Asthma

Question 1

What is asthma?

Answer 1

Chronic inflammatory airway disease characterised by intermittent airway obstructions and hyper-reactivity

Question 2

What type of hypersensitivity reaction is asthma?

Answer 2

Type 1

Question 3

What is the pathophysiology of asthma?

Answer 3

Airway smooth muscle

• constriction
• thickening
• hyperresponsiveness

Sub-epithelial inflammation + fibrosis

Mucus hypersecretion

Increased

• eosinophils
• neutrophils

Question 4

What are the symptoms of asthma?

Answer 4

Cough - dry, nocturnal
Wheeze
Dyspnoea
Chest tightness

Question 5

What can trigger asthma?

Answer 5

Allergens
Dust
Smoke
Cold weather
Exercise
Infection

Question 6

How does asthma present?

Answer 6

Increased respiratory rate
Tachycardia
Wheeze
History of atopy

Question 7

How is asthma diagnosed?

Answer 7

Peak flow

Spirometry - obstructive pattern with good reversibility

Question 8

How is chronic asthma managed preventatively?

Answer 8

Remove triggers if possible

Question 9

How is chronic asthma managed?

Answer 9

SABA
SABA + ICS
SABA + LABA + ICS
SABA + ICS + LTRA

Question 10

How do you identify acute severe asthma?

Answer 10

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Wheeze 
Sats <92%
RR >25
HR >110
Peak flow 33-50%

Question 11

How do you identify life threatening asthma?

Answer 11

Exhausted
Silent chest
Cyanosis 
Bradycardia
Hypotension
Peak flow <33%

Question 12

How is acute asthma managed?

Answer 12

Oxygen 
Salbutamol nebs
Hydrocortisone/prednisolone
Ipratropium bromide
Theophylline/aminophylline