Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

LMCC Study - Peds > Asthma > Flashcards

Asthma Flashcards

1
Q

What are the symptoms of asthma?

A
  • Shortness of Breath
  • Chest tightness
  • Cough
  • Wheezing
  • Chest pain
  • Rhinorrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are common exacerbating factors for asthma?

A
  • Viral infection
  • Allergens (dust, pollen..)
  • Irritants (smoke, fumes)
  • Exercise
  • Emotions
  • Change in humidity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How come wheezing might not be present in a child presenting with asthma?

A
  • Airway obstruction may result in poor air movement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

On exam what findings might be present in a patient presenting with asthma exacerbation?

A
  • Tachypnea
  • Tachycardia
  • Cough
  • Wheeze
  • Prolonged expiration
  • Cyanosis
  • Retractions and accessory muscle use
  • Tripod position
  • Pulsus paradoxus
  • May see other evidence of atopic disease (eczema, allergic rhinitis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is pulsus paradoxus?

A
  • Decrease in blood pressure of >15mm Hg with inspiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 3 criteria needed for a diagnosis of asthma?

A

1) Episodic symptoms of airflow obstruction
2) Airflow obstruction is at least partially reversible
3) Alternative diagnosis are excluded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is pulsus paradoxus associated with? List 5 things

A

1) Obstructive lung disease (Asthma and COPD)
2) PE
3) Tension pneumo
4) Cardiac tamponade
5) Pericarditis
6) Croup
7) Chronic sleep apnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When should a chest radiograph be performed in a child presenting with asthma?

A
  • First episode of asthma (or with recurrent episodes of undiagnosed cough) to rule out anatomic abnormality
  • If child presents with fever (rule our pneumonia)
  • Otherwise a child with known asthma who is afebrile does not require CXR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the preferred long term control therapy medication for those with asthma?

A
  • Inhaled Corticosteroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why do you counsel patients to rinse their mouths after using inhaled steroids?

A
  • Decreases G.I. absorption
  • Reduces risk of:
    • Dysphonia
    • Oral candidiasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the effects of inhaled steroids on growth?

A
  • May decrease growth velocity (approx 1cm in first year)
  • Generally not progressive and may be reversible
  • Note that poorly controlled asthma will also reduce growth velocity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are leukotriene modifiers? How are they given?

A
  • Leukotrienes are potent mediators of inflammation and smooth muscle bronchoconstriction
  • All oral medications
  • Most popular (montelukast or singulaire) is a leukotriene receptor antagonist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When should a long acting beta-2 agonist be used?

A
  • If inhaled steroid treatment alone is not sufficient, adding a long acting bronchodilator to inhaled steroid is more effective.
  • Note combination inhalers of ICS and LABA improve compliance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Fomoterol and salmeterol are in which class of medication?

A
  • Long acting beta-2 agonist (LABA)

- Bronchdilator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is theophylline?

A
  • Bronchodilator, not commonly used anymore
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is typically the role of a short acting beta-2 agonist?

A
  • Acute symptom relief
  • Prophylaxis before exposure or exercise
  • Note overuse of this suggests poor asthma control (over 8 puffs per day or using over 1 puffer per month)
17
Q

How do anticholinergic agents work?

A
  • bind to acetylcholine at muscarinic receptors in the bronchial smooth muscle
    • decreases mucous hypersecretion
    • counteracts cough receptor irritability
18
Q

What is the role for long term use of anticholinergic medications in treating asthma?

A
  • Long term use is currently not supported by the literature
19
Q

What is the role of oral corticosteroids in the treatment of asthma?

A
  • Treatment of acute exacerbations
20
Q

What dose of oral dexamethosone would you use in an acute asthma exacerbation? For how long would you use it?

A
  • 0.6mg/kg
  • Max dose is 16mg/dose
  • Single dose or may be repeated in 24 hours once
  • Not recommended any longer due to risk of metabolic effects
21
Q

What dose of oral prednisone or prednisolone would you use for acute asthma exacerbation? For how long?

A
  • 0.2mg/kg/day on day one, then 0.1-0.2mg/kg/days for the next 2-4 days (3-5 days total)
22
Q

What are the Rules of Two? What do they tell you?

A
  • The rules of two is a tool to determine if a childs asthma is persistent or intermittent
  • It is persistent if when there is either:
    • Daytime symptoms occurring 2 or more times per week
  • Nighttime awakening two or more times per month
  • If persistent requires a daily anti-inflammatory medication (ICS)
23
Q

What is status asthmaticus?

A
  • An acute exacerbation of asthma that does not respond adequately to therapeutic measures and may require hospitalization.
24
Q

What is your initial management for a patient with asthma exacerbation?

A
  • ABC’s
  • Vitals/Monitor (O2 sats important)
  • Supplemental oxygen
  • Short acting bronchodilators (salbutamol +/- ipratropium)
  • Early oral corticosteroids
25
Q

What tests will you order on a patient who presents with an acute asthma exacerbation if any?

A
  • ABG: Consider if unwell and not responding to initial treatment
  • CXR: If first presentation for asthma or if fever, crackles or other abnormal findings on respiratory examination
26
Q

What is magnesium sulfate and how does it work? What is it’s role in the treatment of acute asthma exacerbation?

A
  • Inhibits smooth muscle contraction, decreases histamine release from smooth cells and inhibits acetylcholine release
  • Used if there is clinical deterioration despite bronchodilator and oral steroid treatment
27
Q

When would you consider using epinephrine in the treatment of an asthma exacerbation? What is the dose?

A
  • In severe asthma
  • Child with poor inspiratory flow (cannot get inhaled meds in) or if child is unable to tolerate inhaled therapy
  • Dose is 0.01mg/kg Max of 0.4mg given IM or SC
28
Q

What criteria would put a patient into the “green zone” on an asthma action plan

A
  • No cough, wheeze, chest tightness or SOB during day or night
  • Can do usual activity
  • Asymptomatic essentially*
29
Q

What criteria would put a patient into the “yellow zone” on an asthma action plan

A

Any of:

  • Cough, wheeze, chest tightness or shortness of breath
  • Waking at night due to asthma
  • Can do some but not all of their usual activities
30
Q

What criteria would put a patient into the red zone on an asthma action plan

A

Any of:

  • Very short of breath
  • Rescue meds have not helped
  • Cannot do usual activity
  • Symptoms are same or worse after 24 hours in the yellow zone

LMCC Study - Peds (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions