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Clinical Medicine II > Asthma > Flashcards

Asthma Flashcards

1
Q

What do these symptoms indicate:
- wheezing, dyspnea, chest tightness, worsening at night, flare-ups, non-consistent, cough?

A

asthma

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2
Q

What are the two types of asthma?

A

atopic (allergic) Type 2 – atopy is the strongest defining factor! more common in children

nonatopic (nonallergic) Non-Type 2 – adulthood, exercise, medication, infection induced

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3
Q

What can put someone at risk for asthma?

A

children, low income, underserved areas

Atopic triad + Samter’s triad

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4
Q

What’s the atopic triad?

A

atopic dermatitis, asthma, allergic rhinitis

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5
Q

What’s the samter triad?

A

aspirin/NSAID sensitivity, asthma, nasal polyps/rhinitis

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6
Q

What disease does this characterize:
hyperactive/hyperresponsive inflammation in response to various triggers –> airway obstruction
REVERSIBLE?

A

asthma

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7
Q

What can trigger asthma?

A
  • air pollution
  • tobacco smoke
  • occupational exposures
  • mites, animal dander, cockroaches, fungi, mold, pollen
  • infections
  • diet
  • GERD
  • exercise induced
  • menstruation
  • medications (BBs, aspirin)
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8
Q

What does this PE indicate:
nasal polyps, eczema, prolonged expiratory phase, accessory muscle use

A

asthma

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9
Q

What’s gold standard for asthma diagnosis?

A

PFTs

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10
Q

<__% FEV1 - obstruction

A

70%

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11
Q

If FEV1 increases >___% after bronchodilator, = reversibility

A

12%

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12
Q

What bronchoprovocation testing is a + for asthma?

A

> 20% decrease in FEV1
using methacholine, histamine

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13
Q

What would you see on an asthmatic xray?

A

hyperinflation + air trapping

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14
Q

What would indicate an allergic asthma?

A

IgE

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15
Q

What’s a normal FEV1/FVC for 8-19yrs?

A

85%

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16
Q

What’s a normal FEV1/FVC for 20-39yrs?

A

80%

17
Q

What’s a normal FEV1/FVC for 40-59yrs?

A

75%

18
Q

What’s a normal FEV1/FVC for 60-80yrs?

A

70%

19
Q

What values indicate a mild or intermittent asthma severity?

A

Symptoms - <3-5 days/week
Normal or mildly reduced lung function
STEP 1/ STEP 2

20
Q

What values indicate a moderate asthma?

A

Symptoms - most days
Waking up at night once a week or more
Low lung function
STEP 3

21
Q

What values indicate a severe asthma severity?

A

Symptoms - daily
Waking up at night once a week or more
Recent exacerbations
STEP 4 or 5

22
Q

Every asthmatic should be prescribed a ____

A

rescue inhaler

23
Q

What is treatment for intermittent asthma?

A

Step 1 -
PRN low dose ICS-formoterol

also could do (from current) = low dose ICS daily + SABA PRN or combo ICS+SABA PRN

24
Q

What is treatment for mild asthma?

A

Step 2, which is the same as Step 1

PRN low dose ICS-formoterol

also could do (from current) = low dose ICS daily + SABA PRN or combo ICS+SABA PRN

25
Q

What is treatment for moderate asthma?

A

Step 3

combo low dose maintenance ICS-formoterol daily + when needed

26
Q

What is treatment for severe asthma?

A

Step 4: combo medium dose ICS-formeterol daily and as needed

Step 5:
medium-high dose ICS-formoterol + LAMA* (current said to also add LABA and SABA PRN if wanted)

27
Q

What could be considered for allergic asthma?

A

omalizumab

28
Q

How do you treat mild asthma exacerbations?

A

inhaled SABA + short term increase in ICS

no improvement within 48 hours = 5-7 day oral course of steroids

29
Q

How do you treat moderate asthma exacerbations?

A

continuous administration of inhaled SABA + systemic corticosteroids (if <70 FEV1)

30
Q

How do you treat severe asthma exacerbations?

A

oxygen + high dose inhaled SABA (can add SAMA) + systemic steroids + IV magnesium sulfate

consider abx if infections

31
Q

When should you follow up for reevaluation of asthma treatment?

A

2-3 months or if patient is not doing well

32
Q

At what step do you send them to a pulmonologist?

A

step 5

33
Q

What improves medication delivery in asthma?

A

spacer technique

Clinical Medicine II (11 decks)

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