Asthma= Clinical History Taking is the most important piece of management                 NEJM 360 

Symptoms: signs of cough vs cough varient without wheezing, shortness of breath, dyspnea, wheezing, chest tightness.

Triggers: GERD, infection, environmental allergens exercise adrenaline and even weather. 

Triage by taking good history of above sxs, triggers with use of rescue/maintance therapy to guide the severity. All while keeping in mind of refractory disease can be due to more anatomical/infections./heart complaints/COPD/ Bronchiectasis etc...

Utility of Physical exam is limited to wheezing, decreased breath sounds in the base of lung, accessory muscle use, allergic rhinitis etc 

All together Classfiy them in intermittent vs persistent ; mild moderate severe based on reporteed symptoms with measured lung functions. ​​

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Pathologically (2) 
Type II inflammation via antigen  cascade down to Thymic stromal lymphopoeitin stimulation of Helper type 2 T cells and innate lymphoid cells of group 2. causing IL 4 5 13 cascade