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Pulmonology > Asthma > Flashcards

Asthma Flashcards

1
Q

a chronic, obstructive, inflammatory lung disease characterized by increased airway responsiveness to stimuli that leads to bronchospasms and airway narrowing that is partially-completely reversible

A

asthma

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2
Q

pathophysiology in which inflammatory cells infiltrate the submucosa, smooth muscles around airways hypertrophy, or basement membrane thickens leads to ….

A

airway narrowing

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3
Q

pathophysiology in which there is increased intraluminal mucus accumulation that leads to resistance to air flow and occlusion to airways

A

goblet cell hyperplasia

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4
Q

pathophysiology in which there is an increased sensitivity to allergens and airway reactivity

A

denudation of airway epithelium

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5
Q

what 2 medication types can trigger asthma?

A

beta blockers
NSAIDs (aspirin)

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6
Q

pharmacotherapy that works on beta2 receptors and causes airway smooth muscles to relax, causing bronchodilation

A

beta-adrenergic agonists

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7
Q

what are 4 examples of short acting b2 agonists? (SABA)

A

albuterol
levalbuterol
metaproterenol
terbutaline

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8
Q

what are 3 examples of long acting b2 agonists? (LABA)

A

formoterol
arformoterol
salmeterol

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9
Q

why is formoterol so special? (LABA)

A

long acting with a quick onset of 3 minutes

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10
Q

what can repeated use of SABAs or LABAs lead to?

A

downregulation of pulmonary B2 adrenoreceptors

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11
Q

what would have a faster onset: nebulized albuterol or albuterol MDI with spacer?

A

nebulized albuterol

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12
Q

what do anticholinergics do? (2)

A

airway dilation
reduce mucous secretions
(block parasympathetic system)

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13
Q

what is an example of a short acting muscarinic agent? (SAMA)

A

ipratropium bromide

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14
Q

what are 2 examples of long acting muscarinic agents?

A

tiotropium
umeclidinium

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15
Q

what is used to reverse inflammation, may take months for maximum effect, and is given to all patients with persistent symptoms?

A

inhaled corticosteroids

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16
Q

what are 3 examples of inhaled corticosteroids?

A

fluticasone
mometasone
budesonide

17
Q

what 2 combinations of corticosteroids with a LABA?

A

budesonide-formoterol
mometasone-formoterol

18
Q

what type of corticosteroids are used to control exacerbations (burst therapy), and speeds recover and reduces relapses?

A

oral / injectable corticosteroids

19
Q

what are 2 examples of corticosteroids that can be used for burst therapy?

A

prednisone
methylprednisolone

20
Q

a pharmacotherapy that does not provide immediate effects but long-term use helps prevent chronic airway inflammation

A

leukotriene receptor antagonists

21
Q

what is an example of a leukotriene receptor antagonist?

A

montelukast

22
Q

a medication that is used in moderate-severe asthma that is not controlled by inhaled corticosteroids, but has a narrow TI

A

theophylline (PDI)

23
Q

a medication that prevents mast cells from releasing histamine and leukotrienes, but is only effective if it is taken regularly and prior to exposure to trigger

A

cromolyn sodium

24
Q

what cannot be done during an asthma exacerbation?

A

PFT

25
Q

what would FEV1 prediction on PFT be to confirm airway obstruction/asthma?

A

less than 80%

26
Q

what can be done to show a decrease in FEV1 by 20% or more to lend a positive result?
Only done if spirometry is inconclusive.

A

bronchoprovocation using methacholine

27
Q

a monitor that shows quick measurement of forced expiration following full inspiration

A

peak expiratory flow measurement (PEF)

28
Q

a patient presents with wheezing and increased difficulty breathing, chest tightness, cough +/- sputum, and symptoms often get worse at night. There is visible dyspnea, prolonged expiration, accessory muscle use, tripod position, and pursed lips. what are they experiencing?

A

asthma exacerbation

29
Q

what is a red flag in an asthma exacerbation?

A

quiet breath sounds

30
Q

what is the samter triad?

A

aspirin sensitivity
nasal polyps
asthma

31
Q

what diagnostics should be done for a patient that is having an asthma exacerbation? (2)

A

blood gas
CXR

32
Q

a patient that is hyperventilating, has decreased CO2, normal or elevated pH, normal SPO2, and normal or increased PaO2 is most likely experiencing what level of asthma exacerbation?

A

mild

33
Q

a patient that is hyperventilating, has decreased CO2, elevated pH, and decreased SPO2 and PaO2 is most likely experiencing what level of asthma exacerbation?

A

moderate

34
Q

a patient who has greatly increased CO2, decreased pH, SPO2, and PaO2 is most likely experiencing what level of asthma exacerbation?

A

severe

35
Q

when would we have to order a CXR for patient with an asthma exacerbation?

A

infection is suspected - fever, sputum, fatigue

36
Q

what are the 3 steps in emergent treatment for a patient that presents with an asthma exacerbation?

A
  1. apply oxygen
  2. SABA (albuterol) + SAMA (ipratropium)
  3. corticosteroids - oral or IV
37
Q

in a patient with asthma exacerbation does not respond to any treatment with SABA, SAMA, or corticosteroids, what should we do? (2)

A

IV magnesium
intubate

Pulmonology (22 decks)

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