Asthma * Flashcards
What type of disease is Asthma
Chronic Reversible airway obstruction Airway hyperresponsiveness Inflamed bronchioles Mucus hypersecretion
What is asthma
Chronic reversible airway obstruction due to
- bronchial muscle contraction
- mast cell degranulation
- increased mucus production
What causes airway narrowing in asthma
TH2 Overexpression
TH2 CK release = IgE and eosinophils recruited
Mast cell degranulation leading to inflammation
Increased mucus secretion and bronchial constriction
What are the Presenatations of asthma
Dyspnoea and Tacypnoea Inflated silent chest Cough and SOB Wheeze on auscultation Diurnal variation
What are the signs of a fatal asthma attack
Silent chest Bradycardia Confusion Cyanosis Exhaustion
What are the risk factors for Asthma
Atopy (Allegic tendency)
Low birth weight
Not breastfed
Allergen exposure
Hygiene Hypothesis
Passive smoking
What investigations are done for asthma
*Spirometry
-FEV1/FVC <0.7
-FeNO >35
Bronchodilator reversibility (>12% Inc.FEV1)
ABG (look for type 2 resp fail)
What are the results for asthmatic spirometry
>20% variability on peak flow Reduced FEV1 Normal FVC FEV1/FVC <0.7 12% FEV1 Increase = diagnosed
For bronchodilator reversibility, what FEV1 Improvement value determines asthma
12% raise
How do you manage an Asthma attack
OSHIIT
O-Oxygen (94-98) S-Salbutamol nebuliser H-Hydrocortisone/Prednisolone I- Ipratropium I- IV Magnesium Sulphate T-Theophylline/Aminophylline ICU
How do you manage Chronic Asthma in a child
SABA SABA + ICS Check Inhaler compliance/technique SABA + ICS + LTRA SABA + ICS + LABA (+/LTRA) Increase ICS Dose
What is an example of SABA
Salbutomol
What is ICS for asthma
Inhaled CorticoSteroids (hydrocortisone)
What is an example of LTRA
Montelukast
What is an example of LABA
Salmeterol