A 4 year child with bronchial asthma presents history of with and 3 and more episodes during daytime in a week and 2 wheezing episodes during night in a month. How will you grade this asthma?
Ref: Nelson's Textbook of Pediatrics. 19th Edition, Page: 790.Explanation:This is a straightforward question to assess whether you know the recent NAEPP classification of chronic asthma (2007).Be aware that there are some changes to the previous classification (2002). Latest edition of Nelson gives the most recent classification (2007) and the same is given below. (See table on below) National Asthma Education and Prevention Program (NAEPP) Classification of asthmaCOMPONENTS OFCLASSIFICATION OF ASTHMA SEVERITYSEVERITYMild IntermittentMild PersistentModerate PersistentSeverePersistentImpairment Daytime symptoms< 2 days/wk>2 days/wk but not dailyDailyThroughout the dayNighttime awakenings* Age 0-4 yr * Age >5 yr 0<2 x/month1-2x/mo3-4x/mo3-4x/mo>1x/wk but not nightly>1x/wkOften 7x/wkShort-acting b2-agonist use forsymptoms<2 days/wk>2 days/wk but not daily, and not more than 1 x on any dayDailySeveral times per dayInterference with normal activityNoneMinor limitationSome limitationExtremelimitationLung function: FEV1 % predictedage >5 yrNormal FEV1betweenexacerbations >80%predicted 60- 80% predicted <60%predicted >80%predictedFEV1/FVC ratio* Age 5- 11 yr* Age 2 yrRisk >85%Normal>80%Normal75-80% Reduced 5%<75%Reduced >5%Exacerbations requiring systemic corticosteroids:* Age 0-4 yr0-1/yr> 2 exacerbations in 6 mo requiring systemic corticosteroids or> 4 wheezing episodes/yr lasting >1 day and risk factors for persistent asthma* Age > 5 yr0-1/yr> 2;yr
Mild Persistent
Moderate Persistent
Severe Persistent
Mild intermittent
Disorders of the Respiratory Tract