Asthma Flashcards

1
Q

What is asthma?

A

Airway inflammation mediated by immune system.

It can be spontaneous or from a certain stimuli.

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2
Q

How many adults affected?

A

5-10% more females than males

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3
Q

How many children affected?

A

10-15% more males than females.

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4
Q

How many people are receiving treatment?

A

5.4 million

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5
Q

What are the proven risk factors of asthma?

A

Genetic (atopy)
Occupation
Smoking

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6
Q

Describe the genetic reasoning for asthma.

A

Atyopy : Inherited tendency to IgE response to allergens

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7
Q

What is the strongest factor for genetic inherited asthma?

A

Familial atopic tendency

Maternal atopy is most influential (x3 father)

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8
Q

What are the genetic links for asthma?

A

1) immune response genes: IL-4, IL-5, IgE

2) airway genes; ADAM33

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9
Q

How many cases of adult onset asthma is caused by occupation?

A

10-15%

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10
Q

Name some examples of things that can cause adult onset asthma.
(7 things)

A
Isocyanantes - Twin pack paint
Colophony - Welding solder flux
Labratory animals- Rodent unrinary proteins
Grains- wheat proteins, grain mites
Enzymes- Subtilin, amylase
Drugs- Antibiotics, subutamol
Crustaceans- Prawns and crabs
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11
Q

What is the commonest cause of occupationa asthma?

A

BAKERS - flour

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12
Q

Describe what can happen if a mother smokes during pregnancy?

A

Decrease in FEV1
Increase in wheezy illness
Increase in airway responsiveness
Increase in asthma and severity

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13
Q

Describe the grand mother effect

A

If a mum smokes her babies o cytes are modified so when baby grows up her children will be X2 as likely to develop asthma.

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14
Q

Name the possible risk factors for asthma.

A

Obesity
Diet
Reduced exposure to microbes
Indoor pollution

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15
Q

What is increased Body mass index positively associated with?

A

Asthma
Wheezing
Airway hyperactivity

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16
Q

What is associated with a decrease in FEV1?

A

A decrease in vit E, C, D, B-carotene

17
Q

What is associated with an increased wheeze

A

A decrease in vit E& C, a decrease in fruit and use of margarine

18
Q

What is associated with an increase of asthma?

A

A decrease in selenium,fast food and margarine.

19
Q

what is associated with a decrease in asthma regarding diet?

A

Oily fish consumption and butter

20
Q

What should children be exposed to lightly to decrease risk?

A

Endotoxin
Glucans
Extracapsular polysaccharide

21
Q

Name some household cleaners witch can increase the risk of asthma?

A

Volatile organic compounds
formaldehyde
Fragrances

22
Q

Name some household allergens

A

House dust mite
Cat
Grass pollen( timothy grass)

23
Q

Name the generalised airflow obstruction

A
Asthma (reversible AFO)
COPD (irreversible AFO)
Bronchiectasis
Bronchiolitis
Cystic Fibrosis
24
Q

Name some of the symptoms of asthma?

Or any respiratory disease

A
Wheeze
Short of breath( dyspnoea) 
Chest tightness
Cough, Paroxysmal,usually dry
Sputum (occasional)
25
Q

Name some triggers of asthma?

A

Exercise, cold air, smoke, perfume, URTI`s, Pets, Tree, grass pollen, food, aspirin

26
Q

Probably not asthma if?

A

Clubbing, cervical lymphadenopathy
Stridor
Assymetrical expansion
Dull percussion note (lobar collapse, effusion)
Crepitations (bronchiectasis, CF, Alveolitis, LVF)

27
Q

What would you do if spirometery showed airway obstructed and why?

A

Full pulmonary function testing.

Effectively excluding COPD/Emphysema

28
Q

How does one measure lung volume?

A

Helium- measure change in conc when expired to inspired.

29
Q

If patient is unresponsive tpo bronchodilators what do you do?

A

Use oral corticosteriods (anti inflammatory)

30
Q

Name a specialist investigation.

A

airway responsiveness to methacholine/ histamine- depnding on what you suspect it is?

31
Q

What is shown with exhaled nitric oxide

A

People with asthma have higher levels.

32
Q

Name some useful investigations for asthma?

A

Chest X-ray - ( Hyperinflated, hyperlucent-NO effeustion, collapse,opacities,interstitial changes)
Skin Prick testing (atopic status)
Total and specific IgE
Full blood count- Eosinophillia