Asthma Flashcards
What is the path for asthma?
smooth muscle dysfunction, airway inflammation, airway remodeling.
What is the path for asthma?
smooth muscle dysfunction, airway inflammation, airway remodeling.
Risk factors for asthma?
being male less than 10, atopy, family history, minority in urban area, allergen exposure, PEF varies more than 20% in the morn w/o albuterol and in the afternoon with albeterol, and obesity!!!
what is the triad of symptoms?
cough, wheeze, SOB
what are additional asthma symptoms?
chest tightness, hemoptysis, expective cough, hyperventilation.
asthma: history
intermitten, seasonl waxing and waning of symptoms. Occurs more often at night. exacerbation of sympomts due to exposure: exercise, cold air, allergens, pollutants, smoke, URI, strong odors
asthma: findings
1)high-pitched wheezing. The presence or absence of wheezing is a poor indicator of severity of airflow obstruction. 2) use of accessory muscles 3) Eczema, atopic dermatitis.
What if asthma patient presents only with a cough, what should you consider?
post-nasal drip, GERD, post viral tussive syndrome, drug induced
What are the risk factors for DEATH??
past hx of sudden attacks, prior intubations, admission to ICU, two or more hospitalizations for asthma in past year, three or more ER visits in on year, LOW SES, More than 2 canisters per month of beta agonist, systemic corticosteroids (current or immediate withdrawal), illicit drug use, unable to ID severity.
What cells play a role in asthma?
t lymph, marcophages, neutrophils, epiltheial cells, mast cells, eosinophils.
Describe the morphological changes
smooth muscle HYPERTROPHY Epithelial DAMAGE Inflammatory cell INFILTRATES Basement membrane THICKENING Mucous Gland HYPERSECRETION Vascular DILATION
Asthma: diagnosis
Spirometry will help determine airflow obstruction, and reversiblity of the airway.
- Increase in 12% or more and 200mL in FEV1 after inhaling a short acting bronchodilator indicates SIGNFICANT reversibility
- Histamine or Methacholine: increase until FEV1 drops 20% or more.
FEV declines in direct and linear proportion with clinical worsening of airways obstruction. and increases with treatment.
What if there was no signficant change of 12% or more?
still treat with bronchodilator for 6-8 weeks.
What should a normal FEV1/FVC be for someone with asthma?
greater than 75%. This indicates they can exhale up to 75% of their lung volume in the first second.
What should be considered in asthma control?
- assesment and monitoring
- education
- control of envrionmental factors and comorbities
- medications
