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2a Resp > Asthma > Flashcards

Asthma Flashcards

1
Q

What is atopy?

A

Genetic tendency to develop IgE antibodies in response to common environmental allergens which enter through intact mucosal surfaces

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2
Q

What does the atopic triad consist of?

A

Asthma, eczema and rhinitis

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3
Q

Asthma is a chronic disease characterised by r____ a____ o___, airway hyperresponsiveness, inflamed bronchioles and mucous hypersecretion

A

reversible airway obstruction

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4
Q

Allergic asthma is ___ mediated and a type _ hypersensitivity

A

IgE
type 1

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5
Q

Allergic asthma (70%) often presents early with common triggers being…

A

Pollen
Smoke
Dust
Mould
Antigens

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6
Q

Is non-allergic asthma IgE mediated?

A

No
Associated with smoking

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7
Q

Is allergic or non-allergic asthma easier to treat?

A

Allergic asthma

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8
Q

What can trigger asthma flare ups?

A

Infection
Allergen
Cold weather
Exercise
Drugs (beta-blockers, aspirin)

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9
Q

What is Samter’s triad?

A

Nasal polyps (painless growths in nose or sinuses)

Asthma

Aspirin sensitivity (problems when taking NSAIDs like wheezing, coughing, sneezing)

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10
Q

The pathophysiology of asthma involves the overexpression of ___ cells

A

TH2

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11
Q

What is the role of the TH2 cells in asthma?

A

Release cytokines (IL 3, 4, 5, 13)
Produce IgE
Recruit eosinophil

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12
Q

What does IgE trigger in asthma?

A

Mast cell degranulation releasing histamines, leukotrienes and tryptase

Triggers bronchial constriction and mucous hypersecretion

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13
Q

Overtime, asthma causes chronic remodelling leading to bronchial s____

A

scarring

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14
Q

What are symptoms of asthma?

A

Wheeze
Dry cough
Chest tightness
SOB

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15
Q

What is the PEF (peak flow) in moderate episode of asthma?

A

50-75% PEF

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16
Q

What is the PEF (peak flow) in severe episode of asthma?

A

PEF 33-50%
Can’t reach end of sentences

17
Q

What is the PEF in life threatening asthma?

A

Under 33% with decreased consciousness and silent chest

18
Q

What test measures fractional exhaled nitric oxide which indicates level of lung inflammation when diagnosing asthma

A

FeNO devices

19
Q

What ratio of FEV1:FVC shows obstruction?

A

Less than 0.7

20
Q

If there is less than 12% improvement of FEV1 when using a bronchodilator, what condition is it?

A

COPD

21
Q

How much will the FEV1 improve with a bronchodilator in asthma?

A

At least 12% improvement

22
Q

What is the first step in treatment for asthmas in over 16 y/os?

A

SAB2A as required

23
Q

What is the second stage in treatment for asthma in over 16 y/os?

A

ICS (inhaled corticosteroids)

24
Q

If both a SAB2A and ICS isn’t helping improve the asthma, what should be done?

A

Assess the inhaler technique and compliance

25
Q

What is the 3rd stage in treatment of asthma?

A

Add a LTRA (leukotriene receptor antagonist)
eg. Montelukast

alongside a SAB2A and ICS

26
Q

What is the 4th stage in treatment of asthma?

A

Give a LAB2A with or instead of the LTRA

(Alongside SAB2A and ICS)

27
Q

What is the 5th stage in treatment of asthma?

A

Increase dose of ICS

so now taking:
SAB2A, ICS (higher dose), LAB2A +/- LTRA

28
Q

Give an example of a SABA for asthma

A

Salbutamol

29
Q

Give an example of a LABA for asthma

A

Salmeterol

30
Q

Give an example of a SAMA (short acting muscarinic antagonist)

A

Ipratropium bromide

31
Q

Give an example of a LAMA

A

tiotropium bromide

32
Q

What mnemonic helps to recall treatment for asthma excaerbations

A

OSHITME

33
Q

How do you treat an exacerbation of asthma?

A

Oxygen
SABA (nebulised)
Hydrocortisone (ICS)
Ipratropium bromide
Theophylline (IV)
MgSO4 (IV, bronchodilator)
Escalate (intubation and ventilation)

34
Q

Should CPAP or BPIP be used for asthma?

A

BIPAP (CPAP may cause asthma attacks)

2a Resp (15 decks)

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