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pulmonology > Asthma > Flashcards

Asthma Flashcards

1
Q

Most pts with asthma are allergic to

A

house dust mite

Dermatophagoides pteronyssinus

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2
Q

Age of presentation of asthma

A

any age

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3
Q

Peak age of presentation of asthma

A

3 years

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4
Q

Drugs that can trigger asthma

A

aspirin

beta blockers

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5
Q

Allergic rhinitis is present in _________ % of atopic patients

A

80

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6
Q

Intrinsic asthma

A

non atopic
adult onset
aspirin sensitivity
nasal polyps

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7
Q

When to suspect occupational asthma?

A

When symptoms improve during weekends

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8
Q

Characteristic pathological finding in BA?

A

Thickening of subepithelial basement membrane

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9
Q

Causes of subepithelial basement membrane thickening in bronchioles?

A

Asthma

Eosinophilic bronchitis

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10
Q

Inflammatory changes are predominant in which airway in asthma

A

cartilaginous(bronchi)

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11
Q

beta blockers and asthma

A

avoid all beta blockers

selective and topical too

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12
Q

EIA clinical presentation

A

begins after exercise has ended, and recovers spontaneously within about 30 minutes

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13
Q

Hormonal factors associated with asthma

A

Thyrotoxicosis and hypothyroidism can both worsen athma

low progesterone can worsen asthma

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14
Q

GERD and asthma

A

common in asthmatic patients as it is increased by bronchodilators

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15
Q

ventilatory failure in asthma

A

Very uncommon

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16
Q

prodromal symptoms before asthma attack

A

itching of chin
discomfort between scapula
impending doom

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17
Q

Reversibility

A

> 12% and 200-mL increase in FEV1 15 minutes after an inhaled short-acting 2-agonist or in some patients by a 2 to 4 week trial of oral corticosteroids

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18
Q

role of allergen challenge in asthma

A

occupational asthma

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19
Q

methacholine or histamine challenge

A

reduction of FEV1 by 20%

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20
Q

role of methacholine challenge test

A

DD of chronic cough

Normal PFT

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21
Q

Shadowing in x ray in asthma patients

A

pneumonia

eosinophilic infiltrates in patients with bronchopulmonary aspergillosis

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22
Q

Difference between cardiac asthma and BA

A

basal crackles in cardiac asthma

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23
Q

causes of wheeze

A 
foreign body obstruction
BA
cardiac asthma
eosinophilic pneumonia
churg strauss 
PAN
24
Q

Difference between COPD and asthma

A

symptoms show less variability
never completely remit
show much less (or no) reversibility to bronchodilators

25
Q

Duration of action of SABA

A

3-6 hours

26
Q

SABAs

A

albuterol

terbutaline

27
Q

LABAs

A

salmeterol

formoterol

28
Q

duration of action of LABAs

A

12 hours

29
Q

Most common adverse effect of beta agonists

A

muscle tremor

palpitations

30
Q

Muscle tremor and palpitation due to beta agonists are commonly seen in

A

elderly

31
Q

tolerance to beta agonist therapy

A

rapid in mast cells

no tolerance for airway dilatation

32
Q

anticholinergic therapy in acute severe asthma

A

used only after beta agonists as they have a slower onset of action

33
Q

Most common adverse effect of anticholinergic therapy

A

dry mouth

34
Q

adverse effect of anticholinergic therapy in elderly patients

A

urinary retention

glaucoma

35
Q

anti inflammatory action of theophylline is due to

A

activation of histone deacytelase 2

36
Q

MOA of theophylline

A

Phosphodiesterase inhibitor

37
Q

role of aminophylline in asthma

A

severe exacerbations that are refractory to SABAs

38
Q

Most common side effects of theophylline

A

Nausea
vomiting
headache

39
Q

adverse effects of theophylline occur at plasma concentrations above

A

10mg/L

40
Q

adverse effects of theophylline

A 
nausea,vomiting
headache
diuresis
palpitations
arrythmias
seizures
41
Q

arrythmias and seizures due to theophylline is the result of

A

adenosine A1 receptor antagonism

42
Q

side effects of ICS

A

hoarsness

oral candidiasis

43
Q

how to prevent local side effects of ICS

A

use of large spacer

44
Q

OCS Rx in asthma

A

prednisone or prednisolone 35-40mg od for 5 to 10 days

no tapering needed

45
Q

key side effect of intramuscular triamcinolone in asthma

A

proximal myopathy

46
Q

steroid side effects

A 
osteoporosis
hypertension
diabetes
easy bruising
GI ulceration
cataract
truncal obesity
depression
proximal myopathy
47
Q

cromones

A

cromolyn sodium

nedocromil

48
Q

role of cromones in asthma

A

trigger induced asthma like EIA,SO2,

49
Q

Frequency of omalizumab injection

A

every 2-4 weeks

50
Q

Use of reliever medication more than ________ times/week indicates need for controller therapy

A

3

51
Q

marker of impending respiratory failure in Acute severe asthma

A

normal or raised PCO2

52
Q

O2 sat target in Acute severe asthma

A

> 90%

53
Q

Indication for intubation in acute severe asthma

A

impending respiratory failure

54
Q

Causes of refractory asthma

A 
non compliance
chlamydia/mycoplasma
beta blockers,aspirin
hypo/hyperthyroidism
premenstrual worsening
rhinosinusitis
55
Q

OCS of choice in pregnant patients

A

prednisone

as it is not converted to prednisolone by fetal liver

56
Q

safe antiasthmatic medications

A

SABA
ICS
Theophylline

pulmonology (7 decks)

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