Asthma and COPD

Question 1

What are asthma and COPD?

Answer 1

Common, chronic conditions

COPD less on treatment , less common but more deaths/yr

Question 2

Describe how lung diseases are classified?

Answer 2

AIRWAYS - asthma, bronchitis, bronchiectasis, sleep apnoea, cancer
PARENCHYMAL - emphysema, pneumonia, cancer
VASCULAR - pulmonary embolism

Question 3

What is asthma?

Answer 3

Inflammatory, reversible, variable and hyperactive condition

Question 4

What happens during asthma attack?

Answer 4

Smooth muscle contraction - airflow obstruction, SOB and wheeze
Mucous production - more ariflow obstruction, cough and sputum

Question 5

What is asthma associated with?

Answer 5

Allergies
Obesity
Genetic
Hygiene hypothesis - immune system reacts to harmless things eg grass pollen as no bacteria in life

Question 6

What commonly provokes asthma?

Answer 6

viral infections
allergens
exercise
cold air
stress
beta blockers

Question 7

What may provoke asthma dentally?

Answer 7

Latex
fissure sealants
methymethacrylate
stress
NSAIDS

Question 8

What is used to measure lung capacity in asthamatics?

Answer 8

Peak flow meter

Question 9

What is defined as a severe asthma attack?

Answer 9

PFR less than 50%
Unable to complete sentence in one breath
RR over 25/min
pulse over 110/min

Question 10

What is defined as a life threatening asthma attack?

Answer 10

PFR less than 33%
Sa02 less than 92%
silent chest
cyanosis
hypotension
bradykardia
confusion

Question 11

What is the treatment for asthma?

Answer 11

BETA 2 ADRENIC RECEPTOR AGONISTS
Relax bronchial muscle, improve wheeze,breathlessness
Short acting (SABA) - salbutamol (ventolin) , terbutaline
Long acting (LABA) - salmeterol, formoterol, vilanterol
CORTICOSTEROIDS (prevention)
All purpose anti inflammatories
Decrease bronchial inflammation and hyper-responsiveness
Inhaled - beclametasone, budesonide
Oral - prednisalone
OTHERS
Antimuscarinics - ipratropium
Leukotriene antagonists - monteleukast
Theophylline - chromoglucate
Anti- IgE’s - omalizumab

Question 12

What is COPD?

Answer 12

Chronic Obstructive Pulmonary Disease

Irreversible airflow obstruction

Question 13

What is used to measure lung volume in COPD?

Answer 13

Spirometry

Question 14

What are the causes of COPD?

Answer 14

smoking
coal mining
air pollution

Question 15

What is COPD associated with?

Answer 15

Smoking
Poverty
Malnutrition
Mental Illness
Poor OH

Question 16

What are the symptoms of COPD?

Answer 16

cough
Mucous
Blood
SOB
Ankle swelling
increased RR
Weight loss
wheeze
Pursed lips to increase pressure to expel breath
Lean forward to support ribs and help breathing

Question 17

What complications are associated with COPD?

Answer 17

Corpulminale - heart failure due to poor lungs

Resp failure - type 1 = hypoxic and low CO2, type 2 = hypoxic and high CO2

Question 18

What is the treatment for COPD?

Answer 18

Stop smoking
Beta agonists (SABA and LABA) - bronchodilator
Anti - muscarinics - bronchodilator
Steroids
02
Theophylline

Question 19

What oral problems occur with asthma and COPD?

Answer 19

xerostaemia, candidiasis, mucosal ulceration, gingivitis, perio

Question 20

What emergency treatment should be given in an acute onset?

Answer 20

Salbutamol 5mg
Steroid - hydrocortisone 100mg IV
Ipratropium - 500mcg nebulised
02 - high flow for asthma, careful with COPD

Question 21

What signs of COPD are classically chronic bronchitis?

Answer 21

mucous
bronchial inflammation
airway narrowing

Question 22

What signs of COPD are classically emphysema?

Answer 22

bullae

breakdown of parenchymal tissue