Asthma Flashcards
The primary underlying mechanism of asthma is NOW thought to be
inflammation (the inflammation then causes both the bronchospasm and the airway edema)
inflammation happens first
The 4 categories of asthma are:
intermittent
mild persistent
moderate persistent
severe persistent
Define intermittent asthma
Children in the “intermittent” category have symptoms fewer than 2 days per week, no nighttime wakening due to asthma, use albuterol fewer than twice weekly and have no activity limitations.
A child has asthma but has symptoms only 1 day a week, never wakes up at night due to asthma, has no activity limitations, and uses albuterol less than twice weekly. Their type of asthma is…
intermittent
How to treat intermittent asthma
albuterol as needed
One of the major predictors of persistent asthma is
atopy
The strongest predictor for wheezing developing into asthma is
atopy
Blank is a chronic inflammatory disorder of the lower airways
asthma
The most common cause of asthma exacerbations is
viral respiratory infections
Explain how allergens cause bronchospasm in 2 phases
Early phase (15 min after exposure): mast cells degranulate, increasing histamine and leukotrienes–> causing bronchoconstriction
Second phase (4-12 hours after exposure): cytokines and chemokines stimulate the migration of inflammatory cells to the airways, causing edema and increased mucous production–which is what causes this second phase of bronchospasm
Define severe persistent asthma
Children with severe, persistent asthma have continual daytime symptoms that cause limitation of their activity and have frequent night time symptoms; peak flows are less than 60% of normal.
Criteria for diagnosing asthma:
- Episodic symptoms of airflow obstruction or airway hyper-responsiveness are present.
- Airflow obstruction is at least partially reversible (as determined by spirometry in children ≥5 years).
- Alternative diagnoses are excluded
(it’s a clinical diagnosis)
Ddx for asthma new diagnosis
chronic sinusitis, allergic rhinitis, foreign body obstruction, vocal cord paralysis or dysfunction, vascular rings or slings, laryngotracheomalacia, enlarged mediastinal lymph node or tumor, viral infection, CF, cardiac disease and aspiration
What is the rule of 2s?
It’s a good way of quickly differentiating intermittent asthma from mild persistent asthma. If a child is having symptoms more than twice a week, OR is waking u pat night more than twice a month due to symptoms, then they have persistent asthma.
If a kid has daily asthma symptoms and wakes up more than once a week at night with symptoms, they have this type of asthma
severe persistent
