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Respiratory Conditions > Asthma > Flashcards

Asthma Flashcards

1
Q

Symptoms of Asthma

A

SOB
Wheezing
Cough
Chest tightness

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2
Q

Risk factors for asthma

A

smoking
tendency to allergy (dermatitis, allergic rxn)
family history
obesity
lower SES
males in children
females > 40
stress
anxiety
early puberty

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3
Q

What is the main way to diagnose asthma?

A

spirometer with FEV1 > 80%

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4
Q

What are the short-term triggers for asthma?

A

COLD air
exercise
emotional stress

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5
Q

What are the long-term triggers for asthma?

A

allergens
dust, mites
cockroaches
mold, pollen
pet’s danders

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6
Q

Which conditions should be controlled as they may affect asthma exacerbations?

A

GERD
rhinitis
sinusitis

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7
Q

Non-pharms

A

warm humidifier
air purifier (no evidence)
avoid emotional stress
exercise

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8
Q

What is FEV1?

A

It is the forced expiratory volume one second - amount of air a patient can EXHALE in one second.

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9
Q

What is FVC?

A

Forced vital capacity = total amount of air that the lungs can hold

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10
Q

What is a normal FEV1?

A

> 80% in adults

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11
Q

What is an indicator of LOW respiratory function?

A

Severe FEV1 = < 50%

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12
Q

If in doubt, you can do a methacholine test to confirm diagnosis of asthma. What are the steps to this test?

A
  1. measure FEV1
  2. inhale methacholine
  3. in 15-20 mins, repeat spirometry and measure FEV1. If FEV1 is reduced by > 20% , asthma was triggered by the allergen (methacholine) which caused airway narrowing.
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13
Q

When is peak flow meter used?

A

can be used to monitor asthma. its used at home, easy for day-today home follow up (i.e. for an asthma action plan)

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14
Q

What is the purpose of using a Chest Xray in asthmatics?

A

eliminates possibility of TB or lung cancer

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15
Q

What is the ABG test? (Arterial Blood Gas)

A

determines the need for oxygen therapy; measures lung size, oxygenation, and gas diffusion across alveolar membrane.

normal = SpO2 > 95%
If below < 90%, requires intervention.

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16
Q

Can weight loss help with asthma control?

A

yes

17
Q

General sequence of asthma therapy (GINA GUIDELINES)?

A
  1. Low dose ICS/LABA prn or SABA prn
  2. Medium dose ICS/LABA, alternative: LTRA
  3. PO corticosteroid
  4. IV corticosteroid
18
Q

Examples of ICS + LABA

A

budesonide + formoterol (symbicort)

mometasone + formoterol (Zenhale)

can work both as reliever and controller

19
Q

What frequency of asthma attacks indicates CONTROLLED asthma?

A
  1. Daytime asthma symptoms: ≤2 times per week.
  2. Night-time waking due to asthma: None.
  3. Reliever medication use: ≤2 times per week.
  4. Activity limitation due to asthma: None.
20
Q

Side effects of SABA

A

tremors
nervousness
tachycardia
palpitations
weakness
facial flushing/skin
insomnia
N/V

21
Q

Examples of SABA vs. LABA

A

SABA: salbutamol, terbutaline
LABA: Formoterol (full b2 agonist), Salmeterol (partial agonist)

22
Q

Onset of SABA vs. LABA?

A

SABA: 5 min
LABA: 14 mins but lasts longer (upto 24 hrs). Formoterol has a faster onset compared to salmeterol by 3-5 min

23
Q

Examples of ICS/LABA combo?

A

symbicort: budesonide/formoterol
Breo Ellipta: fluticasone/vilanterol
Advair diskus or MDI: luticasone/salmeterol
Zenhale: mometasone/formoterol

24
Q

side effects of ICS?

A

oral pharyngeal candidasis
dysphonia
cough

25
Q

benefits of ICS?

A

increases lung fxn, reduced airway hyper-responsiveness, reduces symptoms of exacerbations.
-mouth rinsing and using a spacer can reduce steroid AEs
max effect in 2-4 weeks.

26
Q

Example and indication for LTRA?

A

montelukast- can be used in children > 2 yo.
2nd line, or add-on tx as steroid-sparing agent

27
Q

When is omalizumab used?

A

if symptoms are not well controlled with high dose ICS

28
Q

IL-5 inhibitors and when they are used?

A

pt with uncontrolled asthma despite ICS + LABA (or any controller)

mepolizumab - children > 6 yo
benralizumab or reslizumab - > 18 yo

29
Q

which agents are safe to use in pregnancy?

A

SABA
Theophylline
Cromolyn
ICS

30
Q

what is the diagnostic test for asthma in children?

A

spirometer in children over 6.
if less than 6 yo, diagnosis is based on symptoms

31
Q
A

Respiratory Conditions (2 decks)

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