Asthma Flashcards
When is the peak age of presentation for asthma?
- 3 y/o
What is the strongest predisposing factor for developing asthma?
- atopy/allergic triad
What are principal allergens of asthma?
- dust mite
- animal dander
- cockroach
- grass & tree pollen
- alternaria (a soil mold)
What are the etiologies of asthma?
- hygiene hypothesis
- diet
- air pollution
- allergens
- occupational exposures
Describe the pathology of asthma
- REVERSIBLE*
- shedding of airway epithelium
- edema
- mucus plugging
- mast cell activation
- collagen deposition under the basement membrane
T/F: Over time, asthmatics incur permanent physiologic changes.
- True
Airflow is _______ proportionate to the ______ of the airway.
- inversely
- radius
What must be done to determine a definitive diagnosis of asthma?
- spirometry in pts older than 4
What are the symptoms of asthma?
- wheezing
- cough worse @ pm
- recurrent difficulty breathing
- chest tightness
T/F: A lack of wheezing and a normal chest exam do not exclude asthma.
- True
When do asthma symptoms occur or worsen?
- exercise
- inhalant allergens
- irritants
- changes in weather
- strong emotional response
- stress
- menstrual cycles
What are signs of severe asthma?
- hypoxemia
- hypercapnia
- pulsus paradoxus
T/F: CXR is always indicated in asthma r/o
- False, not routinely indicated
What is the hallmark of asthma?
- bronchial hyper-responsiveness
What are tests that can be done for an asthma dx?
- methocholine challenge
- spirometry
- labs
Describe spirometry values for an obstructive dz
- FVC normal or decreased
- FEV1 decreased by < 80%
- FEV1/FVC decreased by <70%
Describe spirometry values for a restrictive dx
- FVC decreased by <80%
- FEV1 decreased
- FEV1/FVC normal
When is stridor heard, inspiration or expiration? wheeze?
- stridor = inspiration
- wheeze = expiration
What is the goal of asthma therapy?
- reduce impairment
- reduce risk
What is the stepwise management of asthma?
- SABA
- LABA
- ICS
- LTR
- cromolyn
- theophylline
- oral steroid
- zileuton
- omalizumab
What are adrenergic beta-agonists?
- rescue inhalers
What is the effect of adrenergic beta-agonists on airways?
- relaxation of airway smooth m.
- increase mucocilliary clearance & mucus secretion
- decrease cough
- no effect on chronic inflam
