Abpa

Question 1

Symptoms

Answer 1

Wheeze
Fever
Cough
Hemoptysis
Chest pain

Question 2

Rosenberg patterson criteria

Answer 2

Primary:
Episodic ba
Eos 1000
Immediate skin exn to asp.antigen
S.prectpitin to antigen
Ige 1000
Specific ige g
Xray- pul.infiltrates/ fleeting opacities
Central bronchiectasis 

Minor:
Sputum culture
Brown plugs
Late skin reaction

Mnemonic: ARTEPICS

Question 3

Isham criteria
1) predisposing
2) obligatory
Supportive

Answer 3

Cf/ asthama - any one
Obligatory- ige 1000 / immeiate test-both
Supportive- e 500/ consistent Radiology/precipitus igG to aspergillus atleast 2

Question 4

Radiology

Answer 4

Infiltrates
Ring sign- thickened bw
Finger in glove
Central bronchiectasis

Question 5

Stages of abpa

5

Answer 5

1- acute- steroids 
2.Remission- f/u
3- exacerbation- steroids 
4- steroid dependant 
5- fibrotic- long term steroid

Question 6

Safs

Answer 6

Severe asthma with fungal sensitivity

H/o poorly controlled asthma
Total ige <1000
Immediate test pos

Question 7

Goals of treatment

Answer 7

Control symptoms
Prevent exacerbation
Reduce inflammation
Prevent fibrosis

Question 8

Toc

Answer 8

Steroid
0.5 - 1mg od for 2 weeks.
Alt day for 8 weeks
If ige dec by 35% and xray better. Then taper

Question 9

Stage 2

Answer 9

Follow up with ige 6mon for 1yr

Then every 1- 2 yrs

Question 10

Stage 4 rx

Answer 10

Aim for lowest possible dose

Question 11

Why Antifungal

Answer 11

Reduce immune activation
Decrease exacerbation
Reduce dose of steroid

Question 12

Ix of antifungal

Answer 12

First relapse of abpa/ gc dependant abpa

Question 13

Doc antifungal
Dose
S/e

Answer 13

Itraconazole
200 bd for 16weeks - monthly lft
Od for 16 weeks
S/e - adrenal insufficiency