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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
Q

What is the definition of reversibility of simple spirometry in asthma means? (Harrison pp 1675)

A

> 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
Q

What collagens are involved with thickening of the basement membrane in asthma? (Harrison pp 1674)

A

Collagen Type 3 and 5

27
Q

It is a test of compliance rather than diagnostic with asthma. (Harrison pp 1676)

A

Exhaled Nitric Oxide

28
Q

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)

A

SABA (albuterol and terbutaline)

29
Q

What is the plasma concentrations of theophylline with additive effects? (Harrison pp 1677)

30
Q

It has a mechanism action of inhibition of phosphodieterase. (Harrison pp 1677)

A

Theophylline

31
Q

At high concentration of theophylline, it causes several side effects , which are the following? (Harrison pp 1677)

A

Cardiac arrhymthmias
Epilectic Seizures
Death

32
Q

Most effective controllers for asthma. It is also the 1st line therapy for patient with persistent asthma. (Harrison pp 1677)

A

Inhaled corticosteroids

33
Q

What are the systemic side effects of Corticosteroids? (Harrison pp 1677)

A 
Truncal obesity 
Bruising 
Osteoporosis
Diabetes
Hypertension
Gastric ulceration
Proximal myopathy
Depression 
Cataracts
34
Q

It has a modest clinical benefit and less effective than ICS (Harrison pp 1678)

A

Antileukotrines (Montelukast)

35
Q

It inhibits the mast cell ad sensory nerve activation (Harrison pp 1678)

A

Cromolyn sodium

Nedocromil sodium

36
Q

It is injected subcutaneous every 2-4 weeks and very expensive. It inhibits IgE mediators. (Harrison pp 1678)

A

Omalizumab

37
Q

Main stay treatment for acute severe asthma (Harrison pp 1679)

A

High dose of SABA

38
Q

The most common reason for poor control of asthma is _______. (Harrison pp 1679)

A

Noncompliance with medications

39
Q

It is defined as failure to respond to a high dose of oral prednisone/prednisolone (40mg/day) for 2 weeks. (Harrison pp 1680)

A

Corticosteroid-Resistant Asthma

40
Q

It is the treatment of choice for brittle asthma. (Harrison pp 1680)

A

Subcutaneous epinephrine

41
Q

It is usually preceded by perennial rhinitis and nasal polyps in nonatopic patient with a late onset of the disease. (Harrison pp 1680)

A

Aspirin Sensitive Asthma

42
Q

It is caused by aspergillus fumigatus and shows with fleeting eosinophilic infiltrates. And what is the treatment of choice? (Harrison pp 1681)

A

Bronchopulmonary aspergillus

Oral antifungal itraconazole

43
Q

Treatment of choice for moderate and persistent asthma (Harrison pp 1679)

A

LABA and ICS low dose

44
Q

Treatment of choice for mild intermittent asthma (Harrison pp 1679)

A

Short-acting beta agonists

45
Q

Aims of asthma therapy (Harrison pp 1676)

A

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
Q

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)

A

Intramuscular triamicinolone acetonide

Pulmonology (9 decks)

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