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Respiratory > Asthma > Flashcards

Asthma Flashcards

1
Q

which antibody is implicated in asthma?

A

IgE

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2
Q

which cell degranulates causing asthmatic symptoms?

A

mast cell degranulation

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3
Q

which granulocyte will activate IL-5?

A

eosinophils

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4
Q

is asthma reversible or irreversible?

A

reversible

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5
Q

what is Hygiene hypothesis ?

A

reduced exposure to pathogens in developed word means child’s immune system does not get chance to learn difference between harmful and harmless substances. Now child is hypersensitive to benign stuff.

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6
Q

asthma prevalence in children? %

A

10%

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7
Q

asthma prevalence in adults? %

A

5-10%

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8
Q

allergens bind to what antibody in asthma?

A

IgE

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9
Q

triggers for asthma?

- give 4

A

dust, pets, cold, exercise

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10
Q

Risk factors for asthma?

-6

A 
FHx 
Atopy prone
Passive smoking 
Low birthweight 
Bottle-fed (not breastfed) 
Work (isocyanate most common cause, in spray painting)
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11
Q

if someone is Atopy prone, what conditions are associated with this?

A

asthma, eczema, allergic rhinitis

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12
Q

define atopy?

A

make extra IgE to benign stimuli

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13
Q

asthma symptoms worse at night.

type of asthma?

A

nocturnal asthma

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14
Q

asthma symptoms worse when waking up

type of asthma?

A

Early-morning asthma

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15
Q

low peak flow at work

type of asthma?

A

occupational asthma

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16
Q

Complications of asthma?

- 4 things

A

infection can exacerbate asthma.
Steroids can stunt growth in children.
pneumothorax
nasal polyps

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17
Q

Eczema, allergic rhinitis and asthma are all mediated by which antibody type?

A

IgE

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18
Q

a wheeze in a child may be caused by what else aside from asthma?

A

viral infection.

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19
Q

symptoms of asthma?

- 3 things

A

Wheezy
SOB
Dry cough

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20
Q

sign on auscultating someone with asthma?

A

expiratory wheeze

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21
Q

peak flow result for asthmatic pt?

A

low

+ diurnal results

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22
Q

gold.S test for asthma?

what is the result?

A

Spirometry

FEV1/FVC <70%

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23
Q

pt has asthma, will FEV1 or FBC be low?

A

↓FEV1

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24
Q

what does one stand for in FEV1 ?

what does the FEV bit mean?

A

1 second

Forced expiratory volume

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25
Q

what does FVC stand for?

A

Forced vital capacity

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26
Q

child aged 5-16 years old, being investigated for asthma.

what is +ive result for Bronchodilator reversibility test?

A

improved FEV1 by ≥12%

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27
Q

what is +ive result for FeNO test?

What does FeNO stand for?

A

> 35 ppb

fractional exhaled nitric oxide

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28
Q

child aged 5-16 years old, being investigated for asthma.

what is the last Ix used to diagnose asthma if all other Ix were inconclusive.

What is +ive result for this test?

A

peak flow meter

variability of >20%

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29
Q

which granulocyte makes FeNO?

a high FeNO correlates with what?

A

eosinophil

inflammation

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30
Q

1st line drug for asthma, give the name?

class of this drug?

MOA of this drug/how does it work?

effect of this drug on bronchodilation?

A

Salbutamol

SABA, short acting beta agonist

activates beta adrenergic receptors on smooth muscles, smooth muscle relaxes

↑bronchodilation

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31
Q

2nd line drug for asthma, give two names examples?

class of this drug?

MOA of this drug/how does it work?

how often should this drug be used?

A

Beclomethasone, budesonide

ICS, inhaled corticosteroids

Anti-inflammatory

every day

32
Q

someone is on brown inhaler.

what are the side effects of this drug?
- 2 things

how often is the brown inhaler taken?

they have no symptoms, should they keep using the drug?

A

sore throat, stunted growth in kids.

take everyday

yes, use it everyday regardless of symptoms

33
Q

someone is on blue inhaler.

what are the side effects of this drug?
- 3 things

A

tachycardia, tremor, palpitations

34
Q

how often is the blue inhaler taken?

A

prn, take for acute relief

35
Q

child aged 5-16 years old.

what is the 1st line drug?

what is the 2nd line Mx?

in the 2nd line Mx what is the dosage of the added drug?

A

salbutamol (SABA)

salbutamol + ICS

ICS is low paed dose <200mcg

36
Q

what is low paed dose for ICS?

what is low adult dose for ICS?

