Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y4 Respiratory Medicine > 2. Asthma and COPD > Flashcards

2. Asthma and COPD Flashcards

1
Q

Characteristics of Asthma

A

Smooth muscle contraction (bronchoconstriction) , irritation and swelling with mucosal oedema, mucous plugging of bronchioles (goblet cells)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What factors predispose to asthma

A

Airway hyperresponsiveness, sensitation to house dust mite, F sex smoking at age 21, atopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What airway remodelling can occur in Asthma

A

Thickened basement membrane - can get fixed airway obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How to diagnose asthma

A

Clinically - 1 or more of
Chest tightness, breathlessness, cough, wheeze esp if worse at night and early morning, in response to exercise, allergen and cold air, after taking aspirin or BB and M/FHx of asthma/atopy

Widepreade wheeze on chest ausc
Unexplained low FEV1/ PEF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Provoking factors for asthma

A

Viral infections, house dust mite, NSAIDS, aspirin and B blockers, other allergens, exercise, temp changes, anxiety, cigarette smoke, food and additives, obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What investigations should be done for Athma with intermediate probability

A

Need to check for airflow obstruction with revesibility testing/ treatment trials with bronchodilator or steroids. Need to have more than 400 mls improvement

Can monitor PEF- variability 20%

CXR, eos, IgE and skin prick tests can also be done.

Assessment of airway responsiveness- histamin to induce bronchoconstriction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What should be done if asthma is suspected

A

initiate treatment with low dose ICS 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mx algorithm for asthma

A

2: Give SABA preventer if asthma diagnosed
3: Recheck compliance, technique, eliminate trigger factors. THEN Add on inhaled LABA to low dose ICS (beclamethasone + fometerol or fluticasone and vilanterol)
4a: If no response to LABA, stop it and consider increase ICS.
4b: IF LABA beneficial but control still inadequate, increase ICS to medium dose.
5: LABA beneficial but control still inadequate, continue both and add LTRA, SR theophyllines, or LAMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

SE of SABA

A

Tachycardia, vasodilation, arrhythmias, hypokalaemia, tremor, insomnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When should nect step of therapy be considered for asthmatic patients

A

When >3 SABA doses a week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does beclamethasone help with asthma

A

Reduces inflammatory cell infiltration, vascular permeability, and increases B2 responsiveness on airway smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do LTRAs work

A

prevent smooth muscle contraction, oedema, increased vasc permeability, mucus secretion and eos chemoattractatnt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does theophylline work

A

Bronchodilation, rasies intracellular cAMP and is an adenosisne antaggonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Possible drugs for severe asthma

A

High dose ICS
Tiotropium
IST
Macrolide Abx
Omalizumab or Mepolizumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is asthma exacerbation

A

PEF <0.8 pred, incr bronchodilator use, incr nocturnal Sx, incr sx scores for 2 or more days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a mild asthma ex and how to treat

A

PEF> 80 but incr salb freq , give 2-4 puffs BA 4hrly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a moderate asthma ex and how to treat

A

PEF 50-80, High dose bnronchodilator ( MDI via space or neb), and IV predni 40mg 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is moderate acute asthma

A

Normal speech, RR< 25, pulse <110

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Severe acute asthme

A

Cannot complete sentences, RR>25, Pulse >110, spiro 33-50

20
Q

Life threatening asthma

A

Silent chest, cyanosis, poor resp effort, brady, dysrhthmia, hypotension, exhuastion, confusion, coma
spiro <33
TIIRF

21
Q

How to treat severe acute asthma

A

High flow O2 + similar as moderate ex, add ipa (SAMA) if no response

Magnesium recommended for severe attack
Aminophylline/ IV slab last line

22
Q

Who to refer to ICU for acute asthma

A

If vent support required, or severe or life threatening asthma is not responsive, eg derioriating PEF, persiting or worsening hypoxia, hypercapnia, exhaution and feeble resp, drowsiness , confusion, coma or resp arrest

