Brainscape's Knowledge GenomeTM

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


See full index

MBBS 3: Pediatrics > Asthma > Flashcards

Asthma Flashcards

1
Q

How can you diagnose asthma?

A
  1. Wheeze is suggestive but not pathognomonic
  2. Response to bronchodilator is suggestive
  3. Chronic cough may be a primary manifestation
  4. HISTORY
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

History taking questions?

A
  1. Recurrent cough or wheeze?
  2. Cold that “go to the chest” or take >10 days?
  3. Cough/wheeze during a particular time of the year
  4. Cough/wheeze/SOB when exposed to certain things?
  5. Used any medications to help you breathe better?
    - in the past 12 months
  6. have you had cough, wheeze, or shortness of breath - At night?, Upon awakening?, After play?
    - in the past 4 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Common asthma triggers?

A
  1. Animals
  2. Cockroaches/rodents
  3. Molds/dampness
  4. Spring (pollen)
  5. Rainy season (molds)
  6. Tobacco
  7. Wood-burning or paraffin stove
  8. Perfumes, cleaning agents, bug spray
  9. maize harvesting season
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Differential diagnosis for acute wheezing?

A
  1. Asthma
  2. Bronchiolitis
  3. Atypical infection - causing atypical pneumonia (Myecoplasma)
  4. Bacterial tracheitis
  5. Foreign body
  6. Anaphylaxis - associated with hives, swollen face, stridor and previous reaction to allergen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Causes of recurrent persistent childhood wheeze?

A
  1. viral episodic wheeze
  2. multiple trigger wheeze
  3. asthma
  4. tracheo-bronchomalacia
  5. bronchopulmonary dysplasia
  6. recurrent anaphylaxis
  7. cystic fibrosis
  8. chronic aspiration
  9. bronchiolitis obliterans
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Structural ddx chronic wheezing?

A
  1. Tracheo-bronchomalacia
  2. Vascular rings
  3. Tracheal stenosis
  4. Cystic masses
  5. Tumors or lymphadenopathy
  6. Cardiac failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Functional ddx chronic wheezing?

A
  1. Asthma
  2. Gastroesophageal reflux (GERD)
  3. Recurrent aspiration (e.g CP)
  4. Cystic fibrosis
  5. Immunodeficiency
  6. Bronchopulmonary dysplacia (ex-premie)
  7. Retained foreign body
  8. Bronchiolitis obliterans
  9. Pulmonary oedema
  10. Vocal cord dysfunction
  11. Interstitial lung disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the stages of asthma?

A
  1. intermittent
  2. mild persistent
  3. moderate persistent
  4. severe persistent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is intermittent asthma?

A

Daytime symptoms 2 or fewer days/week
Nocturnal symptoms 2 or fewer nights/month
No interference in daily activities or play
1 or fewer exacerbations per year

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

What is mild persistent asthma?

A

Daytime symptoms 3-6 days/week
Nocturnal symptoms 3-4 nights/month
Minor interference with daily activities or play
2 or more exacerbations per year

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

Effectiveness of SABAs - rescue inhalers?

A
  • Maximum effect after 10-15minutes
  • Effective for 2 -4 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Use of inhaled corticosteroids (ICS) - preventers?

A

The most effective prophylactic inhaled therapy

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

Side effects of ICS?

A
  1. impaired growth
  2. adrenal suppression
  3. altered bone metabolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is moderate persistent asthma?

A

Daily symptoms
Nocturnal symptoms more than once per week
Daily inhaler use
Some activity limitation

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

What is severe persistent asthma?

A

Symptoms throughout the day
Nocturnal symptoms most nights
Significant limitation in activity

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

Intermittent asthma management?

A

Salbutamol as needed (short acting beta-agonist, SABA)

17
Q

Mild persistent asthma management?

A
  1. SABA as needed
  2. Daily low-dose inhaled corticosteroid (ICS) = beclomethasone
18
Q

Moderate persistent asthma treatment?

A
  1. SABA as needed
  2. Daily medium-dose ICS
19
Q

Severe persistent asthma management?

A
  1. SABA as needed
  2. Daily high-dose ICS or Daily medium-dose +leukotriene receptor antagonist (LTRA)
20
Q

Symptoms of mild asthma?

A
  1. breathlessness while walking
  2. can speak in full sentences
  3. can sit in any position
  4. alert
21
Q

Signs of mild asthma?

A
  1. increased respiraory rate
  2. no use of accessory muscles
  3. expiratory wheeze
  4. pulse rate <100
  5. no pulsus paradoxus
  6. SpO2>95%
22
Q

Symptoms of moderate asthma?

A
  1. breathless while at rest - trouble feeding, shorter/softer cry
  2. can only speak phrases
  3. prefers sitting
  4. agitated
23
Q

Signs of moderate asthma?

A
  1. increased respiratory rate
  2. common use of accessory muscles
  3. wheeze throughout exhalation
  4. pulse rate: 100-200
  5. pulsus paradoxus: 10-25 mmHg
  6. SpO2: 90-95%
24
Q

Symptoms of severe asthma?

A
  1. breathless while at rest - stops feeding
  2. speaks only words
  3. sits upright
  4. agitated, drowsy or confused
25
Q

Signs of severe asthma?

A
  1. respiratory rate>30/min
  2. use of accessory muscles
  3. wheeze on inhalation and exhalation OR silent chest
  4. pulse rate >120 or bradycardia
  5. pulsus paradoxus: 20-40 mmHg
  6. SpO2 < 90%
26
Q

Respiratory rate in children by age?

A

2 - 12 months <50bpm
1 - 5 years <40bpm
6 - 8 years <30bpm

27
Q

Pulse rate by age in children?

A

2 - 12 months <160bpm
1 - 2 years < 120bpm
2 - 8 years <110bpm

28
Q

Exacerbation treatment?

A

Step 1: dexamethasone 0.6 mg/kg (max dose 12-16 mg) or prednisolone (1 -2mg/kg)
Step 2: salbutamol nebulizer over 20 minutes

29
Q

Severe exacerbation treatment?

A
  1. Salbutamol nebulizer (“back to back”)
  2. Magnesium sulfate OR aminophylline
  3. Oxygen therapy
30
Q

Other medications used in severe exacerbations in pediatric intensive care setting?

A
  1. Ketamine
  2. Adrenaline (0.01 mg/kg IM or subQ)
  3. Terbutaline (0.01 mg/kg IM or subQ)
  4. Heliox
31
Q

What is Heliox?

A
  • Heliox is a breathing gas mixture of helium (He) and oxygen (O2)
  • It is used as a medical treatment for patients with difficulty breathing
  • The mixture generates less resistance than atmospheric air when passing through the airways of the lungs, and thus requires less effort by a patient to breathe in and out of the lungs
32
Q

Respiratory support in severe exacerbations?

A
  1. BiPAP > CPAP
  2. Avoid intubation if possible
33
Q

What is BiPAP?

A

bilevel positive airway pressure (BiPAP) - delivers higher pressure on inspiration and lower pressure on expiration

34
Q

What is CPAP?

A

Delivers equal pressures both in inspiration and expiration

35
Q

When to discharge in asthma?

A
  1. Able to go 4 hours in between salbutamol treatments
  2. No longer requiring oxygen
  3. Able to eat and drink
36
Q

Discharge planning in asthma?

A
  1. Continue salbutamol for next 48 hours then gradually space out
  2. 3-5 days of prednisone (2 mg/kg first dose then 1 mg/kg BD)

MBBS 3: Pediatrics (43 decks)

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