Asthma

Question 1

What is asthma?

Answer 1

Lung condition that causes breathing difficulties caused by inflammation in the tubes of the lungs. There is often a trigger which causes the airways within the lungs to narrow, making it harder to breath. The airways may produce more mucus too which also narrows the airways further.

Question 2

What can causes asthma to occur?

Answer 2

Allergens such as pollen
Irritants e.g. cigarette smoke, strong smells, cold air
Exercise
Chest infections

Question 3

What are the symptoms of asthma?

Answer 3

Chest pain
breathlessness 
Coughing 
Polyphonic Wheeze
Cough at night

Question 4

What are the stages of treatment of asthma?

Answer 4

Stage 1: SABA - salbutamol
Stage 2: SABA + ICS e.g. beclomethasone proprionate
Stage 3: SABA + ICS + LABA e.g. salmeterol
Stage 4: SABA + ICS + Leukotriene antagonist or muscarinic antagonists
Stage 5: Everything above + oral steroids e.g. prednisolone

Question 5

What is status asthmaticus? and how is it treated?

Answer 5

Severe life threatening asthma - asthma attacks follow one after another without a pause.
Oxygen
Salbutamol and ipotropium
Prednisolone or IV hydrocortisone immediately

Question 6

What are complications of asthma if its poorly controlled?

Answer 6

Persistent tiredness
underperformance at school/work
lung infections
disruption to work/leisure time due to appointments

Question 7

Specific history taking questions

Answer 7

Have you noticed breathlessness is worse after exercise?
Is there anything that triggers your breathlessness?
Have you noticed any coughing during the night?

Question 8

What can too much b2 agonist cause?

Answer 8

Tremor

Question 9

How do beta 2 agonists work?

Answer 9

Cause bronchodilation - making it easier to breathe. Bind to b2 receptors which are coupled to Gs proteins to stimulate adenlyl cyclase which causes an increase in cAMP which decreases the intracellular calcium concentration and activates myosin light chain phosphatase -> leads to smooth muscle relaxation