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respiration > Asthma - Adults and Kids > Flashcards

Asthma - Adults and Kids Flashcards

1
Q

what is the definition of asthma (3)

A

increased responsiveness of airway by stimuli

wide spread narrowing - changes in severity

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2
Q

what are the symptoms of asthma (in adults) (5)

A

expiratory wheeze
dry cough
chest tightness (central = cardiac, peripheral = respiratory)
dyspnoea (S.O.B)

expiration difficulties

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3
Q

what is the scale of acute asthma attacks - what else should you keep in mind when dealing with patents in these attacks

A

moderate, severe, life threatening, near fatal

that life threatening attack might not cause distress

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4
Q

what is asthmas mechanism of attack

A

airway inflammation by immune system

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5
Q

what is the prevalence of asthma in adults

A

5-10% of adults (most chronic UK condition)

it adulthood it effects females at a greater rate than males

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6
Q

what dose airway inflammation lead to (2)

A

widespread narrowing of airways

or increase airway reactivity

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7
Q

what does increased airway reactivity lead to (2)

A

spontaneous airway narrowing

airway narrowing by a stimuli

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8
Q

what is the difference between a normal airway and asthmatic airway

A

asthmatic airway has is thicker and chronically inflamed

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9
Q

what happens to a asthmatic airway during a attack

A

the relaxed smooth muscle tightens and traps air in the alveoli

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10
Q

what are the 3 proven risk factors for asthma

A

inherited genes
maternal smoking
occupation

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11
Q

what is atopy

A

an inherited predispostiton

produce IgE when exposed to environmental allergens

leads to hightend immune response

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12
Q

what is atopy

A

an inherited predisposition

produce IgE when exposed to environmental allergens

leads to heightened immune response

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13
Q

if first degree family memebers have asthma or another atopic disease what happens

A

the risk of you getting asthma increases

especially if mum has it (3X more likely compared to dad)

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14
Q

if first degree family members have asthma or another atopic disease what happens

A

the risk of you getting asthma increases

especially if mum has it (3X more likely compared to dad)

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15
Q

what dose maternal smoking cause in the child

A

higher risk of asthma

higher risk of attack due to higher airway responsiveness

child has reduced FEV1

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16
Q

what is the grandmother effect - what phenomenon is this

A

grandma smokes (on maternal side, more likely to get asthma)

epigenetic = hereditary trait that doesn’t relate to a change in DNA sequence

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17
Q

how much asthma is caused by occupation

A

10-15% of adult onset asthma

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18
Q

what are some examples of occupations at higher risk of asthma

A

backers , painters

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19
Q

what is the most important thing about making a asthma diagnosis

A

HISTORY!!!!

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20
Q

what relating to the symptoms of asthma can lead to a more likely diagnosis

A

variation of symptoms depending on time/season/work or weekend

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21
Q

asthma also has triggers what are some of them

A 
exercise 
URTI - rhinovirus
cold air 
cigarette smoke 
pets 
drugs
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22
Q

what drugs act as asthma triggers (2)

A

Beta blockers

aspirin

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23
Q

it wont be asthma if there is (3)

A

clubbing
stridor (something blocking the airway, pos. aspiration)
asymmetric expansion

24
Q

what is asthma an example of

A

a obstructive disease

obstructs airflow

25
Q

what tests are done to diagnoses asthma

A

spirometry
peak flow monitoring
CO gas transfer test
response to bronchodilator - beta2 agonist

26
Q

what spirometry value is expected from asthma

A

FEC1/FVC = less than 70%

27
Q

why is a peak flow test used

A

to determine if there is variability in airflow obstruction

28
Q

what are the symptoms of a moderate attack

A

mildly greater symptoms than normal

PEF 50-75%

29
Q

what are the symptoms of a sever attack

A

anyone

cant complete full sentences in 1 breath
HR over 110bpm
RR over 25 breaths per minute
PEF = 22-50% of predicted

30
Q

what are the symptoms of a life threatening attack

A

grunting
impaired consciousness, confusion
silent chest

o2 saturation is lower than 92

PaO is lower than 60mmHg

31
Q

what are the symptoms of a near fatal asthma attack

A

raised PaCO2

need for mechanical ventilation

32
Q

what two drugs cause reversibility in asthma

A

beta2 agonists

corticosteroids

33
Q

what is the Co gas transfer test used for

A

distinguishing between asthma and COPD

34
Q

how dose the CO gas transfer test work

A

Co is passed on the Hb this is reduced in COPD and increased in asthma

35
Q

what is the one thing to remember with asthma - NO..

A

no wheeze

no asthma

36
Q

what are the similarities of adult asthma with children’s asthma (5)

A

its common
symptoms are the same
triggers, treatment and pathology are also all the same

37
Q

what is the prevalence of asthma in children (2)

A

prevalence 0-15%

more boys than girls have asthma

38
Q

what are the multiple hits that lead to asthma

A

genes
inherited abnormal lungs
early onset atopy
later exposures (rhinovirus, exercise, smoking0

39
Q

why is rhinovirus a trigger

A

as asthma as a unusual response to infection due to the already inflamed airway

40
Q

how can you tell there is a wheeze - is this different in kids

A

the wheeze is musical

kids airway narrower so more likely to be musical

41
Q

what is a differential diagnosis for a child that has a wheeze

how would you diagnose

A

VIW - viral induced wheeze

as asthma is a dimmer switch of symptoms

VIW is a light switch - on/off when have a virus

42
Q

what treatment is given for VIW

A

salbutamol

43
Q

how do you confirm a asthma diagnosis

A

trial of inhaled cortical steroids

44
Q

is there a asthma test for children

A

no

45
Q

is there a lower age limit for diagnosis

A

no

46
Q

what are ICS (inhaled cortical steroids) good for in peads

A

diagnostic
as a regular preventer
very safe

47
Q

what should be added to a paediatric therapy routine if needing regular preventer (step 2)

A

add a beta 2 agonist

48
Q

what are the adverse effects of ICS in peads

A

height suppression

49
Q

what is step 3 in a peads asthma therapy

A

add LABA

50
Q

what must you do for peads when giving the LABA for step 3

A

do not use without ICS

use as a fixed dose inhaler

51
Q

what must kids used when using a pMDI

A

always use a spacer

52
Q

what is the preferred method of treatment of peads asthma

A

pMDI with spacer

53
Q

what other non medical management should be tried for kids asthma

A

stop smoking exposure

remove environmental triggers

54
Q

what are the best treatment for step 1

A

SABA

55
Q

how should steroids be delivered in acute asthma settings

A

oral steroids

56
Q

how should steroids be delivered in chronic asthma settings

A

inhaled steroids

57
Q

what is important about childhood asthma compared to adult asthma

A

its very steroid sensitive

respiration (17 decks)

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