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Asthma Flashcards

1
Q

Most common chronic disease (Harrison pp 1669)

A

Asthma

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2
Q

Asthma occurs 2x more in males than female during childhood. (Harrison pp 1669) True or False

A

True

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3
Q

What are the major risk factors for asthma deaths? (Harrison pp 1669)

A

Frequent use of bronchodilators
Lack of or poor compliance with ICS therapy
Previous admission to hospital with near fatal asthma

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4
Q

Major risk factor for asthma (Harrison pp 1669)

A

Atopy

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5
Q

What are the endogenous factors that triggers asthma? (Harrison pp 1670)

A 
Genetic predisposition
Atopy
Airway hyperresponsiveness
Gender
Ethnicity
Obesity
Early viral infections
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6
Q

What are the environmental factors that triggers asthma? (Harrison pp 1670)

A 
Indoor allergens
Outdoor allergens
Occupational sensitizers
Passive smoking 
Respiratory infections
Diet
Acetaminophen (paracetamol)
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7
Q

What are the common triggers of asthma? (Harrison pp 1670)

A 
Allergens
Upper respiratory tract viral infections
Exercise and hyperventilation
Cold air
Sulfur dioxide and irritant gases
Drugs (beta blockers and aspirin)
Stress
Irritants
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8
Q

Most common allergen of asthma in inner cities (Harrison pp 1670)

A

Cockroaches

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9
Q

Most common allergen of asthma in laboratory workers (Harrison pp 1670)

A

Rodents

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10
Q

What are the interlukins commonly associated with atopy? (Harrison pp 1670)

A

IL-3, IL-5, IL-9, IL-13

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11
Q

What chromosomes are involved in atopy? (Harrison pp 1670)

A

Chromosome 5q

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12
Q

It is a hypothesis proposes that the lack of infections in early childhood preserves the TH2 cell bias at birth. (Harrison pp 1670)

A

Hygiene Hypothesis

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13
Q

Diets that are associated with increase risk of asthma (Harrison pp 1670)

A

Low in Vitamin C, A, Mg, Selenium and Omega 3

High in Sodium and Omega 6

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14
Q

It is an independent risk factor for asthma (Harrison pp 1670)

A

Obesity (> 30 kg/m^2)

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15
Q

It occurs late onset, concomitant nasal polyp and may be aspirin sensitive. (Harrison pp 1671)

A

Intrinsic Asthma or Nonatopic asthma

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16
Q

Most common allergens that trigger asthma (Harrison pp 1671)

A

Dermatophagoides species

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17
Q

Upper respiratory viruses that commonly triggers acute severe exacerbations (Harrison pp 1671)

A

Rhinovirus
Respiratory syncytial viruses
Corona Virus

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18
Q

It typically begins after exercise has ended and resolves spontaneously within about 30 mins. It is worse in cold, dry climates than in hot and humid conditions. (Harrison pp 1671)

A

Exercise induced asthma (EIA)

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19
Q

Food additives that are associated with asthma (Harrison pp 1671)

A

Metabisulfite

Tartazine

20
Q

What are the characteristics findings in pathology with patient that has asthma? (Harrison pp 1672)

A

Thickening of the basement membrane (subepithelial collagen deposition)
Mucous plug

21
Q

Important in initiating the acute bronchoconstrictor responses to allergens. (Harrison 1672)

A

Mast cells

22
Q

Major presenting cells in the lungs (Harrison pp 1672)

A

Dendritic Cells

23
Q

Is the characteristic physiologic abnormality of asthma and linked with frequency of asthma symptoms (Harrison pp 1675)

A

Airway hyperactive responsiveness (AHR)

24
Q

Characteristics symptoms of asthma (Harrison pp 1675)

A

Wheezing
Dyspnea
Coughing

25
What is the definition of reversibility of simple spirometry in asthma means? (Harrison pp 1675)
> 12% and 200ml increase in FEV1 15 mins after inhalation of short acting B agonists or in some patient 2-4 weeks trial of oral corticosteroids
26
What collagens are involved with thickening of the basement membrane in asthma? (Harrison pp 1674)
Collagen Type 3 and 5
27
It is a test of compliance rather than diagnostic with asthma. (Harrison pp 1676)
Exhaled Nitric Oxide
28
It has duration of action of 3-6 hours, most common side effects are muscle tremor and palpitation, and rapid onset of bronchodilatation (Harrison pp 1676)
SABA (albuterol and terbutaline)
29
What is the plasma concentrations of theophylline with additive effects? (Harrison pp 1677)
5-10mg/L
30
It has a mechanism action of inhibition of phosphodieterase. (Harrison pp 1677)
Theophylline
31
At high concentration of theophylline, it causes several side effects , which are the following? (Harrison pp 1677)
Cardiac arrhymthmias Epilectic Seizures Death
32
Most effective controllers for asthma. It is also the 1st line therapy for patient with persistent asthma. (Harrison pp 1677)
Inhaled corticosteroids
33
What are the systemic side effects of Corticosteroids? (Harrison pp 1677)
``` Truncal obesity Bruising Osteoporosis Diabetes Hypertension Gastric ulceration Proximal myopathy Depression Cataracts ```
34
It has a modest clinical benefit and less effective than ICS (Harrison pp 1678)
Antileukotrines (Montelukast)
35
It inhibits the mast cell ad sensory nerve activation (Harrison pp 1678)
Cromolyn sodium | Nedocromil sodium
36
It is injected subcutaneous every 2-4 weeks and very expensive. It inhibits IgE mediators. (Harrison pp 1678)
Omalizumab
37
Main stay treatment for acute severe asthma (Harrison pp 1679)
High dose of SABA
38
The most common reason for poor control of asthma is _______. (Harrison pp 1679)
Noncompliance with medications
39
It is defined as failure to respond to a high dose of oral prednisone/prednisolone (40mg/day) for 2 weeks. (Harrison pp 1680)
Corticosteroid-Resistant Asthma
40
It is the treatment of choice for brittle asthma. (Harrison pp 1680)
Subcutaneous epinephrine
41
It is usually preceded by perennial rhinitis and nasal polyps in nonatopic patient with a late onset of the disease. (Harrison pp 1680)
Aspirin Sensitive Asthma
42
It is caused by aspergillus fumigatus and shows with fleeting eosinophilic infiltrates. And what is the treatment of choice? (Harrison pp 1681)
Bronchopulmonary aspergillus | Oral antifungal itraconazole
43
Treatment of choice for moderate and persistent asthma (Harrison pp 1679)
LABA and ICS low dose
44
Treatment of choice for mild intermittent asthma (Harrison pp 1679)
Short-acting beta agonists
45
Aims of asthma therapy (Harrison pp 1676)
Minimal (ideally no) chronic symptoms including nocturnal Minimal exacerbations No emergency visits Minimal use of required B agonist No limitations on activities, including exercise Peak expiratory flow circadian variation <20% Normal peak expiratory flow Minimal or no adverse effects from medicine
46
It is a depot preparation of steroids that is use for non compliant patient and has a usual sideeffect of proximal myopathy. (Harrison pp 1678)
Intramuscular triamicinolone acetonide

Pulmonology (9 decks)

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