Asthma

Question 1

What is the most common pediatric disease?

Answer 1

Asthma

Question 2

At what age is asthma usually acquired?

Answer 2

Before the age of 10

Question 3

They exhibit hyper-reactive airways; What are some examples of this?

Answer 3

spasm, constriction, swelling, & secretions in the lumen of the airways

Question 4

What are the two types of asthma?

Answer 4

Intrinsic and extrinsic

Question 5

What type of asthma is associated with respiratory tract infections?

Answer 5

Intrinsic

Question 6

What type of asthma usually develops with exposure to allergenic substances?

Answer 6

Extrinsic

Question 7

What happens in the acute allergic phase?

Answer 7

Rupture or degranulation of mast cells.

Mast cell releases histamines, leukotrienes, eosinophilic factors & prostaglandins.

Question 8

What damage is done by the release of mast cells?

Answer 8

The smooth muscles of the tracheobronchial tree are affected. Results in bronchospasm, edema, vasodilation, increased secretions, and accumulation of eosinophils.

Question 9

What happens in the inflammatory phase?

Answer 9

Eosinophils, neutrophils, macrophages, and lymphocytes release mediators

Question 10

What does the terminal phase mean?

Answer 10

acute respiratory failure

Question 11

As resistance to flow increases, what else is happening?

Answer 11

An increased WOB = V/Q mismatch

Question 12

Air trapping results to an increased what?

Answer 12

FRC

Question 13

When the airways narrow, what is the significance?

Answer 13

A larger V/Q mismatch that leads to hypoxemia that leads to hyperventilation that leads to hypocarbic conditions

Question 14

What are some cardiovascular & metabolic function changes/

Answer 14

Dehydration, tachypneic, & fever
lactic acid buildup
metabolic acidosis

Question 15

What are signs and symptoms of asthma?

Answer 15

wheezing, SOB

dehydration, infection

Question 16

dry cough, slight wheeze classifies as what degree of attack?

Answer 16

mild

Question 17

A productive cough, tachypnea, wheeze, tachycardia, cyanosis classifies as what degree of attack?

Answer 17

Moderate

Question 18

Diminished breath sounds, retractions, shallow breathing, stupor/lethargy from hypoxemia classifies as what degree of attack?

Answer 18

Severe

Question 19

What are the 4 stages of ABG’s?

Answer 19

1. normal limits
2. decreased PCO2/pH slightly alkalotic
3. normal PCO2/pH in fatigued, hypoxemia patients
4. increased PCO2/decreased pH/decreased PO2 = INTUBATE ASAP!!!

Question 20

To measure the amount of obstruction present and to measure the response to treatment, what would you measure?

Answer 20

PEFR

Question 21

What would be proper treatment for asthma?

Answer 21

O2 for hypoxemia
80:20 heliox
multiple inhaled resp. agents

Question 22

What category of drug plays a significant role in maintaining airway?

Answer 22

NANC (nonadrenergic noncholinergic)

Question 23

What is the oldest drug that is used to treat asthma?

Answer 23

Epinephrine

Question 24

Examples of parasympatholytics.

Answer 24

Atropine & derivatives

Question 25

Examples of corticosteroids.

Answer 25

Beclomethasone, Flovent, Funisolide

Question 26

What do corticosteroids help with?

Answer 26

prophylactic reversal of airway hyper-reactivity, and suppress release of inflammatory mediators

Question 27

Name some misc. medications.

Answer 27

Intal
Tildac
antibiotics
adequate hydration
subcutaneous epic
adequate humidification for secretion clearance
intubation & MV
magnesium sulfate
heliox

Question 28

How often are aerosol treatments recommended?

Answer 28

Q3-Q4

Question 29

Acute exacerbation will require how long of a treatment?

Answer 29

high dose continuous

Question 30

In what order should medications be given?

Answer 30

1. give parasympathetic agent to have better bronchodilator of larger airways
2. sympathomimetic agent to better penetrate peripheral airways (Oral theophylline to reduce symptoms)

Question 31

Why should you be aware of rebound bronchoconstriction from overuse of B2 adrenergic?

Answer 31

Desensitization