Asthma

Question 1

What is asthma?

Answer 1

Narrowing of airways due to smooth muscle contraction, thickening of the airway wall and inflammation.

Question 2

What triggers asthma?

Answer 2

Occupational sensitisers: wood, dust, bleach
cold air, exercise, diet, drugs

Question 3

What are the signs and symptoms of asthma?

Answer 3

Dyspnoea, wheeze, cough, sputum, symptoms worse at night, SOB

Question 4

Investigations?

Answer 4

Lung function tests eg. PEFR
skin prick test to identify trigger

Question 5

What are the stages of asthma exacerbation severity

Answer 5

moderate: 50-75% PEFR
acute severe: 33-50% PEFR
life threatening: PEFR< 33%

Question 6

Management?

Answer 6

Immediate: oxygen, nebulised 5mg salbutamol
Beta-2-agonists eg. SABA (salbutamol), LABA (salmeterol)
Muscarinic antagonists eg. SAMA (ipratropium), LAMA (tiotropium)
Inhaled corticosteroids

Question 7

Treatment guidelines?

Answer 7

SABA
SABA + ICS
SABA + LABA +ICS
SABA + LABA + ICS +4th drug