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Cough Variant Asthma — RACP Paediatrics MCQ

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ModerateRespiratoryCough Variant AsthmaRACP Paediatrics

A 5-year-old child is being assessed for cough variant asthma. He has a chronic dry cough, especially at night, with no wheeze. Spirometry is normal. What test may help confirm the diagnosis?

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Correct answer: D — Peak flow diary showing >20% variability

Cough variant asthma presents with chronic cough (often nocturnal) without wheeze. When spirometry is normal, PEF variability >20% over 2 weeks or an elevated FeNO (>35 ppb in children) supports the diagnosis. A therapeutic trial of ICS is also diagnostic.

Reference: National Asthma Council Australia – 2024 – Australian Asthma Handbook