Asthma Flashcards

1
Q

Essentials of DX for what issue
(1) Episodic or chronic symptoms of wheezing, dyspnea, or cough.
(2) Symptoms frequently worse at night or in the early morning.
(3) Prolonged expiration and diffuse wheezes on physical examination.
(4) Limitation of airflow on pulmonary function testing or positive Broncho provocation challenge.
(5) Reversibility of airflow obstruction, either spontaneously or following bronchodilator therapy.

A

Asthma

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2
Q

Asthma is a common disease, affecting approximately what % of the population?

A

8–10%

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3
Q

It is slightly more common in what demographics?

A

male children (younger than 14 years)
female adults

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4
Q

What is a chronic disorder of the airways characterized by variable airway obstruction, airway hyperresponsiveness, and airway inflammation

A

Asthma

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5
Q

What is the most common phenotype of asthma?

A

Allergic

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6
Q

True/false
Allergic asthma usually begins in childhood and is associated with other allergic diseases such as eczema, allergic rhinitis, or food allergy

A

True

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7
Q

What is characterized by episodic wheezing, shortness of breath, chest tightness, and cough.

A

Asthma

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8
Q

During severe asthma exacerbations, airflow may be too limited to produce wheezing, and the only diagnostic clue on auscultation may be _____________.

A

globally reduced breath sounds with prolonged expiration.

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9
Q

(normal/abnormal)
Arterial blood gas (ABG) measurement may be _______ during a mild asthma attack

A

normal

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10
Q

Ture/False
Respiratory alkalosis and an decrease in the alveolar-arterial oxygen difference (A–a–DO2) are common

A

False
INCREASE in alveolar arterial oxygen difference

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11
Q

During severe ASTHMA exacerbations,
______ develops and the PaCO2 returns to normal.

A

hypoxemia

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12
Q

CXR’s on asthma usually show what

A

usually normal or show only hyperinflation

may include bronchial wall thickening and
diminished peripheral lung vascular shadows

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13
Q

when is chest imaging indicated for asthma

A

pneumonia
another disorder mimicking asthma
a complication such as pneumothorax is suspected

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14
Q

The combination of an increased PaCO2 and respiratory acidosis may indicate what

A

impending respiratory failure

VENTALATE THAT MOFO

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15
Q

What are the five important aspects of chronic asthma management?

A

(a) Assessing asthma control and severity,
(b) Distinguishing between severe asthma and uncontrolled asthma,
(c) Personalized pharmacologic therapy for asthma,
(d) Treatment of modifiable risk factors and control of environmental factors
(e) Guided self-management education and skills training

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16
Q

Most asthma medications are administered by what two routes.

A

inhalation or by oral dosing

17
Q

What is the first line therapy for asthma management?

A

Inhaled corticosteroids

18
Q

All patients who have asthma must have access to what class of medication?

A

Shot acting Beta-agonists
(SABAs)

19
Q

What are some examples of SABAs?

A

ALBUTEROL
levalbuterol
bitolterol
pirbuterol
terbutaline

20
Q

What are the mainstays of reliever or rescue therapy
for asthma patients

A

SABA’s

21
Q

Beta-agonists are divided into what sub classes

A

SABA’s- Short acting
LABA’s -Long acting

22
Q

Treatment of exacerbations:
What is the action to take if your patient has a poor reaction to a SABA, IE PEF < 50% predicted or
personal best and have symptoms of respiratory distress

A

refer to emergency room/evac

23
Q

Your pt has exacerbation with some minor changes in airway function, PEF greater than 60% of their best and minimal signs of airway dysfunction.

Is this Mild/severe?
What would be effective to use for this reaction?

A

Mild exacerbation
SABA alone may show quick response

24
Q

Severe exacerbations of asthma can be life threatening, so treatment should be started _________.

A

Immediately

25
Q

Severe Exacerbations:
Early initiation of WHAT type of therapy is paramount because asphyxia is a common cause of asthma deaths

A

oxygen therapy

26
Q

All patients with a severe exacerbation should immediately receive what?

A

Oxygen, high doses of an inhaled SABA, and systemic corticosteroids.

27
Q

________ are most effective in achieving prompt control of asthma during acute exacerbations

A

Systemic corticosteroids

28
Q

What are the examples of corticosteroids

A

prednisone
prednisolone
parenteral methylprednisolone

29
Q

Severe Exacerbations:
Supplemental oxygen should be given to maintain a SaO2 greater than __% or a PaO2 greater than __ mm Hg.

A

SaO2 >90%
PaO2 >60 mm Hg

30
Q

What is STEP 2 in the approach to the management of Asthma

A

Daily Low dose ICS
Carry SABA

31
Q

What is STEP 3 in the approach to the management of Asthma

A

Low-dose ICS- LABA

32
Q

What is STEP 4 in the approach to the management of Asthma

A

Medium dose ICS - LABA

33
Q

What is STEP 5 in the approach to the management of Asthma

A

High dose ICS - LABA

34
Q

These issues with asthma; what is the action to take
1) Atypical presentation or uncertain diagnosis of asthma, particularly if additional diagnostic testing is required (bronchoprovocation challenge, allergy skin testing, rhinoscopy, consideration of occupational exposure).
2) Complicating comorbid problems, such as rhinosinusitis, tobacco use, multiple environmental allergies, suspected allergic bronchopulmonary mycosis.
3) Occupational asthma.
4) Uncontrolled symptoms despite a moderate-dose inhaled corticosteroid and a LABA.

A

REFER

35
Q

Refer?
Patient not meeting goals of asthma therapy after 3–6 months of treatment.

A

Yes

36
Q

Can an idc manage this patient?
-Frequent asthma-related healthcare utilization.
-More than two courses of oral prednisone therapy in the past 12 months.
-Presence of social or psychological issues interfering with asthma management.

A

No refer