Asthma Flashcards

1
Q

What is the atopic triad?

A

infant atopic dermatitis
childhood allergic rhinitis
asthma

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2
Q

At what age should your diagnosis for asthma shift from therapeutic medicine trial to obtaining spirometry?

A

< 5 years old

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3
Q

On spirometry, what percentage of airway reversibility and change in FEV1 is consistent with asthma diagnosis?

A

12% and 200 mL

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4
Q

Diagnostic criteria for asthma on spirometry

A

FEV1 < 80% predicted

significant reversibility after inhaling SABA: 12% and FEV1 increase by 200 ml

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5
Q

What four historical points should you get from every asthmatic to help determine symptom burden?

A
  • daytime symptoms
  • nocturnal symptoms
  • rescue SABA use
  • activity limitations
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6
Q

Which asthma classification does this describe?

Symptoms < 2x/week
Nocturnal sx < 2x/month

A

Mild intermittent asthma

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7
Q

Which asthma classification does this describe?

Symptoms > 2x/week but not daily

Nocturnal sx > 2x/month

A

mild persistent

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8
Q

Which asthma classification does this describe?

Daily symptoms, daily SABA use, activities affected

Nocturnal sx > 2x/week

A

Moderate persistent asthma

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9
Q

Which asthma classification does this describe?

Continual symptoms
Frequent nocturnal symptoms

A

Severe persistent

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10
Q

What treatment is first line for mild to moderate allergic rhinitis?

A

Monotherapy with intranasal corticosteroids

second line: antihistamines, leukotriene modulators, immunotherapy

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11
Q

What is the most appropriate treatment for acute bronchospasm?

A

albuterol

inhaled SABA

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12
Q

Once a pt is diagnosed with mild or moderate persistent asthma, what must you include in their therapy

A

inhaled corticosteroids

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13
Q

What is the role of LABA therapy in asthma management?

A

Used in combination with low to medium dose Inhaled corticosteroids and are the preferred combo therapy for management of moderate and severe persistent asthma

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14
Q

How does outpatient asthma management change as a child ages?

A

Additional therapies are available, and inclusion of ICS + LABA is initiated earlier

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15
Q

When can you consider stepping down therapy in management of asthma?

A

Step down can be considered if asthma is well controlled for 3 months or more

  • decrease dose of ICS gradually by 25-50% every 3-6 months
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16
Q

what measurement should be obtained at each asthma visit, and used at home as pts evaluate the severity of symptoms

A

PEF = peak expiratory flow

  • 80% or more of personal best = green
  • 50-80% of personal best = yellow
  • <50% of personal best = red zone
17
Q

What is the definition of acute asthma exacerbation?

A

PEF decreased < 50% predicted personal best in conjunction with physical signs and symptoms

18
Q

Management of acute asthma exacerbation

A
  • Oxygen
  • systemic corticosteroids
  • inhaled nebs: ipratropium and SABA
19
Q

How do you diagnose exercise-induced bronchoconstriction on spirometry?

A

10% decrease in FEV1 after exercise is diagnostic

20
Q

Management of exercise induced bronchoconstriction

A

SABA pretreatment prior to exercise

low-dose ICS if not controlled

LABA not recommended

21
Q

Management of asthma COPD Overlap syndrom

A

Treat toward predominant symtoms

22
Q

Management of asthma during pregnancy:

  • schedule of evals
  • preferred SABA
  • preferred controlled medication
A
  • monthly eval
  • albuterol is preferred SABA (cat C)
  • Budesonide is preferred controller med