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MS4 - Respiratory > Asthma > Flashcards

Asthma Flashcards

1
Q

Presentation of acute asthma attack

A

Acute SOB

Wheeze

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2
Q

Asthma attack triggers

A

Infection

Travel

Exercise

Cold weather

Dust

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3
Q

Ix for acute asthma

A

PEF

ABG

Bloods

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4
Q

ABG findings in acute asthma

A

PaO2 normal or reduced

PaCO2 decreased, may later rise as pt tires (send to ITU for ?intubation)

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5
Q

Severity of acute asthma

A

Moderate

Severe

Life threatening

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6
Q

Moderate acute asthma

A

PEF > 50% predicted/best

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7
Q

Severe acute asthma

A

Can’t complete sentences with 1 breath

PEF < 50%

RR > 25

HR > 110

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8
Q

Life threatening acute asthma

A

PEF < 33

%SpO2 < 92%

“CHEST”

Cyanosis

Hypotension

Exhaustion, confusion

Silent chest

Tachy-/brady-/arrhythmias

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9
Q

Admission criteria for asthma

A

Life threatening acute asthma

Severe acute asthma persisting despite initial Rx

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10
Q

Discharge criteria for acute asthma

A

Stable on discharge meds > 24 hrs

PEF > 75% 1hr after initial Rx

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11
Q

Mx of acute asthma

A

Sit up/O2

Nebulised Salbutamol 5 mg every 15 mins

Prednisolone 40 mg / IV hydrocortisone 100 mg

Ipratropium 0.5 mg every 4 hrs

Consider aminophyline

If life threatening - MgSO4 2g IV over 20 mins

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12
Q

Age of chronic asthma

A

Peaks at 5yrs, most outgrow by adolescence

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13
Q

Pathophysiology of acute asthma

A
  • Mast cell-Ag interaction → histamine release
  • Bronchoconstriction, mucus plugs, mucosal swelling
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14
Q

Pathophysiology of chronic asthma

A
  • TH2 cells release IL-3,4,5 → mast cell, eosinophil and B cell recruitment
  • Airway remodelling
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15
Q

General causes of asthma

A

Atopy

Stress

Drugs: NSAIDS, β-Blockers

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16
Q

symptoms of chronic asthma

A
  • Cough ± sputum (often at night)
  • Wheeze
  • Dyspnoea
  • Diurnal variation with morning dipping
17
Q

Things to consider when taking an asthma history

A
  • Precipitants
  • Diurnal variation
  • Exercise tolerance
  • Life effects: sleep, work
  • Other atopy: hay fever, eczema
  • Home and job environment
18
Q

signs of asthma

A
  • Tachypnoea, tachycardia
  • Widespread polyphonic wheeze
  • Hyperinflated chest
  • ↓ air entry
19
Q

Diseases associated with asthma

A
  • GORD
  • Churg-Strauss
  • Allergic Bronchopulmonary Aspergillosis (ABPA)
20
Q

Blood results for asthma

A

FBC (eosinophila)

↑IgE

Aspergillus serology

21
Q

Spirometry results for asthma

A

Obstructive pattern

FEV1:FVC < 0.75

≥15% improvement in FEV1 with β-agonist

22
Q

PEFR results for asthma

A

Diurnal variation >20%

Morning dipping

23
Q

Conservative management of asthma

A

TAME

Technique for inhaler use

Avoidance: allergens, smoke (ing), dust

Monitor: Peak flow diary (2-4x/d)

Educate (Rx compliance, Emergency action plan)

24
Q

Chronic asthma meds (British Thoracic Society Guidelines)

A
  1. SABA + ICS
  2. LABA
  3. increase ICS
  4. Leukotriene receptor antagonist/Theophylline
  5. Prednisolone
25
Q

SABA eg

A

Salbutamol

26
Q

LABA eg

A

Salmeterol

27
Q

ICS eg

A

Beclomethasone

28
Q

Leukotriene receptor antagonist eg

A

Montelukast

MS4 - Respiratory (11 decks)

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