Airways Disease Flashcards
Severe asthma comorbidities
rhinosinusitus/polyps
psychological factors
vocal cord dysfunction
obesity
smoking
OSA
Hyperventilation
hormonal - thyroid
GORD
drugs
difficult asthma
poor adherence
psychosocial issues
dysfunctional breathing
allergen test
Acute severe ex asthma
PF 33-50%
RR >25
HR >110
inability to complete sentences
Life threatening ex asthma
PF <33%
Sats <92%
paO2 <8
normal/high CO2
altered conscious level
exhaustion
arrhythmias
hypotension
cyanosis
silent chest
poor respiratory effort
risk of fatal/near fatal asthma
Prev near fatal attack - I&V
admission in last year
>3 classes of medications
increase SABA use
repeated A&E attendances
behavioural or psychosocial issues
risk of future asthma attacks
prev attacks
poor control
increase SABA use
increase age
female
reduced lung function
obesity
smoking
depression
Mepolizumab
for eosinophilic asthma
anti IL5 antibody
>300 + 4 ex needing steroids in 12 months
>400 + 3 ex needing steroids in 12 months or continuous steroids
or >5mg pred/day in 6 montha
100 mg ever 4 weeks
try for 12 months
benralizumab
anti - IL5 antibody - as per mepo
Reslizumab
anti-IL5 antibody
>400 +3 ex in 12 months
COPD severity
FEV1
Mild >80%
Mod 50-80%
Severe 30-50%
Very severe <30% or <50% & T2RF
GOLD classfication
BODE index
BMI
airflow Obstruction (FEV1)
Dyspnoea (MRC scale)
Exercise capacity (6MWT)
DECAF score
for inpatient mortality
Dyspnoea ( eMRCD 5a - 1; eMRCD 5b - 2)
eosinopenia <0.05
consolidation
acidaemia pH<7.3
AF
0=0%
1=1.5%
2 = 5%
3 = 15%
4 = 30%
5 = 40%
6 = 50%
Prognosis in COPD
FEV1
smoking
mMRC
Cor pulmonale/hypoxia
Low BMI
Exacerbations
Hospital admissions
CAT score
6MWT
TLCO
Frailty
mMRC
0 - not troubled except on strenous exercise
1 - SOB when hurrying or walking up hill
2 - walks slower on ground level or SOB when walking at own pace
3 - stops for breath at 100m for few min on ground level
4 - too SOB to leave house or when dressing
