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CR3 > Asthma > Flashcards

Asthma Flashcards

1
Q

What FEV1: FVC ratio gives an obstructive picture

A

> 80%

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2
Q

How can bronchodilator spirometry be used to diagnose asthma

A
  • FEV1 pre and post beta agonist

- Shows a 12% and 200ml improvement for FEV1

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3
Q

What is direct challenge testing

A

Drop in FEV1 by 20% when patient exposed to a provoking substance

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4
Q

How can peak flow be diagnostic of asthma

A

20% variability

Twice daily readings for 2 weeks

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5
Q

When, within asthma, should the anaesthetist be called

A 
33-92 CHEST
peak flow: <33
Sp02: <92
C- cyanosis
H- hypotension
E- exhaustion
S- silent chest
T- tachy or brady cardia
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6
Q

What are the 5 categories of BTS severity

A
  • Brittle asthma (type 1 and 2)
  • Moderate asthma exacerbation
  • Acute severe
  • Life threatening asthma
  • Near fatal
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7
Q

Type 1 Brittle Asthma?

A

Wide PEF variability (>40% diurnal variability for 50% of the time over 150 days) despite intense therapy

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8
Q

What is type 2 brittle asthma?

A

Sudden severe attack on background of well controlled asthma

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9
Q

Criteria for moderate severe asthma?

A
  • Increasing symptoms
  • PEF> 50-75% best or predicted
  • No features of acute severe asthma
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10
Q

Critera for acute severe asthma?

A
  • PEF 33-50%
  • Resp rate 25/min
  • HR 110
  • Inability to complete sentence in one breath
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11
Q

Criteria for life threatening asthma

A
  • PEF<33%
  • SpO2 <92%
  • PaO2 <8kPa
  • Silent chest, cyanosis, feeble resp effort, confusion, coma`
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12
Q

Critera for near fatal asthma

A
  • Increased paCO2

- Mechanical ventilation

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13
Q

From which level of severity should you admit a patient?

A

Acute severe

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14
Q

MoA of short and long acting beta agonist?

A

Activation of sympathetic nervous system
Bronchodilation and mucociliary clearance
Relaxes smooth muscle, relieves bronchospasm

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15
Q

SE of beta agonists

A

Tremor
Tachycardia
Sweats
Agitation

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16
Q

SE of inhaled corticosteroids

A

Oral candidiasise

17
Q

MoA of leukotriene antagonist

A

reduces bronchoconstriction by blocking leukotriene receptors

18
Q

SE of Leukotriene antagonist

A

Nausea and headaches

19
Q

SE of anti-Ige

A

aching, headache, nausea, joint pain

20
Q

What is the mneumonic for emergency management of asthma

A 
O- oxygen
S- salbutamol
H- hydrocortisone
I- Ipratroprium bromide
T- theophylline
!- Magnesium sulphate
21
Q

How is salbutamol adminstered in an asthmatic emergency

A

Nebulised with oxygen

2.5mg-5mg every 10 minutes

22
Q

How is hydrocortisone administered in an asthmatic emergency

A

IV 100mg-200mg QDS

23
Q

How is ipatropim bromide administered in an asthmatic emergency

A

Nebulised with oxygen

500mg every 4-6 hours

24
Q

How is magnesium sulphate administered in an asthmatic emergency

A

1.2-2g over 20 mins IV

CR3 (8 decks)

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