Asthma

Question 1

asthma cardinal symptoms

Answer 1

cough
dyspnea
wheezing

Question 2

asthma risk factors

Answer 2

atopy 
indoor allergen exposures 
rhinitis (chronic) 
occupational 
pollution 
respiratory infections 
active or passive smoke exposure 
obesity 
early menarche 
maternal age 
medications

Question 3

what types of medications are associated with asthma?

Answer 3

beta blockers (non selective) 
NSAIDs (aspirin)

Question 4

what is the common denominator and primary physiologic finding in asthma?

Answer 4

airway obstruction

Question 5

what is the cause of airway obstruction in asthma? the degree of severity depends on what?

Answer 5

inflammation and cellular infiltration

degree of bronchial hyperresponsiveness

Question 6

the inflammation seen in asthma has what three identifiable components?

Answer 6

1. infiltration of airway with eosinophils and lymphocytes
2. upregulation of normal cells to proinflammatory state
3. alterations in non cellular components of airway wall

Question 7

what are the four main inflammatory mediators of asthma pathogenesis?

Answer 7

histamine
leukotrienes
kallikrein
platelet activation factor

Question 8

what are the four components of airway obstruction?

Answer 8

inflammation
smooth muscle contraction and hypertrophy
mucus gland hypersecretion and mucus plugging
airway remodeling

Question 9

are infection related asthma attacks usually bacterial or viral?

Answer 9

viral

Question 10

what are the specific diagnostic tests indicating asthma?

Answer 10

bronchoprovocation
pre and post bronchodilator spirometry
serial peak flow measurements

Question 11

what are the pitfalls of provocation testing?

Answer 11

false positive may follow recent infection
false negative may occur if patient is tested while on medication
presence of bronchial hyperreactivity alone is NOT diagnostic of asthma

Question 12

what is the relationship of asthma and bronchial hyperreactivity?

Answer 12

everyone with asthma has bronchial hyperreactivity, but not everyone with bronchial hyperreactivity has asthma

Question 13

what are the criteria for classification of asthma severity?

Answer 13

days with symptoms
nocturnal symptoms
peak flow rates
peak expiratory flow rate variability

Question 14

what is the treatment for patients with intermittent asthma only (less than 2 episodes weekly)?

Answer 14

PRN rapid acting beta agonist only

Question 15

COPD patients are typically treated with what medication class?

Answer 15

anticholinergics

Question 16

what medication should NEVER be used as a monotherapy for asthma?

Answer 16

long acting beta agonists

Question 17

if a patient has more than intermittent asthma what must be added to the treatment regimen?

Answer 17

inhaled corticosteroid

Question 18

what is the indication for prednisone in the context of asthma?

Answer 18

exacerbation in outpatient / ER setting