Asthma in adults -evaluation

There is no consensus on definition of asthma. It can be stated that asthma represents an umbrella term for several diseases with similar clinical manifestations but different underlying pathophysiological mechanisms often referred to as asthma endotypes.GINA ( Global initiative for asthma ) in 2015 described asthma as a heterogeneous disease , usually characterized by chronic airway inflammation . It is defined by the h/o resp symptoms such as wheeze , shortness of breath , chest tightness and cough that vary over time and in intensity , together with variable expiratory airflow limitation.

Terminology - Severe asthma -is defined as asthma which requires treatment with high dose of inhaled corticosteroid ( ICS ) plus a second controller ( and or systemic corticosteroids ) to prevent it from being uncontrolled or which remains uncontrolled despite this therapy Problematic severe asthma ( PSA ) is described by Bush et al as asthma in children who require specialist referral because of the apparent poor reponse to maximum asthma treatment. This is further broadly divided into(1 ) Difficult to treat ( or difficult ) asthma ( DA )( 2) Asthma with co-morbidities ( Asthma plus )(3 ) Severe therapy resistant asthma Thunderstorm asthma - epidemics...