LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Neumología Pediátrica. Anexos ❚ 117 14. Know that increased biomarkers of eosinophilic airway inflammation, such as eosinophil major basic protein and exhaled nitric oxide correlate with the degree of bronchial hyperresponsiveness 15. Understand the role of lymphocytes and their products in the pathogenesis of asthma 4. Diagnosis and clinical manifestations a. History 1. Know the conditions that cause symptoms and findings that may be confused with asthma (eg, laryngomalacia, tracheomalacia, laryngeal web, tracheostenosis, and vascular rings) 2. Understand that the possibility of foreign body aspiration must be considered in a young patient who has an abrupt onset of wheezing 3. Know that cough may be the only symptom of asthma in childhood 4. Know that the use of aspirin may induce asthma in the context of the aspirin triad (nasal polyposis, asthma, and aspirin hypersensitivity) 5. Know the history that suggests that allergy is contributing to asthma 6. Know the history and findings that suggest that gastroesophageal reflux is contributing to asthma 7. Know that chronic sinus disease is associated with nocturnal cough and worsening of asthma symptoms 8. Know that asthma can accompany other forms of obstructive lung disease 9. Recognize the clinical presentation of exercise-induced asthma 10. Recognize the clinical presentation of vocal cord dysfunction mimicking and/or complicating asthma b. Physical examination 1. Know that the use of accessory muscles of respiration indicates a moderate to severe acute asthma attack 2. Know that clubbing is rarely seen in patients with asthma 3. Know the definition and significance of pulsus paradoxus in patients with asthma 4. Know that the absence of wheezing in an acute asthma exacerbation with increased work of breathing indicates moderate to severe airway obstruction 5. Describe the physical findings of allergy in an asthmatic patient c. Imaging 1. Recognize the indications for x-ray study of the chest in a patient with acute asthma 2. Recognize typical findings on an x-ray study of the chest in a patient with asthma d. Pulmonary function tests 1. Know the changes in pulmonary function during recovery from status asthmaticus 2. Recognize the changes in pulmonary function associated with acute asthma 3. Understand that lung function in a child with mild asthma is usually normal between attacks 4. Know that mean pleural pressure is markedly subatmospheric during inspiration in patients with status asthmaticus