281 - Asthma Flashcards
Asthma is an __ disease.
obstructive
As developed countries become more ___, the number of asthma cases increases .
urban
The increase in __ disease is correlated with the increase in asthma.
allergic
The prevalence of __ and other allergic diseases has also increased over the same time, suggesting that the reasons for the increase are likely to be __ rather than confined to the lungs.
atopy
systemic
Asthma can appear at any age, but peaks at __, more in __ (in adults there is not difference between sexes).
3
boys
As the patients gets older, they become less __, but reverts at an __ age.
symptomatic
elder
What are the risk factors for mortality due to asthma?
uncontrolled with frequent use in bronchodilators
low compliance to ICS treatment
previous admission due to severe asthma
The main risk factor for asthma is ___.
atopy
__ infections (__) are common triggers for asthma __.
viral
RSV
exacerbation
Living with __ and __ are risk factors for asthma, removing them can improve the clinical symptoms.
mold
moisture
Low ___ diet were found to increase the risk for asthma.
antioxidant
Low vitamin __ intake is a risk factor for asthma.
D
__, mostly in __, is a risk factor for asthma.
obesity
women
Air __ (diesel/NO2) is a risk factor for asthma.
pollution
Suspect occupational exposure when symptoms improve during the __ and __.
weekends
holidays
Name 5 other risk factors for asthma:
SGA
young maternal age
duration of breast feeding
paracetamol intake at a young age
Non-atopic/intrinsic asthma will have negative __ test for common inhalant __, and normal __.
skin
allergens
IgE
Intrinsic asthma is more common in __ patients with nasal __ and __ sensitivity.
older
polyps
aspirin
Intrinsic asthma tend to have more __ symptoms .
severe
B blockers can be __ for asthma patients.
dangerous
Physical activity is a common __, mostly in __.
trigger
children
EIA=__
Exercise-induced asthma
EIA usually starts after the exercise is __, and relived __ minutes after.
over
30
__ and __ air is a trigger for asthma.
cold
dry
How can you prevent EIA?
take Beta 2 agonist before exercise
Laughing is a __ for __.
trigger
asthma
Clinical deterioration can occur in women approaching their monthly __.
menses
__toxicosis and hypo__ can trigger asthma,
thyro
thyrodism
Mental __ can also worsen asthma.
stress
AHR-___
Airway Hyperresponsiveness
The typical symptoms in asthma: 3
wheezing
dyspnea
cough
Symptoms increase during the __, causing patients to __ early.
night
wakeup
Prodromal symptoms can start with an itching sensation below the __, discomfort sensation between the ___.
chin
scapula
Which pulmonary function test are decreased in asthma?
PEF
FEV1/FVC
FEV1
After SABA/ 2-4 weeks of OCS __ should improve by __% and 200 mL.
FEV1
12
200
What are the two treatment categories for asthma?
bronchodilators
controllers
Bronchodilators give __ relief to symptoms, but does not effect the __ process itself.
quick
inflammatory
What are the 3 categories of bronchodilators?
Beta 2 agonist
anticholinergic
theophylline
Beta 2 agonist is the most __ bronchodilator.
useful
SABA (__/__) are active for - hours. They are good __ and for __.
albuterol/terbutaline
3-6
reliver
EIA
LABA (__/__) are active for >_ hours, Since they do not affect the __, give together with __.
salmeterol/formoterol
12
inflammation
ICS
Mention 3 common S/E for Beta 2 agonists:
tremor
palpitation
hypokalemia
In prolonged Beta 2 agonists use- __ will develop.
tolerance
LAMA-__
long acting muscarinic antagonists
ICS is the best __ therapy for asthma.
control
ICS reduce __
AHR (Airway Hyperresponsiveness)
ICS is the __ line of treatment. If uncontrolled- add __.
first
LABA
In acute severe asthma use __ .
IV OCS
PEF=__
Peak expiratory flow
Using a reliever for > __/week is a testimony for using __.
2
controller
In patients with mild intermittent asthma- __ could be sufficient treatment
SABA
If controllers are required- use __ per day. If symptoms are relieved after 3 months, consider __ the dosage.
twice
decreasing
If after 3 months with ICS the symptoms are still uncontrolled- add __.
LABA
If symptoms are still uncontrolled (ICS+LABA), increase __ dosage.
ICS
If symptoms are still uncontrolled (maximal ICS+LABA), add __.
OCS
Name 3 clinical signs of acute severe asthma which do not improve under treatment:
chest discomfort
wheezing
dyspnea
In acute severe asthma patients will struggle to finish __, and may appear __.
sentences
cyanotic
When examining acute severe asthma patients may be suffering from hyper-__ and __
inflation
tachycardia
The ABG of patients with acute severe asthma will show- __ and decreased __ (due to hyperventilation).
hypoxemia
CO2
Acute severe asthma with normal/elevated PCO2 is an indication for an immanent ___ and requires ___ treatment, such as ___.
respiratory failure
immediate
prophylactic intubation
Acute severe asthma should be treated with high dose __, reaching > _% and ___.
oxygen
90
SABA
In severely ill acute asthma patients add ___. If there is not reaction- add __ inhaler.
IV beta 2 agonist
anticholinergic
If acute severe asthma patients do not respond to inhaler treatment- add slow drip of __.
aminophylline
__ sulfate is useful when added together with __.
magnesium
beta 2 agonist
Patients with COPD and asthma should be treated with triple treatment:
ICS + LABA + LAMA