Asthma

Question 1

Pathophysiology

Answer 1

chronic, relapsing, inflammatory disorder characterisd by hyper-reactive airways which leads to episdoes of reversible bronchospasm
typically caused by a trigger which results in an acute inflammatory response
- bronchoconstriction
- increased capillary permeability
- mucus gland hypertrophy and secretion

Question 2

Clinical Implications

Answer 2

airflow limitation 
impaired airway clerance 
impaired gas exchange 
dyspnoea 
reduced exercise tolerance

Question 3

Clinical Features

Answer 3

episodic symptoms

• wheezing
• chest tightness
• breathlessness
• potentially a productive cough
• obstructive pattern in spirometry which is reversed with inhalation of bronchodilators
• reduced peak expiratory flow

Question 4

Medical Management

Answer 4

Pharmacology - inhaled preventers and relievers
use spacer with inhaler
written asthma action plan
risk prevention - avoid triggers

Question 5

Physio Management

Answer 5

spirometry/PEF testing 
inhaler technique education 
reinforce the action plan 
airway clearance techniques 
positions for breathlessness
exercise

Question 6

Exercise Prescription

Answer 6

Frequency - at least 2-3 days per week
Intensity - at least 60% of VO2 peak
Time - 20-30 mins per day
Type - aerobic activities that target large muscle groups
Progression - increase to 70% of VO2 peak
- 40 mins per day
- 5 days per week