A

<200mcg

<400mcg

37
Q

child aged 5-16 years old.

what is the 3rd line Mx?

A

SABA + ICS + LTRA

38
Q

give example of LTRA?

what does LTRA stand for?

moa of LTRA ?

A

montelukast

leukotriene receptor antagonists

stops leukotrienes

39
Q

what do leukotrienes do in asthma?
-3

which cells cause release of leukotrienes?
-2

A

bronchoconstriction, inflammation, ↑mucus

Mast cells & eosinophils

40
Q

example of fast-acting LABA?

A

formoterol

41
Q

example of slow-acting LABA?

A

salmeterol

42
Q

does MART have slow or fast acting LABA?

43
Q

what is MART a combo of?

- give the drug classes?

A

ICS & fast-acting LABA

44
Q

is MART used for acute relief or prevention?

A

used for both

45
Q

child is on SABA+ICS+LTRA.

which step of the management tree are they on?

give named example of LTRA?

the LTRA has had no effect, what do you swap it out for (give drug class)

A

3rd step

montelukast

LABA

46
Q

what does LABA stand for?

give two named examples?

effect of LABA on smooth muscle of bronchioles?

effect of LABA on bronchus lumen?

A

long-acting beta agonist

salmeterol, formoterol

relaxes smooth muscle

widens lumen, bronchodilation

47
Q

how often should LTRA be taken?

48
Q

how often should LABA be taken?

someone is on LABA but says they do not have any symptoms right now, can they stop taking LABA?

A

every day

no, keep taking every day

49
Q

is LABA for acute relief or prevention?

A

prevention

50
Q

is LTRA for acute relief or prevention?

A

prevention

51
Q

child has asthma attack.

what drugs do you give (name, route)?
2 drugs

A

Salbutamol via spacer + ICS 3-5 days

52
Q

child has asthma attack.

what are the 3 categories of asthma attack?

which category indicates hospital admission and which indicates going home?

A

Moderate - go home
Severe - hospital
Life-threatening - hospital

53
Q

SpO2 value in moderate, severe & life threatening asthma?

A

Moderate - >92%
Severe - <92%
Life-threatening - <92%

54
Q

child has asthma attack.

silent chest and poor resp effort.

what category of attack is this?

A

Life-threatening

55
Q

child has asthma attack.

child has altered consciousness

what category of attack is this?

A

Life-threatening

56
Q

child has asthma attack.

child is too breathless to talk.

what category of attack is this?

57
Q

child has asthma attack.

child is using accessory neck muscles to breathe.

what category of attack is this?

58
Q

child >5 years old has asthma attack.

SpO2 >92% .

what category of attack is this?

59
Q

child >5 years old has asthma attack.

HR>125

what category of attack is this?

60
Q

child >5 years old has asthma attack.

RR>30

what category of attack is this?

61
Q

child >5 years old has asthma attack.

PEF<33%.

what category of attack is this?

A

Life-threatening

62
Q

child >5 years old has asthma attack.

PEF 33-50%

what category of attack is this?

63
Q

child >5 years old has asthma attack.

PEF > 50% best or predicted

what category of attack is this?

64
Q

child has asthma attack.

there is cyanosis

what category of attack is this?

A

Life-threatening

65
Q

child has asthma attack.

Poor resp effort.

what category of attack is this?

A

Life-threatening

66
Q

child >5 years old has asthma attack.

RR is 24.

what category of attack is this?

67
Q

child >5 years old has asthma attack.

RR is 34.

what category of attack is this?

68
Q

What HR denotes a severe asthma attack in a child under 5 years old vs a child over 5 years old?

A

child <5 years old - HR>140

child >5 years old - HR >125

69
Q

What HR denotes a severe asthma attack in a child under 5 years old vs a child over 5 years old?

A

child <5 years old - HR>140

child >5 years old - HR >125

70
Q

What RR denotes a severe asthma attack in a child under 5 years old vs a child over 5 years old?

A

child <5 years old - RR>40

child >5 years old - RR >30

71
Q

child <5 years old has asthma attack.

HR is 132.

is this moderate or severe?

72
Q

child <5 years old has asthma attack.

HR is 144.

is this moderate or severe?

73
Q

child <5 years old has asthma attack.

RR is 46.

is this moderate or severe?

at what RR does it become sever in child under 5 years old?

A

severe

RR>40 = severe

74
Q

Signs of acute asthma attack are 3,

what are they?

A
  1. Bilateral expiratory polyphonic wheeze
  2. Hyperinflation
  3. Prolonged expiration
75
Q

should you use spacer?

Respiratory (22 decks)

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