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Semester 2 > Asthma > Flashcards

Asthma Flashcards

1
Q

What is asthma?

A

a disease characterise by an increased responsiveness of the airways to various stimuli and manifested by a widespread narrowing of the airways that changes in severity either spontaneously or as a result of therapy

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2
Q

What is the main symptom of asthma?

A

Wheezing

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3
Q

Is asthma restrictive or obstructive?

A

Obstructive

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4
Q

What is COPD?

A

Chronic, slowly progressive disorder that is characterised by airflow obstruction - does not change markedly over several months

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5
Q

Is asthma triggered by a stimulus or spontaneously?

A

Can be either

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6
Q

Is the airflow obstruction in asthma reversible?

A

Yes

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7
Q

If there is no wheeze can it be asthma?

A

No

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8
Q

What is dyspnoea?

A

Shortness of breath

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9
Q

What are the symptoms of asthma?

A 
Wheeze 
Short of breath 
Severity chest tightness 
Cough (usually dry) 
Sputum occasionally
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10
Q

Is asthma more common in boys or girls?

A

Boys

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11
Q

Is asthma more common in men or women?

A

Women

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12
Q

What is the prevalence of asthma in children?

A

10-15%

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13
Q

What is the prevalence of asthma in adults?

A

5-10%

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14
Q

What is wheezing?

A

A whistling sounds that occurs during breathing when the airways are narrowed

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15
Q

What is the character of a cough in asthma?

A

Dry

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16
Q

What are some potential triggers of asthma?

A 
Exercise
Cold air 
Smoke 
Perfume 
Grass pollen 
Pets
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17
Q

What are the obs taken in a patient with suspected asthma?

A

Ability to speak
Heart rate
Respiratory rate
O2 saturation

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18
Q

What is bronchospasm?

A

When the smooth muscle of the airways contract therefore narrowing the airways

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19
Q

What is bronchiectasis?

A

The abnormal widening of one or more airways

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20
Q

In bronchiectasis what is extra produced?

A

Extra mucus

Prone to infection

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21
Q

What other conditions can wheezing occur in?

A

Cystic fibrosis
An infection in the respiratory tract
Bronchiolitis
Bronchiectasis

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22
Q

What is peak flow investigation?

A

Patients are given a peak flow meter to use at home to encourage self monitoring
Record a peak flow diary
Doctor looks at the diary and looks to see if the range is out with 15%

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23
Q

In moderate asthma what is the PERF?

A

> 50-75%

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24
Q

In acute severe asthma what is the PERF?

A

33-50%

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25
In life threatening asthma what is the PERF?
Less than 33% Essentially None Test not possible As the person will not be able to breathe out
26
What are some of the symptoms of acute severe asthma?
Heart rate >110 bpm | Inability to complete sentences in one breath
27
What are the clinical signs of life threatening asthma?
``` Altered consciousness Exhaustion Hypotension Cyanosis Silent chest Poor respiratory effort ```
28
What are the similarities between COPD and asthma?
Both involve small airways and cause airflow limitation Both result from environment interaction Both are usually characterised by mucus and bronchoconstriction
29
Why is asthma so important?
Because so many people suffer from the condition
30
Is asthma chronic or a one off condition?
Chronic
31
How does smoking link to asthma?
Maternal and grandmother smoking during pregnancy
32
What are possible risk factors for asthma?
Obesity Diet Reduced exposure to microbes Indoor pollution
33
Is wheezing only present in asthma?
No it can be present in other conditions meaning it is important to differentiate it from other causes of wheeze
34
Is the airflow obstruction in asthma reversible?
Yes
35
Is wheezing more prominent when you breathe in or out with asthma?
Breathe out
36
If the beta 2 agonist drugs work what is the likely diagnosis?
Asthma
37
When should peak flow at home be measured?
In the morning and night
38
If in doubt of an asthma patient what should be measured?
Blood gas
39
What are the different types of asthma?
Occupational related Allergy Genetic
40
What are some triggers for asthma?
``` Pets Cold Dust Exercise Perfume Food Allergens Occupationally related ```
41
Does physical examination aid in the diagnosis of asthma?
Not really
42
What are some useful but not diagnostic investigations for asthma?
CXR Skin pricking test Specific and total IgE FBC - eosinophilia
43
Will eosinophilia be present in COPD patients or in asthma patients?
Asthma patients
44
What 2 techniques can be used to measure lung function?
Spirometry | Peak Flow
45
Why are lung function test carried out before and after taking a bronchodilator?
To check the reversibility of the airflow obstruction | If the use of a bronchodilator improves symptoms and lung function it is likely you have asthma
46
What can a nitric oxide test indicate for asthma?
High NO exhaled levels can sometimes be present in patients presenting with asthma
47
Is occupational asthma common or uncommon in children?
uncommon
48
Describe moderate asthma?
Able to speak and complete sentences HR<110 RR<25 PERF 50-75%
49
Describe severe asthma?
``` Any of Unable to speak HR>110 RR>25 PERF - 33-50% ```
50
Describe life threatening asthma?
``` any of grunting impaired consciousness HR>130 Cyanosis PaO2 is low But PCO2 is normal ```
51
What is the main indication of near fatal asthma?
High PCO2
52
Describe a cough in a child with asthma?
Dry Nocturnal Exertional
53
If a child is wheezing but does not respond to treatment what is the diagnosis?
Viral induced wheeze
54
is asthma more common in under 18 months or over 5 years old?
Over 5
55
If you think its asthma | but you are not sure...
Give a short course of inhaled steroids | and see if you have a cure
56
What 2 main groups of drugs are given to asthma patients?
Anti-inflammatorys | Bronchodilators
57
What medication should you never give to an asthma patient?
Beta blockers
58
What are some pharmacological solutions to asthma?
``` Weight loss if BMI >30 Vaccines - yearly for flu and pneumonia Allergen avoidance Smoking cessation Physiotherapy ```
59
What does MDI stand for?
Metered does inhalers
60
Why are MDI great for treating asthma?
Deliver small amounts of the drug Delivered straight to the target organ - lungs Onset of effect is faster Minimal systemic exposure - especially because they're steroids
61
Who can find it difficult to use an inhaler device?
The young Old Uncoordinated
62
What device can be used to aid with the use of an inhaler?
Spacer
63
What is defined as the complete control of asthma?
``` No daytime symptoms No night time disruption No need to reuse medication No asthma attacks No limitations on activities ```
64
What is a reliever?
SABA | Blue inhaler
65
What is the most prescribed drug in the UK?
Salbutamol
66
Should you start on high or low doses of reliever inhalers?
Low
67
What is an ICS?
Inhaled corticosteroids
68
What do ICS do?
They work to prevent the onset of asthma symptoms
69
What is a common ICS prescribed?
Beclomethasone
70
when do you start a patient on preventers?
When using reliever x3 times a week Waking one night a week or more due to asthma Requiring oral steroid for an exacerbation in the past 2 years Often symptomatic
71
Which LAB is commonly used?
Fostair
72
What is the 5 step asthma treatment plan?
``` Reliever SABA Add a preventer Add a LABA Add an anti-muscarinic Oral steroids ```
73
What inhalers will you be prescribing as an FY1?
Inhaled steroids SABA ICS LABA
74
What should you always have prescribed before starting a patient on LABA treatment?
ICS preventer
75
Is there a cure for asthma?
No
76
What is the maximum dose of inhale that can be given to children?
800 microg
77
What CANNOT be prescribed to children?
Oral steroids

Semester 2 (150 decks)

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