09 Asthma Gallegos

Question 1

What happens with airway remodeling in asthma?

Answer 1

Inflammation. Mucus hypersecretion. Subepithelial fibrosis. Airway smooth muscle hypertrophy. Angiogenesis. Remodeling usually only happens in chronic uncontrolled asthma

Question 2

What is Atopy?

Answer 2

A risk factor of asthma. The propensity to produce abnormal amounts of IgE in response to exposure to environmental allergens

Question 3

What foods should be avoided with Sulfite Sensitivity?

Answer 3

Processed foods, shrimp, beer, or wine if they cause symptoms

Question 4

What are the key measures of Spirometry?

Answer 4

FVC (forced vital capacity). FEV1 (forced expiratory volume in 1 second)

Question 5

What FEV1 is considered mild, moderate, or severe?

Answer 5

Mild: 61-80. Moderate: 41-60. Severe < 40

Question 6

For treatment step-up, what is preferred in Step 1?

Answer 6

SABA PRN

Question 7

For treatment step-up, what is preferred in Step 2?

Answer 7

Low-dose ICS

Question 8

For treatment step-up, what is preferred in Step 3?

Answer 8

Low-dose ICS + LABA. OR. Medium-dose ICS

Question 9

For treatment step-up, what is preferred in Step 4?

Answer 9

Medium-dose ICS + LABA

Question 10

For treatment step-up, what is preferred in Step 5?

Answer 10

High-dose ICS + LABA and consider Omalizumab for patients who have allergies

Question 11

For treatment step-up, what is preferred in Step 6?

Answer 11

High-dose ICS + LABA + oral corticosteroid and consider Omalizumab for patients who have allergies

Question 12

What are the ICS options?

Answer 12

Beclomethasone, Ciclesonide, Flunisolide, Fluticasone, Budesonide, Mometasone

Question 13

What is the Mast Cell Stabilizer that can be used?

Answer 13

Cromolyn

Question 14

What are the LTRA options?

Answer 14

Montelukast, Zafirlukast, Zileuton

Question 15

What is the Methylxanthine option?

Answer 15

Theophylline

Question 16

What is the “Rules of 2”?

Answer 16

If any of the following are identified, patient may need an adjustment in asthma controller medication (assuming patient is compliant): Daytime symptoms frequency >2/week, Nighttime symptom frequency > 2/month, >2 canisters of SABA/year, 2+ exacerbations/year (/6 months for 0-4 years old). Answering yes to any of these questions may indicate that asthma is not well controlled

Question 17

What is PEK flow based on?

Answer 17

Gender, age, and height

Question 18

What are the LABAs that can be used?

Answer 18

Salmeterol, Formoterol