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Resp AM > Asthma > Flashcards

Asthma Flashcards

1
Q

What is asthma?

A

Airway inflammation mediated by type 1 hypersensitivity

Widespread narrowing of airways and increased airway activity

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2
Q

What are some risk factors for asthma?

A

Genetics- atopy
Occupation
Smoking- esp mother/grandmother smoking during pregnancy

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3
Q

What is the presentation of asthma?

A 
Wheeze
SOB
Chest tightness
Cough, often worse at night
Sputum
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4
Q

What investigations are done for asthma?

A

Spirometry- obstruction with reversibility

Peak flow- serial in clinic and at home

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5
Q

What are the diagnostic criteria for asthma?

A

Wheeze

Response to treatment

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6
Q

What are the features of a moderate asthma attack?

A 
Able to speak and complete sentences 
HR <110
RR <25
Peak flow 50-75% best 
O2 sats >92
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7
Q

What are the features of a severe asthma attack?

A 
Unable to speak in complete sentences 
HR >110
RR>25
Peak flow 33-50% best 
O2 sats >92%
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8
Q

What are the features of a life threatening asthma attack?

A 
Grunting, impaired LOC 
HR >130 or bradycardic 
Hypoventilation 
Silent chest 
Arrythmia 
Peak flow <33% best 
Cyanosis, sats <92%
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9
Q

What investigations/obervations are most helpful acutely?

A

Sats, RR and HR

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10
Q

What is the management of acute asthma?

A 
O SHIT 
Oxygen 15l through non rebreather 
Salbutamol neb 5mg 
Hydrocortisone 100-200mg IV 
Ipratropium 0.5mg neb 
Theophylline- small print, rare 
Magnesium sulphate IV if no improvement
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11
Q

What is step 1 in chronic asthma management?

A

SABA

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12
Q

What is step 2 in chronic asthma management?

A

SABA + ICS

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13
Q

What is step 3 in chronic asthma management?

A

SABA + ICS + LTRA

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14
Q

What is step 4 in chronic asthma management?

A

SABA + ICS + LABA/LAMA +/- LTRA

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15
Q

What is step 5 in chronic asthma management?

A

Long term oral steroids

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16
Q

What is step 6 in chronic asthma management?

A

Steroid sparing immunosuppressants very last resort

17
Q

What are the indications for step up of treatment?

A

Reliever needed 3x a week
Symptomatic 3x a week
Waking 1 night a week

18
Q

What are the side effects of inhaled ICS?

A

Oropharyngeal candidiasis

Dysphonia

19
Q

What are the side effects of LAMA?

A

Dry mouth
GI upset
Headache

Resp AM (17 decks)

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