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Resp Summary Sheets JB > Asthma > Flashcards

Asthma Flashcards

1
Q

What is asthma?

A

It is an inflammatory disorder of the airways

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2
Q

Describe the symptoms of asthmas?

A

Dyspnoea
Cough
Wheeze
Chest tightness

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3
Q

Describe diurnal variation?

A

This is when asthma is worse in the morning and worse at night

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4
Q

What are the two classes of asthmas?

A

Extrinisc

Intrinsic

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5
Q

Describe Extrinsic Asthma

A

There is a definite external cause

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6
Q

Describe intrinsic asthma

A

There is no definite external cause

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7
Q

Describe the development of Extrinsic asthma?

A 
The production of IgE antibodies to an external antigen
Eg: Pollen
Smoke
Dust
Environmental Pollution
Respiratory Infection
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8
Q

Describe the acute response of asthma?

A

This is reversible

  • Bronchoconstriction (Wheeze)
  • Mucosal Inflammation and inflammatory cell recruitment
  • Excess Mucous Production
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9
Q

Describe the signs of Asthma?

A

Tachypnoea
Audible Wheeze
Hyper inflated chest
Diminished air entry

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10
Q

Describe the immunology of asthma?

A

An external antigen presents and IgE antibodies are made. Once the antigen has been the cleared, the spare IgE antibodies bind to mast cells via Fc receptors. When the antigen is re-encountered, it causes mast cell degranulation, release of inflammatory mediators

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11
Q

Describe the chronic response of asthma?

A
  • Increased smooth muscle mass
  • Accumulation of interstitial fluid
  • Increased mucous secretion
  • Epithelial Damage
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12
Q

Describe airway hyperresponsiveness?

A

Chronic inflammation and epithelial damage causes the nerve endings to become exposed. This means smaller quantities of bronchoconstrictor are required to cause a change in FEV1

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13
Q

Describe drug associated asthma?

A

Aspirin and other NSAIDs can induce asthma
This is by the process of spontaneous mast cell degranulation
Occurs in 20% of asthmatics

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14
Q

Describe the most common presentation of drug associated asthma?

A

Asthmatic takes Aspirin

1-3 hours later has an asthma attack

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15
Q

Describe the treatment of Drug associated asthma?

A

Anti-Leukotriene therapy

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16
Q

Describe the inflammatory mediators released from Mast cells in asthma?

A

The mast cells release Histamine, Leukotriene C4 and Prostaglandin D2

17
Q

What do the inflammatory mediators stimulate?

A

They stimulate Eosinophils to release Leukotrienes and epithelial damaging proteins This causes bronchial constriction and epithelial damage.

18
Q

What is Samter’s Triad?

A

Nasal Polyps
Salicylate Sensitivity (Aspirin/NSAIDs)
Asthma

19
Q

Investigations in asthma?

A

Peak Flow

Spirometry

20
Q

Describe the findings of Spirometry in asthma?

A

The FEV1 is decreased

The FVC is the same

21
Q

What kind of disease is asthma?

A

Obstructive

22
Q

What is obstructive disease?

A

This is difficulty exhaling all the air from the lungs due to damage to the lungs or narrowed airway
Causes an abnormal amount of air to remain in the lungs after expiration

23
Q

If the FEV1 is ≥ 80% of the expected value, what class of asthma is this?

24
Q

If the FEV1 is ≥ 50%-60% of the expected value, what class of asthma is this?

25
Q

If the FEV1 is ≥30% of the expected value, what class of asthma is this?

A

Life Threatening

26
Q

Describe the first step in asthma treatment?

A

Blue Inhaler

  • Short Acting B2 Adrenoreceptor Agonist
  • Salbutamol
  • When Required
27
Q

Describe the side effects of Salbutamol?

A

Muscle Tremor
Tachycardia
Palpitations and Arrythmias

28
Q

Describe the second step in asthma treatment?

A

Addition of a low dose inhaled steroid

Eg: Beclometasone Proprionate

29
Q

What are the side effects of Beclametasone?

A

Thrush
Cough
Hoarseness

30
Q

Describe the third step in asthma?

A

Addition of a long acting beta 2 agonist

Eg: Salmeterol

31
Q

Describe the side effects of Salmeterol?

A

Hoarseness
Sore Throat
Tachycardia

32
Q

Describe the fourth step in asthma?

A

Addition of a Leukotriene Receptor Antagonist (orally)

Eg; Monteleukast

33
Q

Describe the other effects of Monteleukast?

A

Also work in aspirin induced asthma

34
Q

Describe the fifth step in asthma?

A

Oral Steroids

Eg: Prednisolone

35
Q

Describe the side affects of oral steroids?

A

Water Retention
Weight Gain
Retarded Growth
Hypertension

36
Q

Describe treatment of Acute Asthma

A 
O SHIT MAN
Oxygen
Salbutamol (Nebulused)
Hydrocortisone IV or Prednisolone ORAL
Ipratropium Bromide (Nebulised)
Theophylline
Magnesium
Anaesthetist
37
Q

Describe chronic asthma treatment (Summary)

A 
SABA - Salbutamol
Inhaled Steroid - Beclometasone
LABA - Salmeterol
Leukotriene Antagonist - Monteleukast
Oral Steroid - Prednisolone
38
Q

Describe the symptoms of a life threatening asthma attack?

A

Silent Chest
Cyanosis
Bradycardia

39
Q

Side effects of Monteleukast?

A

Abdominal Pain

Headache

Resp Summary Sheets JB (27 decks)

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