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YR3 Core Conditions > Asthma > Flashcards

Asthma Flashcards

1
Q

Define Asthma

A

Common chronic inflammatory condition of the airway which is reversible

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2
Q

Common characteristics of asthma

A
  1. Reversible airflow limitation
  2. Airway hyper-responsiveness
  3. Bronchial inflammation
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3
Q

What are the changes to the airway in chronic asthma?

A

Irreversible airflow limitation as a result of airway remodelling and mucus impaction

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4
Q

Prevalence

A

Increasing globally
More common in the west
Affects around 5-8% of the population

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5
Q

Classification of asthma

A

Extrinsic (allergic)

Intrinsic (non allergic)

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6
Q

Causes and triggers of Asthma

A
  1. Allergens
  2. Occupational sensitisers
  3. Viral
  4. Atmospheric pollution
  5. Emotion
  6. Drugs i.e. NSAIDs, B-Blockers
  7. Cold air
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7
Q

Why are NSAIDs contraindicated in asthma?

A

NSAIDs inhibit the COX-1 pathway which further prevents the production of anti-inflammatory prostaglandins. This results in the overproduction of pro-inflammatory leukotrienes to causes severe exacerbations of asthma

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8
Q

Why are Beta blockers contraindicated in asthma?

A

Airways have a direct parasympathetic innervation

No direct sympathetic innervation on airways

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9
Q

Clinical symptoms of Asthma

A

Wheeze
SOB
Diurnal variation
Cough

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10
Q

Key questions to ask when taking an asthma history

A
  1. Precipitants
  2. Diurnal variation
  3. Exercise tolerance
  4. Home enviroment
  5. Acid reflux
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11
Q

Clinical signs of Asthma

A 
Tachypnoea
Audible wheeze
Hyperinflated chest
Hyperresonant percussion
Inability to complete sentences
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12
Q

Clinical tests

A 
PEFR
FBC
U+E
Spiro
CRP
ABG
Sputum culture
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13
Q

Asthma differentials

A 
Pulmonary oedema
COPD
Large airway obstruction
SVC obstruction
PE
Pneumothorax
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14
Q

Main aims of treatment

A

Abolish symptoms
Restore normal/best possible lung function
Reduce risk of severe attacks
Enable normal growth of children

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15
Q

Step 1 of management

A

Occasional symptoms

Manage with SABA (i.e. Salbutamol)

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16
Q

When do you escalate to step 2?

A

If the SABA is used more than once daily

17
Q

Step 2 of management

A

SABA + ICS (i.e. beclemtasone)

18
Q

When do you escelate to step 3?

A

If condition is still uncontrolled

19
Q

Step 3 of management

A

ICS + LABA (i.e. salmeterol)

Increase ICS if still symptomatic

Stop LABA if no effect

20
Q

Step 4 of management

A

Consider max dose of ICS + modified release theophyline + modified release B2 agonist

21
Q

Step 5 of management

A

Oral prednisolone + step 4 + Refer

22
Q

Summarise stepwise management

A
  1. SABA
  2. SABA + ICS standard dose
  3. LABA + ICS
  4. LTRA + max dose ICS + oral theophylline
  5. Refer + oral pred + step 4

YR3 Core Conditions (32 decks)

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