23
Q

What is chronic bronchitis

A

Cough productive of sputum on most days for 3 months over 2 consecutive years

24
Q

Characteristic of d chronic bronchitis

A

Hyperplasia of goblet cells in the airways, leads to mucus hypersecretion, usually associated with increased inflammatory cells in these areas of the lungs

25
Q

What is emphysema

A

Permanent dialatation of airspaces distal to terminal nbonchiles, accompanied by destruction of their walls, w/o obv fibrosis

Loss of elastic recoil leads to airflow limitation

26
Q

Types of emphysema, which lobe they are predominant in, and who they are common in

A

Centrilobular, UL, common in smokers
Panlobular ( whole lobule destroyed) , LL, common in a-1 AT deficiency ( predominantly pasal)

27
Q

Risk factors for COPD

A

SMOKING
Occu dust and chemicals eg. coal mining
Second hand smoke
Air pollution
Recurrent childhood infxns
SES
—
a-1 antitrypsin deficiency
Hyper-responsiveness

28
Q

How are airways affected in asthma and COPD respectively

A

Bronchoconstriction vs small airway narrowing and alveolar destruction

29
Q

Characteristics of dyspnoea in COPD

A

Persistent
Progressive
Characteristically worse with exercise

30
Q

Describe cough in COPD

A

Chronic, but may be intermittent and may be unproductive (Emphysema) , and may have chronic sputum production ( chronic bronchitis phenotype)

31
Q

Possible Sx of COPD on inspection
Which ones are more common in emphysematous phenotype

A

Use of accessory muscles, overinflation of lungs eg. protruding abdomen, central cyanosis, peripheral oedema,

weight loss, barrell shaped chest, pursed lip breathing

32
Q

What breath sound is common in COPD

A

Wheezing . Respiratory crackles may occur with coughing esp if pneumonia is present

33
Q

Is COPD dx spirometry based or clinical

A

Both
Consider Sx of sputum pdtn, cough, or dyspnoea. or exposure to risk factors
+
Spirometry - FEV1/FVC <0.7

34
Q

How to measure severity of COPD

A

post bronchodilator FEV1, not FEV1/FVC

Mild- FEV1>80
Moderate - 50 to 80
Severe 30 to 50
Very sever Less than 30

35
Q

What is a sig. response to bronchodilators suggestive of asthma

A

Large increase in FEV1 (>400)

36
Q

What scale to assess Sx of COPD/ asthma

A

mMRC
0- breathless with strenous ex
1- when hurrying on level or up slighthill
2- slower than most on level, or have to stop for breath on the level
3- stop for breath after 100m/ few mins on the level
4- Too breathless to leave the house/ breathless when dressing or undressing

CAT- self assessment tool

37
Q

What is ABCD assessment for COPD

A

Based on risk ie. number of excaerbations ( or whether there was at least one that led to hospital), and symptoms ie. mMRC or CAT

38
Q

What can CT scan be used for in COPD

A

To quantify emphysema (and bronchiectasis)

39
Q

Residual volume and diffusing capacity in COPD

A

High RV, low DC due to gas trappinf

40
Q

Vaccination for COPD

A

Influenza and penumococcal vacc (one off)

41
Q

what chemical does BA increase and what is it

A

cAMP, results in bronchodilation

42
Q

What must ICS be combined with in COPD Tx

A

LABA eg. beclomethasone and formoterol
OR LABA LAMA

43
Q

First line for COPD

A

LAMA ( or LABA)

44
Q

How to increase therapy for COPD

A

Add LABA or LAMA, or ICS if asthmatic qualities?
For severe, high risk, can give triple therapy if further exacerbations/ persistent Sx on LABA+ICS and then consider roflumilast if FEV1 <50 % predicted and chronic bronchitis in pt, or macrolides in former smokers

45
Q

Most common bacterial and viral pathogens that cause COPD exacerbations

A

Rhinovirus and Influenza, esp during winter months

46
Q

When should nebuilisers be given to COPD pts

A

if extremely bronchoconstricted (long term home therapy for severe COPD and Sx disease, or short term for exacerbations)

47
Q
A

Y4 Respiratory Medicine (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions