Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

A- Resp and cardio > Asthma > Flashcards

Asthma Flashcards

1
Q

What is the lifethreatening peak flow for asthma?

A

PEFR <33% baseline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Criteria for asthma patinet -> hospital

A

-Can’t finish sentence
Blue inhaler more than hourly
RR over 20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When is asthma worse

A

First thing morning and at night - diurnal variation in PEFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is asthma?

A

Chronic inflammatory condition of the AWs characterised by hyperresponsiveness and constriction in response to variety of stimuli
Intermittent symptoms but inflammation can lead to irreversible AW obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pathophysiology of asthma

A

Excessive Th2 mediated IgE immune response to exposure of environmental pathogen.
IgE bonds to bronchial mast cells -> degranulation + release of pro inflammatory mediators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Phases of inflamamtion

A

Acute phase - bronchosconstirction and AW oedema
Delayed phase - bronchial hyperresponsiveness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does the delayed phase of asthma cause bronchial hyperresponsiveness?

A

Delayed phase = Pro inflammatory mediators eg IL5 recruit eosinophils, basophils and Th2 lymphocutes -> inflammation, sensitisation of sensory nerve endings, -> bronchial hyperresponsiveness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the acute phase of asthma?

A

bronchosconstriction + AW oedema - within minutes exposure, resolves within hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Risk factors for asthma

A

Personal history of atopy - eczema, hayfever
FH asthma or atopy
Inner city environment, socioeconomic deprivation
Obesity
Prematurity and low birth weight
Viral infections in early childhood
Smoking
Maternal smoking
Early exposure to broad spectrum antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Asthma triggers

A

Resp inections
Cold air
Exercise
Pollution
Allergens eg pollen, dust mites, animals
Time of day
Work related
Drugs eg beta blockers, NSAIDs
Emotional factors eg stress, laughter
GORD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Symptoms of asthma

A

Intermittent SOB
Wheeze - polyphponic
Cough often nocturnal, with or without sputum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Asthma signs

A

Decreased chest expansion
Bilateral polyphonic wheeze
Tachypnoea
Tachycardia
Reduced air entry
Hyperinflated chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Complications of asthma

A

Pneumonia
Pneumothorax
Pneumomediastinum
Respiratory failure and arrest
Pulmonary collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Investigations for acute asthma

A

Bloods
ABG - if sPO2 <92%
CXR - rule out pneumonia/pneumothorax, normal or hyperinflation and flattened diaphram
Peak flow - % of patients previous best value
ECG - often sinus tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Investigations for chronic asthma

A

Spirometry
Peak flow
FeNO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Bloods in acute asthma and what for

A

FBC - raised WCC + typically eosinophilia
U+Es - salbutamol -> hypokalemia
CRP - rule out infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What spirometry value is considered obstructive?

A

FEV1/FVC ratio under 70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the other option except spirometry for obstruction measuring?

A

Bronchodilator reversibility reversibility tes t indicated by improbement 12% FEV1 or more and increased involume 200ml

19
Q

What is PEFR useful for in asthma?

A

Monitoring patients with established astham
Basic
Diurnal variation

20
Q

What is FeNO?

A

Gold standard for diagnosing asthma, fractional exhaled nitric oxide
Measures level of NO in exhaled breath _ provides indication of eosinophilic inflammation in lungs - adults >40 = positive

21
Q

Grading of asthma

A

Moderate
Severe
Life threatening
Near fatal

22
Q

Moderate asthma parameters?

A

PEFR 50-75% predicted or best
Speech normal
RR <25/min
Pulse <110BPM

23
Q

What is the SpO2, PaO2 and PaCO2 in life threatening asthma?

A

SpO2 <92%
PaO2 <8kPa
‘Normal’ PaCO2

24
Q

Parameters for severe asthma

A

PEFR 33-50% best or predicted
Can’t complete sentences
RR > 25/min
Pulse >110BPM

25
Q

Life threatening asthma symptoms

A

Altered consciousness level
Exhaustion
Arrhythmia
Hypotension
Cyanosis
Silent chest
Poor respiratory effort

25
Q

Life threatening asthma symptoms

A

Altered consciousness level
Exhaustion
Arrhythmia
Hypotension
Cyanosis
Silent chest
Poor respiratory effort

26
Q

When is life threatening asthma nearly fatal?

A

Raised PaCO2 and or requiring mechanical ventilation with raised inflation pressures

27
Q

Management of acute asthma

A

Sit patient up and high flow oxygen 15 L
Nebulised beta 2 agonist - salbuatmol 5mg and nebulised antimuscarinic - ipatropium bromude 0.5mg
Corticosteroid: prednisolone (40-50mg) or IV hydrocortisone
Consider IV magnesium sulphate (1.2-2.0g IV over 20 min). If little response to above considerIV aminophylline
ITU referral

28
Q

What is slabutamol?

A

Beta 2 agonist

29
Q

What is an antimuscarinic used in treatment of acute asthma?

A

ipatropium bromide - 0.5mg

30
Q

When refer acute asthma to ITU?

A

Fail to respond to theray eg
Deteriorating PEF, persisting or worsening hypoxia, hypercapnia, resp acidosis, exhaustion, feeble respiration, drowsiness, confusion, altered consciousness state, respiratory arrest

31
Q

Management for acute asthma pneumonic

A

O SHIT ME
Oxygen
Salbutamol
Hydrocortisone
Ipatropium
Theophylline
Magnesium sulphate
Escalation

32
Q

How does ipatropium work?

A

Antimuscarinic - prevent smooth muscle contraction in larger airways

33
Q

Management chronic asthma phase 1

A

Short acting beta agonist SABA eg Salbutamol
If nto controlled on this SABA + low dose inhaled corticosteroid eg beclomethasone or budesonide

34
Q

Second stage chronic asthma management

A

Add Leukotriene receptor antagonist (LTRA) eg montelukast 10mg OD to existing SABA and low dose ICS

35
Q

What drug do you perscribe if a LTRA doesnt work in chronic asthma?

A

add a LABA (long acting beta agonist) eg formoterol, potnetially continuing LTRA if still responded a bit to it

36
Q

What are the options for unresponding chronic asthma?

A

MART - maintenance and reliever therapy incl low dose ICS eg symbicort (budenoside with formoterol)
Long acting antimuscarinic receptor antagonist eg tiotropium , theophylline

37
Q

What class of drug is theophylline, tiotropium

A

Long acting antimuscarinic receptor antagonist

38
Q

Signs that asthma is unmanaged

A

Symtpoms are coming back - wheeze, tight chest, SOB, cough
Nocturnal, waking up
Symptoms interfering with ADL
Using reliever inhaler 3x or more a week

39
Q

How many hours in between needing an inhaler counts as an asthma attack?

A

if more than every 4 hours - having an asthma attack, need to take emergency action

40
Q

When is someone having an asthma attack?

A

Need a reliever inhaler more than every 4 hours
Difficult to walk or talk
Difficult to breathe
Wheezing a lot or have v tight chest or coughing a lot

41
Q

What to do in an asthma attack

A

Sit up straight and try and keep calm
Take one puff of your reliever inhaler - blie every 30-60s, max of 10 puffs
If feel worse or dont feel better after 10 puffs call 999
Repeat step 2 after 15 minutes while waiting for an ambulance
See GP within 48 hours

42
Q

What to monitor in asthma review?

A
  • Peak flow
  • Education
  • Symptom recognition
  • quality life indicators eg
  • symptoms during day
  • difficulty sleeping
  • usuial activities
43
Q

What to ask specifically in an asthma history?

A
  • Best peak flow
  • Home nebulisers
  • Recent exacerbations and antibiotics
  • ICU admissions

A- Resp and cardio (58 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions