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JG Year 2 > 210 Asthma > Flashcards

210 Asthma Flashcards

1
Q

What is extrinsic asthma?

A

Most common form of asthma - IgE mediated hypersensitivity reaction and usually develops in children <10

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2
Q

What is intrinsic asthma?

A

Less common than extrinsic with no extrinsic cause - develops in later life and less responsive to treatment and more progressive

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3
Q

What are the 3 major characteristics of asthma?

A
  1. Airway narrowing
  2. Increased sensitivity to bronchoconstricting stimuli
  3. Increased inflammatory cell no in the bronchioles
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4
Q

How long does the early response in asthma last?

A

Develops in minutes and subsides within ~2 hours

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5
Q

What is a type 1 hypersensitivity reaction in asthma?

mention mast cells; histamine; IL-5

A
  • antigen crosslinking with IgE on mast cells causing degranulation
  • histamine and prostaglandins and leukotrienes cause from the degranulation cause bronchoconstriction; increased mucous; microvascular leakage
  • IL-5 encourages eosinophilic recruitment
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6
Q

What should be given as treatment for late response asthma?

A

Corticosteroids as less responsive to B2 agonists

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7
Q

Which cells cause diffuse inflammation in late response asthma?

A

Eosinophils but also: Th2, B cells, macrophages, basophils

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8
Q

What is the result of immune cell mediated diffuse inflammation in asthma?

A

Airway inflammation; oedema; mucous plugs; hyper-responsiveness and bronchoconstriction (due to SNS stimulation)

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9
Q

What is the long term damage in asthma?

A

Bronchial wall thickening (collagen deposition)
SM and goblet cell hypertrophy
Epithelial loss

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10
Q

What 5 investigations can be performed to diagnose asthma?

A
  1. PEFR
  2. Spirometry
  3. Methacholine challenge
  4. Skin prick testing (allergy)
  5. Excercise test (useful in children)
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11
Q

What pattern does asthma show in spirometry?

A

Obstructive i.e. decreased FEV1: FVC ratio

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12
Q

Name the 6 pharmacological treatment of asthma

A
  1. B2 agonists
  2. ICS
  3. LABAs
  4. Leukotrienes
  5. Xanthines
  6. Biologics
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13
Q

Give 1 example of an ICS (used in the Tx of asthma)

A

Beclometasone
Fluticasone
Budesomide

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14
Q

Give 1 example of a LABA (used in the Tx of asthma)

A

Salmeterol

Formeterol

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15
Q

Give 1 example of a leukotriene receptor antagonist (used in the Tx of asthma)

A

Montelukast

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16
Q

Give 1 example of a Xanthine (used in the Tx of asthma)

A

Theophylline

Aminophylline

17
Q

Give 1 example of a biologic used in the Tx of asthma

A

Omaluzimab

18
Q

What is treatment for intermittent asthma?

A

No controller

19
Q

What is the treatment for mild persistent asthma?

A

Low dose ICS

20
Q

What is the treatment for moderate persistent asthma?

A

Low to medium dose of ICS + LABA

21
Q

What is the treatment for severe persistent asthma

A

High dose ICS + LABA +/- other drugs

22
Q

Which group of drugs should be avoided in asthma?

A

NSAIDs - block COX-2 inhibition which catalyses arachodonic acid –> thromboxane which causes further bronchoconstriction

23
Q

What are the 3 red flags of acute asthma?

A

Cyanosis
Silent chest
Lack of distress

24
Q

What investigations should be performed in severe asthma attack?
(5 listed)

A 
ABG
CXR - to exclude PnTx, infection etc
Bloods
Blood culture
Sputum cultures
25
Q

What are the S&S of life-threatening asthma?

A

PEFR <33%
bradycardia
hypotension
confusion

26
Q

What can be seen in ABG result in life threatening asthma?

A

Increased PCO2
Decreased PO2
Respiratory acidosis
i.e. type II respiratory failure

27
Q

What is the treatment of life-threatening asthma?

A 
ITU admission
Intubation
Ventilation
IV:
     B2 agonists
     MgSO4
     Aminophylline
28
Q

What are the cautions about aminophylline when treating life-threatening asthma?

A

Narrow therapeutic window - can cause tachycardia

JG Year 2 (28 decks)

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