Fast Five Quiz: How Much Do You Know About Allergic Asthma?

Zab Mosenifar, MD

Disclosures

February 09, 2022

Figure 2. A woman with allergies begins to sneeze.

Signs of atopy or allergic rhinitis, such as conjunctival congestion and inflammation, ocular shiners, a transverse crease on the nose due to constant rubbing associated with allergic rhinitis, and pale violaceous nasal mucosa due to allergic rhinitis, may be present in the absence of an acute episode, such as during an outpatient visit between acute episodes. Turbinates may be erythematous or boggy. Polyps may be present. Skin examination may reveal atopic dermatitis, eczema, or other manifestations of allergic skin conditions.

Cervical or supraclavicular adenopathy would suggest malignancy, sarcoidosis, or infection.

Wheezing heard only or mostly over the neck may suggest vocal cord dysfunction or other laryngeal abnormality, although vocal cord dysfunction can be present without a localizing wheeze.

Increased jugular venous distension may point to an alternative explanation, such as heart failure, for the patient's dyspnea and wheezing. Patients with status asthmaticus may have a pulsus paradoxus greater than 10 mm Hg. A murmur, S3 gallop, or rub suggests a cardiac problem and not asthma.

Learn more about the clinical presentation of asthma.

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