Acute Asthma Flashcards

1
Q

What is Asthma?

A

A chronic inflammatory condition that causes reversible and paroxysmal obstruction of the bronchioles

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2
Q

What causes it? (3)

A
  1. Bronchial Muscle contraction (triggered by multiple stimuli)
  2. Mucosal swelling and inflammation (caused by mast cells and basophils)
  3. Increased mucous production
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3
Q

What happens if asthma isnt treated?

A

It can be life-threatening, or long term it can cause fixed airways disease

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4
Q

Is it common?

A

Yes very, it affects 5-8% of the population, 1 in 12 people

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5
Q

Who does it affect?

A

It mostly affects children and is the most common chronic condition of childhood

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6
Q

Risk factors (10)

A

Atopy (allergic rhinitis and eczema), family history, inner city environment, socio-economic deprivation, obesity, prematurity and low birth weight, viral infections in early childhood, smoking, maternal smoking, early exposure to broad spectrum antibiotics

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7
Q

Symptoms (3)

A

Intermittent dyspnoea, nocturnal cough, sputum

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8
Q

Signs (6)

A

Wheeze, morning reduction in peak flow, tachypnoea, hyperinflated chest, reduced air entry, tachycardia

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9
Q

What are the life-threatening signs? (4)

A

Silent chest, cyanosis, hypercapnoea, confusion

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10
Q

What are the precipitants for asthma?

A

Cold air, exercise, emotion, allergens, infection, smoking, pollution, NSAIDs, Beta blockers

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11
Q

Differentials (6)

A

Bronchiolitis, Cystic fibrosis, GORD, Croup, Bronchiectasis, COPD

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12
Q

Investigations (4)

A

Peak flow, lung function tests, spirometry, chest xray

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13
Q

What is the first step treatment? (1)

A

Occasional short acting beta agonist use e.g Salbutamol

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14
Q

What is the second step treatment? (2)

A

Daily inhaled steroid e.g Beclamethasone and use of Beta agonist for rescue e.g Salbutamol

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15
Q

What is the third step treatment? (3)

A

Addition of long acting beta agonist e.g Salmeterol, increase dose of Beclamethasone, add Leukotriene Receptor Antagonist

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16
Q

What is the fourth step treatment? (1)

A

Increase steroid dose

17
Q

What is the fifth step treatment? (2)

A

Oral and high dose inhaled steroids, refer to respiratory physician

18
Q

What is the treatment for acute life-threatening asthma? (5)

A

15 litres oxygen non-rebreathe mask, 5mg Nebulised Salbutamol with 5litres oxygen, 100mg Hydracortisone, 5mg Ipratropium, Single dose Magnesium Sulphate, ask for senior help

19
Q

What are the complications? (6)

A

Pneumonia, pneumothorax, pneumomediastinum, respiratory failure, respiratory arrest, death

20
Q

Is there a good prognosis?

A

1000 asthma deaths in UK per year, but most children grow out of asthma

21
Q

Is there any way to prevent it?

A

Hygiene hypothesis, breast feeding, smoking cessation, maternal diet