Asthma Flashcards

1
Q

Risk factors for asthma?

A

Atopy, maternal smoking, low birth weight, bottle fed, air pollution, other IgE mediated conditions: eczema and allergic rhinitis.

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2
Q

Asthma symptoms

A

Dyspnoea, expiratory wheeze, tightness, cough, reduced PEF

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3
Q

Asthma investigations

A

Spirometry- FEV1 significantly reduced
FVC- normal
FEV1/FVC- < 0.7
Obstructive lung disease

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4
Q

Asthma management

A

1st line: SABA e.g. salbutamol. Increases SM relaxation in bronchial walls. Symptoms reliever.
2nd line: Add ICS e.g. beclomethasone/fluticasone. Preventer, take every day.
3rd line: LTRA e.g. Montelukast. Oral daily medication.
4th line: LABA e.g. Salmeterol. Take every day.

If still symptomatic consider a higher dose of ICS.
Only continue LTRA if helpful.
Consider stepping down dose every 3 months.

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5
Q

Acute asthma attack- features

A

Moderate- PEF 50-70%. No other adverse signs.
Severe- PEF 33-50%. Can’t complete sentences, RR > 25, HR > 110.
Life threatening:
PEF < 33%.
Oxygen sats < 92%. Silent chest, cyanosis, feeble respiratory effort, bradycardia, hypotension, exhaustion, confusion.

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6
Q

Acute asthma assessment

A

Do ABG if O2 sats < 92%. CXR only recommended if life threatening, suspected pneumothorax or not responding to treatment.

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7
Q

Acute asthma management

A
Oxygen
Salbutamol nebulised
Hydrocortisone/prednisolone. Continued for > 5 days.
Ipratropium bromide 
Magnesium sulphate 
Theophylline/aminophylline
Escalate care to ITU

To discharge: No nebulisers or oxygen for 24 hours. Inhaler technique checked. PEF > 75%.

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