suggest diagnostic tests are performed in which order?
FeNo - Spirometry with bronchodilator reversibility - Peak flow variability – Skin prick test / Bronchial challenge tests
FeNo - Spirometry with bronchodilator reversibility - Peak flow variability – Skin prick test / Total IgE and blood eosinophils
Correct!
You’ve got the order for diagnostic testing in children 5 – 16 spot on.
Incorrect!
Not quite. Bronchial challenge tests do not feature in the order of diagnostic tests for children 5 – 16, according to the guidelines.
Click to play. You can also expand the video to full screen. When prompted, click Next to continue.
What is the normal level of FeNO expected in adults?
100%
>80%
>70%
>50%
Correct!
That’s correct! Normal FeNo levels in adults without asthma is expected to be around 80%, with typically FEV1/FVC of <70% demonstrating obstructive airway disease.
Incorrect!
Not quite. Normal FeNo levels in adults without asthma is expected to be around 80%.
Click to play. You can also expand the video to full screen. When prompted, click Next to continue.
Which of the following is a ‘red flag’ indicating you should refer a patient to a specialist?
They need further tests which are not available through Primary Care
They’ve had a poor response to asthma treatment
The patient is anxious and requires reassurance
Your assessments show some unexpected clinical findings
Correct!
If your tests show something abnormal or unexpected, you may need to refer the patient to the necessary specialist.
Incorrect!
If your patient needs further tests that aren’t available through a Primary Care setting you should refer to a specialist, but it isn’t a red flag to suggest something more serious just yet. If your patient had a poor response to asthma treatment, this may require the help of a specialist to work on a different treatment plan, but it shouldn’t be a red flag at this stage. If your patient is anxious and requires reassurance, this isn’t a red flag that could suggest anything more serious, but it might be worth referring the patient for specialist advice to help combat their concerns.
Well done you have successfully completed this module
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