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Clin Med 1 - Exam 2 > Asthma > Flashcards

Asthma Flashcards

1
Q

Safest asthma medication to use in pregnancy

A

Inhaled corticosteroids (Advair, Dulera, Symbicort)

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2
Q

True or false. Strenuous exercise should be avoided in asthmatics

A

False

Take inhaler/LTRA 5-20 minutes before exercise

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3
Q

Which ethnicities most commonly suffer from asthma?

A

Puerto Rican > Black > White > Mexican

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4
Q

What does FEF 25-75 measure?

A

Average forced expiratory rate during mid FVC

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5
Q

Apart from spirometry, another kind of pulmonary function test which gives more detail but is rarely done is …

A

Plethysmography

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6
Q

Which asthma medications are associated with cleft palate and gastroschisis birth defects if taken during pregnancy?

A

SABA (Albuterol, levalbuterol)

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7
Q

Does the hyper-responsive inflammatory component of asthma relate to the mucosal or smooth muscle layer of the airway?

A

Mucosal

Constriction is the smooth muscle layer

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8
Q

How many children with asthma have full remission during puberty

A

1 in 4

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9
Q

True or false. Asthma can often begin after the age of 50.

A

False. If onset is after age 50, it’s probably not asthma

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10
Q

A patient with asthma day symptoms 6 times a week and night symptoms once a week, with an FEV1 of 82% would get what treatment?

A

Low-dose ICS (Advair, Dulera, Symbicort)

(patient is in mild persistent class)

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11
Q

True or false. Allergy testing can diagnose asthma.

A

False.

May identify triggers, but cannot diagnose

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12
Q

Describe (4) potential causes of nocturnal asthma

A

Physiologic sleep changes

Bedroom/late-day allergens

GERD

Sleep apnea

(take asthma meds before bed, might help)

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13
Q

Which asthma medication is associated with cleft palate, pre-eclampsia, gestational diabetes, and low birth weight complications if taken during pregnancy?

A

Oral steroids

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14
Q

Asthma is commonly seen in a “march” with these two other conditions

A

Atopic dermatitis (eczema)

Seasonal allergies

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15
Q

What should be given to a patient with occupational asthma?

A

Take home peak expiratory flow device for them to measure at work

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16
Q

In addition to spirometry, what needs to be added to diagnose asthma?

A

Bronchodilator and repeat spirometry

Improvement = asthma

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17
Q

How long should systemic steroids be used in outpatient management of asthma?

A

One to three weeks

Avoid long term use

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18
Q

What is the gold standard for asthma diagnosis?

A

Methacholine/histamine challenge

19
Q

Which type of PFT is most commonly done in asthma testing?

A

Spirometry

20
Q

Theophylline is rarely used in asthma management due to …

A

Risk of seizures/arrythmias

21
Q

For patients who don’t respond to initial asthma management in the ER, what are the next two potential steps?

A

2g IV magnesium

If that fails, then mechanical ventilation (with ABGs)

22
Q

Describe initial asthma management in the ER

A

Supplemental O2
- >92% normally (>95% if pregnant)

Promptly give SABA
- add ipratropium if severe to relax lung muscles

Promptly give systemic glucocorticoids

23
Q

Patients with asthma triggered by aspirin may have this unique sign on physical exam

A

Nasal polyposis

24
Q

Asthma patients with atopic dermatitis (eczema) will have red, dry, inflamed skin on these areas of their body

A

Flexor surfaces of elbows and knees

25
Q

The two most common asthma symptoms are …

A

Expiratory wheeze

Cough (worse at night)

26
Q

A patient with asthma day symptoms once a week and night symptoms once a month, with an FEV1 of 90% would get what treatment?

A

PRN SABA (Albuterol)

(patient is in intermittent class)

27
Q

In asthma would you see decreased FVC or decreased FEV1/FVC ratio on spirometry?

A

Decreased FEV1/FVC ratio (obstructive)

28
Q

Nasal polyposis is associated with which sub-type of asthma?

A

Aspirin exacerbated asthma

29
Q

Name some common environmental asthma triggers

A

Ragweed
Dust
Mold
Exercise in cold air

30
Q

Medications to avoid in asthma management

A

Non-selective beta-blockers (propranolol)

Aspirin too if they’re one of those ones

31
Q

All suspected cases of asthma should be given this diagnostic test

A

PFT - pulmonary function tests

32
Q

A patient with asthma day symptoms throughout the day and night symptoms often nightly, with an FEV1 of 50% would get what treatment?

A

Med-high ICS (Advair, Dulera, Symbicort) AND LABA (Salmeterol or Formoterol)

With or without oral prednisone

33
Q

Upon ER discharge after an asthma attack, which medication should be prescribed, and for how long?

A

Oral corticosteroids (prednisone)

For 5-7 days

34
Q

Best management medication for asthma in patients with co-occurring allergies/atopy

A

Humanized monoclonal antibodies against IgE

Xolair

35
Q

In treatment of post-nasal drip in asthmatics, what unique physical exam sign would be seen?

A

Cobble stoning of the throat

36
Q

Describe the appearance of a flow-loop pattern in asthma

A

Scooped out shape and smaller (obstructive)

37
Q

In restrictive lung diseases would you see decreased FVC or decreased FEV1/FVC ratio on spirometry?

A

Decreased FVC

38
Q

True or false. Leukotriene inhibitors are less effective than inhaled corticosteroids for treatment of inflammation

A

True

39
Q

A patient with asthma day symptoms 7 times a week and night symptoms five times a week, with an FEV1 of 72% would get what treatment?

A

Low-dose ICS (Advair, Dulera, Symbicort) AND a LABA (Salmeterol or Formoterol)

OR

Medium dose ICS

(patient is in moderate persistent class)

40
Q

These four signs on physical exam indicate a more severe case of asthma

A

Hyper-resonance of chest

Use of accessory muscles in breathing

Pulsus paradoxus

Quiet chest (low air flow)

41
Q

Describe the appearance of a flow-loop pattern in restrictive lung diseases

A

Normal shape, decreased size

42
Q

1 in 10 school age children, but is it more common in boys or girls in childhood and men or women as adults?

A

Boys in childhood and women in adulthood

43
Q

Name medications that commonly trigger asthma

A

Aspirin

Non-selective beta-blockers

44
Q

Asthma in pregnancy usually shows up in which trimester?

A

2nd trimester

Clin Med 1 - Exam 2 (5 decks)

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