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

Zab Mosenifar, MD

Disclosures

June 04, 2019

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.

Clubbing of the fingers is not a feature of asthma and indicates a need for more extensive evaluation and workup to exclude other conditions, such as cystic fibrosis.

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.

For more on the clinical presentation of asthma, read here and here.

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