Asthma Flashcards
Reversible chronic inflammatory airway disorder, characterized by increased responsiveness of the tracheobronchial tree to various stimuli resting in episodic reversible narrowing of the airway
Asthma
Most common type of asthma
occupational
Which immune responses are responsible for the development of asthma?
Th1 type and Th2 type cytokine response.
Th1 type does what
fights infection
Th2 type immune response does what
contributes to the development of asthma
Inducer stimuli that cause inflammation are
- inhaled allergens
- low molecular weight sensitizers
- viral of mycoplasmal respiratory infections
- noxious gases
Which inducers cause asthmatic bronchoconstriction
- Exercise
- Cold air
- laughter
- emotional upset
- inhaled irritants
What are triggers responsive for sudden severe bronco constriction
- Acetylsalicylic acid
- non steroidal antiinflammatory drugs
- B-adrenergic blockers
- food allergies
- certain food additives
- stings
- bites
- injections
- inhaled allergens
What type of asthma is this: Symptoms <2 days a week night-time <2 times/month SABA use <2/days week effect on normal activity none Lung function test Normal FEV > 80% FEV/FVC normal
Intermittent asthma
Symptoms: > 2 days a week/not daily
nighttime 3-4 times/month
SABA use: >2 days/week not daily and not more than once on any day
Effect on activity: minor limitation
Lung function test: FEV >80% of predicted value
FEV/FVC normal
mild persisten asthma
Symptoms: daily
night time awakening: once a week not nightly
SABA use: daily
Effect on activity: some limitation
Lung function: FEV > 60% but less than 80%
FEV/FVC reduced
moderate
Symptoms: throughout the day night time: often 7 times a week SABA use: several times a day Effect on function: severe limitation lung function: FEV <60% FEV/FVC reduced
severe
What are possible co-morbidities for asthma
- Glaucoma
- HTN
- GERD
- DM
- Arthritis
- Neoplasm
Are serum IgE levels decreased or increased with patients with asthma
Total IgE is elevated in people with asthma which is associated with disease severity
Why does the color of the patients sputum change during an asthma attack
Eosinophil peroxidase
What are the causes of PNA
- Fungal
- Bacterial
- Viral
Which breath sounds are likely to be heard while assessing for PNA?
- Bronchial breath sounds
- Egophony
- Bronchial breath sounds and egophony?
- Rales
- Bronchial breath sounds and egophony
How is PNA caused by mycoplasma treated?
Macrolide antibiotics
Pneumonic for treating mycoplasma PNA
Mycoplasma
Atypical
Mild symtoms
Macrolide
What are the two main types of asthma medications?
- Controller
2. Reliever
What are the types of controller asthma medications?
- ICS
2. Long acting beta agonist bronchodilator
What are add on controller asthma medications?
- Anticholinergic
- Anti IgE
- Anti-IL5
- Systemic cortico steroids
List asthma reliever medication names
- Short acting B2 agonist bronchodilators
- low-dose ICS fomoterol
- Short acting anticholinergics
Which step is this?
High dose IGC + LABA+oral glucocorticoid
no alternative
SABA
STEP 6
What step in asthma treatment is this?
High-dose IGC+LABA
SABA
Step 5
Asthma treatment which is this?
Medium dose IGC +LABA
Alt
Medium-dose IGC+ either LTRA, theophylline or Zileuton
Step 4
This is step what?
Low-dose IGC + LABA or medium dose IGC
Low-dose IGC +
either LTRA, theophylline, or Zileuton
Step 3
This is what step in the asthma treatment stepwise approach?
Low dose IGC
Alt
Cromolyn, LTRA or theophylline
Step 2
No daily medication needed
Saba this is step number?
Step 1
Regular low dose ICS is the recommendation for what types of patients?
Regular low dose ICS is recommended for all patients with asthma who have symptoms more often than twice a month, waking with asthma more than once a month and any asthma symptoms plus risk factor exacerbations
A patient with seasonal asthma, what is the ideal treatment for seasonal allergic asthma?
start ICS immediately upon onset of symptoms and discontinue 4 weeks after exposure ends
When should asthma be treated with an antibiotic?
- Fever
- Purulent sputum
- evidence of pneumonia
- Bacterial sinusitis
What is the purpose of peak flow in patients with
Periodic severe asthma exacerbations
The purpose of peak flow monitoring is to help asthma patients follow their disease and predict exacerbations , triggers and response to treatment
Zone Green is what in the asthma chart
- PEF measurement is at least 80