Alternative diagnoses in adults | Right Decisions

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Asthma pathway (BTS, NICE, SIGN) [SIGN 244]
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Alternative diagnoses in adults

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

This content is from the BTS/SIGN British guideline on the management of asthma (SIGN 158), 2019.

Clinical clue	Possible diagnosis
Without airflow obstruction
Predominant cough without lung function abnormalities	Chronic cough syndromes; pertussis
Prominent dizziness, light headedness, peripheral tingling	Dysfunctional breathing
Recurrent severe ‘asthma attacks’ without objective confirmatory evidence	Vocal chord dysfunction
Predominant nasal symptoms without lung function abnormalities	Rhinitis
Postural and food-related symptoms, predominant cough	Gastro-oesophageal reflux
Orthopnoea, paroxysmal nocturnal dyspnoea, peripheral oedema, pre-existing cardiac disease	Cardiac failure
Crackles in auscultation	Pulmonary fibrosis
With airflow obstruction
Significant smoking history (ie, >30 pack-years), age of onset >35 years	COPD
Chronic productive cough in the absence of wheeze or breathlessness	Bronchiectasis; inhaled foreign body; obliterative bronchiolitis; large airway stenosis
New onset in smoker, systemic symptoms, weight loss, haemoptysis	Lung cancer; sarcoidosis

*may also be associated with non-obstructive spirometry