Asthma Flashcards
What gene has been found to increase risk of asthma?
ADAM 33 - Metalloproteinase
Who are most likely to get asthma?
FamHx and Allergies
– Male young children, but more commonly women are more severely affected into adulthood
What age do most children stop experiencing asthma symptoms?
Age 6, if they continue, then more likely to experience eczema, allergic rhinitis, allergic conjunctivitis.
What is the biggest risk factor for asthma in adults?
Obesity, especially women
What increases a risk for developing asthma in childhood?
- Abx in the first year of life
- smoking during pregnancy / smoke exposure
- C-section
DECREASED RISK = Daycare, sibilings
What exposures increase development of asthma and increased risk of exacerbations?
Environmental allergens/irritants, RSV VIRUS, SMOKE, Air Pollution
What are the most common symptoms of asthma?
- Wheezing / SOB – ESPECIALLY NIGHT TIME
- Chronic Cough
- Chest pain with exercise
How does exercise induced asthma present?
Usually 5-10 minute after starting and lasting more than 10 minutes after stopping.
- Poor conditioning SOB begins before 5 minutes into exercise and resolves less than 5 minutes after stop
How much must FEV1 improve with broncodilators to diagnose asthma?
12% or 200mL, if not then likely COPD
What are the different zone system breakdown for asthma?
Green – 80-100% of target peak flow
Yellow – 50-80% of target peak flow
Red –
What kind of prevention should a 25 year old asthmatic receive?
Flu Vaccine
Pneumococcal Vaccine
If a patient has 2x days of asthma symptoms per week, 2x night symptoms per mouth without symptoms between, what is the severity of the asthma?
Intermittent
- No intererence with normal activity
- Normal FEV1 80%+
If a patient has daytime symptoms 4 times per week and night time symptoms 1x per week, what is the severity of asthma?
Mild Persistent
- FEV1 80%+ of predicted
- Minor limitation in normal activites
If a patient has daily daytime asthma symptoms, nighttime symptoms 2 times per week, uses albuterol inhaler daily, what is severity?
Moderate Persistent
- FEV1 60-80%
- FEV1/FVC reduced by as much as 5%
If a patient is using their albuterol inhaler on a daily basis, frequent nighttime symptoms, limited physicial acitivty due to symptoms?
Severe Persistent
– FEV1
Does increasing an inhaled steriod dose, improve symptom control?
No. Adding long acting B-agonist works better if more symptom control is needed.
How do Leukotriene antagonist symptom control compare to inhaled corticosteriods?
Worse. Inhaled Steroids are more effective.
– Leukotriene antagonist is a 2nd line single agent
What patients are immunotherapy used best for in asthma?
Patients with a high IgE load
- Anti-IgE
- Allergy Shots
During an acute exacerbation of asthma, what should be added to nebulizers if they are completely working?
Ipratropium Bromide, systemic steroids can be used as well for 7-10 days to reduce recurrence
What is the most important management of long term control of persistent asthma?
Developing a regimen that the patient can maintain normal activity levels and prevent exacerbations. Also having a treatment plan for the patient to adjust accordingly at home.
