Asthma is a common lung disorder in which inflammation causes the bronchi to swell and narrow the airways (bronchospasm). History and physical are important, not only for making the diagnosis but also to help guide classification which is essential for the management plan.
Notes: FEV6 (volume after 6 seconds) can be considered rather than FVC in adults for whom full exhalation may take several seconds and be associated with light headedness | There are contraindications to spirometry (e.g., unstable cardiac disease or recent MI, aneurysms, recent thoracic or abdominal surgery, active viral infection, unexplained hypertension) | pre and post bronchodilator testing may be done in pulmonologist practice)
While targeted questions and examination are helpful, a good overall history and physical remain important to identify co-morbidities (e.g., sinusitis, rhinitis, GERD, other respiratory disorders, obstructive sleep apnea). It is also important to remain cognizant that multiple external factors can trigger an attack, including respiratory infections, smoking, allergies, exposure to cold or humid air, pollution, exercise, severe emotional and/or physical stress. Spirometry is currently the primary diagnostic tool for asthma.
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