Asthma

Question 1

What is asthma?

Answer 1

A chronic condition where the airways narrow and swell and is REVERSIBLE

Question 2

Symptoms of asthma?

Answer 2

SOB
Cough
Wheeze

Question 3

Investigations for asthma?

Answer 3

Peak flow test - to look for variation

Question 4

Management of asthma?

Answer 4

NICE guidelines 2020

1. SABA
2. • Low dose ICS
3. • LRTA
4. • LABA
5. MART (LABA+ICS) +/- LRTA. (Moderate dose ICS)
6. (High dose ICS) Refer for specialist care e.g. theophylline

Question 5

What is acute asthma?

Answer 5

Progressive worsening of asthma symptoms

Question 6

Grades of severity of acute asthma?

Answer 6

Brittle
Moderate
Acute severe
Life-threatening
Near-fatal

Question 7

What defines acute severe asthma?

Answer 7

PEF 33-50% best or predicted
RR >25/min
HR >110/min
Inability to complete sentences in one breath

Question 8

What is life-threatening asthma?

Answer 8

33 – 92 – CHEST + normal PaCO2

PEF <33%
Sats <92%
Cyanosis
Hypotension
Exhaustion
Silent chest
Tachycardia

Question 9

What is near fatal asthma?

Answer 9

Raised PaCO2 and requiring mechanical ventilation

Question 10

What severities of asthma require admitting?

Answer 10

Acute severe
Life-threatening
Near-fatal

Question 11

Management of acute asthma attack?

Answer 11

OSHIT!

Oxygen
Salbutamol – nebulised with 02
Hydrocortisone IV or prednisolone PO 
Ipratropium bromide – nebulised with 02
Theophylline – in LIFE THREATENING
! Mg SO4 IV - in ACUTE SEVERE

If not improving –> ITU for ventilator support