Asthma
Pulmonary · ~9% of blueprint- Pathophysiology
- Airway inflammation + bronchial hyperresponsiveness → reversible bronchoconstriction, mucus, and edema.
- Signs & Symptoms
- Episodic wheeze, cough, chest tightness, dyspnea; worse at night/with triggers; prolonged expiration.
- Gold Standard Diagnosis
- Spirometry: obstructive pattern (↓ FEV1/FVC) with post-bronchodilator FEV1 or FVC rise ≥12% AND ≥200 mL (adults).
- First-line Treatment
- Inhaled corticosteroid (ICS) is the controller foundation; current guidelines favor as-needed ICS-formoterol (SMART) as the preferred reliever over a SABA alone. Step up controller therapy (add LABA) by symptom control.
High-Yield Pearl
Degree of reversibility does not reliably separate asthma from COPD. Every asthmatic needs ICS-containing therapy — guidelines now favor ICS-formoterol as reliever, not SABA monotherapy.
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Sources
Reviewed September 2026- Global Strategy for Asthma Management and Prevention, Updated 2026 — Global Initiative for Asthma (GINA), 2026
- 2020 Focused Updates to the Asthma Management Guidelines — National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group (NHLBI), 2020
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