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Respiratory > 6. Asthma > Flashcards

6. Asthma Flashcards

1
Q

What are the key features of asthma?

A

Chronic inflammatory airway disease
Affects small airways
Intermittent obstruction and hyper-reactivity
Usually reversible

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2
Q

What are the 2 types of asthma?

A

Atopic

Non-atopic

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3
Q

What are the features of atopy?

A

Triad of:
Asthma
Eczema
Hayfever

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4
Q

What happens in type 1 hypersensitivity?

A

Allergen (1st exposure), comes into contact with antigen presenting cell (macrophage), present allergen to T helper 2 cell, antibodies then produced (IgE)
In asthma, IgE attach themselves to mast cells and cross over, causing mast cell degranulation, cause inflammation, mucus production and bronchoconstriction

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5
Q

What are symptoms of atopic asthma?

A 
Breathless (exhalation)
Chest tightness
Wheeze
Cough (dry) - nocturnal
Atopy
Intermittent symptoms
Triggers/hyper-responsive
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6
Q

What are the signs of asthma?

A

Increased RR
Increased HR
Low O2

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7
Q

What are the investigations for asthma?

A 
Peak flow (peak expiratory flow rate)
Spirometry (low FEV:FVC)
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8
Q

What is the management for high probability asthma?

A

Typical presentations

Start treatment

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9
Q

How does low probability asthma present?

A

Little/no typical features, other diagnosis more likely

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10
Q

How does intermediate probability asthma present?

A

Some, not all symptoms

Treatment for other cause not working

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11
Q

What is the management for asthma?

A 
Patient education (remove triggers)
Pharmacology (inhalers)
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12
Q

What inhalers are given in step 1 of treatment?

A 
Reliever inhaler (Short acting beta 2 antagonist) - blue
Preventer inhaler (inhaled corticosteroid) - brown
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13
Q

What is step 2 of the treatment of asthma?

A

Inhaled corticosteroid inhaler and long acting beta 2 antagonist inhaler, and a reliever

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14
Q

What is step 3 of treatment for asthma?

A

Increase dose of inhaled corticosteroid

Leukotriene receptor antagonist (LTRA)

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15
Q

What is seen in acute severe asthma?

A 
Can’t complete full sentences
O2 >92%
RR > 25
HR > 110
PEFR 33-50%
Hyperventilating
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16
Q

What is seen in life-threatening asthma?

A 
Cyanosis
Drowsy, poor resp. effort
O2 <92%
PEFR <33%
Arrhythmia, hypotension
17
Q

What are the ABGs in acute severe asthma?

A

Low CO2
High pH - respiratory alkalosis
Low O2 - type 1 respiratory failure

18
Q

What are the ABGs in life-threatening asthma?

A

Looks normal however need to look at the patient
Possibly treatment is working
Or patient is deteriorating (rising CO2)

19
Q

What is the treatment for acute severe or life-threatening asthma?

A 
Oxygen
SABA (nebuliser)
Steroids
Admit +/- ITU
CXR (possible pneumothorax)

Respiratory (23 decks)

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