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Pediatrics > Asthma > Flashcards

Asthma Flashcards

1
Q

What happens to the airways during an asthma exacerbation?

A

Experience smooth muscle tightening
Become inflamed
Fill with mucous

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2
Q

How do we reduce impairment for asthma?

A 
Prevent sx
Reduce SABA use
Maintain pulmonary function
Maintain normal activities
Meet patient's satisfaction
Meet family/caregiver satisfaction
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3
Q

How do we reduce risk for patients with asthma?

A 
Prevent exacerbations
Minimize emergency department visits
Minimize hospitalizations
Prevent lung loss
Maintain lung growth
Optimize therapy
Prevent medication ADR
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4
Q

What are the components of asthma impairment?

A 
Sx occurrences
Nighttime awakenings
Rescue medication use
Interference with daily activity
Lung function (FEV1, FEV1/FVC)
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5
Q

What are the types of medications for asthma use?

A 
SABA
Low dose ICS
HD ICS
Combination products
Monoclonal antibodies
Interleukin-5 receptor antagonist
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6
Q

What are parts of an environmental assessment?

A

Exposure to allergens and irritants
Co-morbid conditions
Gastrointestinal disease

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7
Q

What are co-morbid conditions that can affect asthma?

A 
Pulmonary dz (pneumonia, flu)
ENT dz
Obstructive sleep apnea
Rhinitis
Sinusitis
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8
Q

What level of impairment has sx for = 2 days/week?

A

Intermittent

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9
Q

What level of impairment has sx for > 2 days per week?

A

Mild

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10
Q

What level of impairment has sx daily?

A

Moderate

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11
Q

What level of impairment has sx throughout the day?

A

Severe

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12
Q

What level of impairment has nighttime awakenings at >/= 5 years for = 2x/month?

A

Intermittent

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13
Q

What level of impairment has nighttime awakenings at >/= 5 years for 3-4x/month?

A

Mild

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14
Q

What level of impairment has nighttime awakenings at >/= 5 years for >1x/week?

A

Moderate

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15
Q

What level of impairment has nighttime awakenings at >/= 5 years for more often than 7x/week?

A

Severe

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16
Q

What level of impairment has nighttime awakenings at < 5 years for 1-2x/month?

A

Mild

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17
Q

What level of impairment has nighttime awakenings at < 5 years for 3-4x/month?

A

Moderate

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18
Q

What level of impairment has nighttime awakenings at < 5 years for >1x/wk?

A

Severe

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19
Q

What level of impairment is a patient that uses their SABA = 2 days/week

A

Intermittent

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20
Q

What level of impairment is a patient that uses their SABA > 2 days/weeks?

A

Mild

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21
Q

What level of impairment is a patient that uses their SABA daily?

A

Moderate

22
Q

What level of impairment is a patient that uses their SABA several times per day?

A

Severe

23
Q

What level of impairment is a patient that has a lung function of: 5-11 years
FEV > 80%
FEV/FVC > 85%

A

Intermittent

24
Q

What level of impairment is a patient that has a lung function of: 5-11 years
FEV >/= 80%
FEV/FVC >/= 80%

A

Mild

25
Q

What level of impairment is a patient that has a lung function of: 5-11 years
FEV 60-80%
FEV/FVC > 75-80%

A

Moderate

26
Q

What level of impairment is a patient that has a lung function of: 5-11 years
FEV < 60%
FEV/FVC < 75%

A

Severe

27
Q

What level of impairment is a patient that has a lung function of: >/=12 years
FEV > 80%
FEV/FVC normal

A

Intermittent

28
Q

What level of impairment is a patient that has a lung function of: >/=12 years
FEV >/= 80%
FEV/FVC normal

A

Mild

29
Q

What level of impairment is a patient that has a lung function of: >/=12 years
FEV > 60-80%
FEV/FVC reduced by 5%

A

Moderate

30
Q

What level of impairment is a patient that has a lung function of: >/=12 years
FEV < 60%
FEV/FVC reduced by > 5%

A

Severe

31
Q

What level of impairment is a patient if they have exacerbations requiring oral corticosteroids 0-1x/year?

A

Intermittent

32
Q

How do you classify mild/moderate/severe impairment in patients the require oral corticosteroids for exacerbations?

A

< 5 years:
>/= 2x in 6 months requiring steroids OR >/= 4 wheezing episodes a year lasting > 1 day AND RF for persistent asthma

> /= 5 years: >/= 2x/year

33
Q

What are Step 1 preferred treatments?

A

SABA PRN

34
Q

What are Step 2 preferred treatments?

A

Low dose ICS

35
Q

What are step 2 alternative treatments for patients < 5 yo?

A

Cromolyn/singulair

36
Q

What are step 2 alternative treatments for patients >/= 5 yo?

A

Cromolyn
Nedocromil
LRTA
Theophylline

37
Q

What are step 3 preferred treatments for patients < 5 years old

A

Medium dose ICS

38
Q

What are step 3 preferred treatments for patients 5-11 years old?

A

Low dose ICS + LABA/LRTA/Theophylline
OR
Medium dose ICS

39
Q

What are step 3 preferred treatments for patients >/= 12 years old?

A

Low dose ICS + LABA
OR
Medium dose ICS

40
Q

What are step 3 alternative treatment options for >/= 12 years old?

A

Low dose ICS + LRTA/theophylline/zileuton

41
Q

What are step 4 preferred treatments for patients < 5 years old?

A

Medium dose ICS + LABA/Singulair

42
Q

What are step 4 preferred treatments for patients >/= 5 years old?

A

Medium dose ICS + LABA

43
Q

What are step 4 alternative treatments for 5-11 year olds?

A

Medium dose ICS + LABA/theophylline

44
Q

What are step 4 alternative treatments for >/= 12 year olds?

A

Medium dose ICS + LRTA/theophylline/zileuton

45
Q

What are step 5 preferred treatments for < 5 years old?

A

High dose ICS + LABA/singulair

46
Q

What are step 5 preferred treatments for 5-11 year olds?

A

High dose ICS + LABA

47
Q

What are step 5 preferred treatments for >/= 12 year olds?

A

High dose ICS + LABA
AND
Consider omalizumab for patients who have allergies

48
Q

What are step 5 alternative treatments for 5-11 year olds?

A

High dose ICS + LRTA/theophylline

49
Q

What are step 6 preferred treatments for < 5 years old?

A

High dose ICS + oral corticosteroids + LABA/singulair

50
Q

What are step 6 preferred treatments for 5-11 year olds?

A

High dose ICS + LABA + oral corticosteroids

51
Q

What are step 6 preferred treatments for >/= 12 year olds?

A

High dose ICS + LABA + oral corticosteroids
AND
Consider omalizumab for patients who have allergies

52
Q

What are step 6 alternative treatments for 5-11 year olds?

A

High dose ICS + LRTA/theophylline + oral corticosteroids

Pediatrics (9 decks)

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