asthma

Question 1

regarding pulsus paradoxus when is it seen

Answer 1

may be seen in moderate astha and almost always seen in severe asthma
not seen in life threatening asthma

Question 2

pefr in severe asthma

Answer 2

less than 60

Question 3

etco2 is raised in

Answer 3

severe astha

Question 4

what alternative diagnosis wud you consider if patient is bronchodil unresponsie

Answer 4

vocal cord dysfunction
Vocal cord dysfunction Early recognition of vocal cord dysfunction (VCD), the inappropriate adduction of the vocal folds during respiration, may prevent β2 agonist toxicity and unnecessary intubation. VCD may mimic refractory asthma, affects 4–10% of asthma clinic patients, is more common in females, and a physical cause is identified in only 25% [3]. Diagnosis is by fibre optic observation of paradoxical vocal cord movement and possibly by computed tomography (CT) of the larynx

Question 5

β2 agonist toxicity

Answer 5

Side effects include tachycardia, arrhythmia
hypertension, hypotension, tremor, hypokalaemia, worsening of V/Q mismatch, and hyperglycaemia. β2 agonist toxicity may cause lactic acidosis with respiratory compensation, which can be mistakenly attributed to worsening or unresponsive asthma; often leading to further inappropriate β2 agonist administration [4]. β2 agonist toxicity is most often seen with intravenous (iv) infusions and continuous nebulization.