Asthma and COPD

Question 1

What is asthma? 2

Answer 1

Asthma is chronic inflammatory disease that results in recurrent reversible airway obstruction

Question 2

What are the common symptoms of asthma? 4

Answer 2

1. Nocturnal cough
2. Weezing
3. Shortness of breath
4. Chest tightness

Question 3

Describe the epidemiology of asthma. 3

Answer 3

1. Common chronic disease in children in both devloped and devleloping countries.
2. Also common in adults.
3. It is increasing in prevalence and severity.

Question 4

What is the big difference between asthma and COPD

Answer 4

Asthma is reversible

Question 5

What are the causes of COPD? 6

Answer 5

1. Cigarette smoking (most common)
2. Marijuana smoking
3. Post-tuberculosis lung disease
4. Biomass fuels
5. Dust exposure
6. Air pollution

Question 6

Describe COPD

Answer 6

1. Involves chronic bronchitis
2. Obstruction and/or destruction of alveoli and elastin fibres in lung parenchyma (emphysema)
3. Airflow obsturction is the characteristic feature
4. Hyper-reactivity of the airways and partial reversibility may be present
5. Small airways fibrosis
6. Lung function tests are essential

Question 7

Describe asthma 6

Answer 7

1. Intermittent attacks of wheezing
2. Shortness of breath
3. Nocturnal cough
4. Acute attacks are reversible
5. Underlying pathalogical disorder can progress in older patients to chronic state resembling COPD
6. Acute severe asthma is not readily reversible (cause hypoxaemia)

Question 8

Complete the gold COPD table 15

Answer 8

Question 9

Describe the COPD ABCD classifcation

Answer 9

Question 10

Complete the table of the difference between COPD and ASthma 12

Answer 10

Question 11

This is just a picture of an ashtmatic bronchiole

Answer 11

Question 12

Describe the stepwise management of asthma

Answer 12

1. First thing to do is spirometry
2. FEV1/ FVC < 0.75 indicative of an obstructive disorder
3. Is history suggestive of asthma
4. If yes, perform PEF
5. Is the patient currenlty obstructed (are there currently signs of asthma)?
6. If yes, perform a bronchodilatory reversibility test (key characterisitic of asthma is that obstruction is reversible)

• Take baseline PEF
• administer a ß2 agonist
• wait 15 minutes
• PEF increase of > 15% (chidren) >20% adults is indicative of asthma

1. If no, peak flow variability

• Self PEF test
• take measurement 2-4 per day
• measure variability and convert into a percentage
• >13 % (adults) > 10% kids indicates asthma

1. exercise challenge test

Question 13

What is spirometry

Answer 13

Spirometry is a lung function test that measures how much air you inhale and exhale and the speed at which you exhale

Question 14

What are the 2 types of asthma medications?

Answer 14

1. Controllers
2. Relievers

Question 15

What are relievers? 2

Answer 15

1. Short acting bronchodilators that are inhaled
2. Used when necessary

Question 16

What are the 3 types of relievers?

Answer 16

1. Rapid and short acting ß2 agonists
2. Inhaled ipratopium bromide
3. Short acting xanthine derivatives (theophylline) (hardly ever used )

Question 17

What are controllers?

Answer 17

1. Drugs with sustained bronchodilatory and anti-inflammatory effects
2. Used to prevent an attack

Question 18

List the types of controllers 5

C L B T I

Answer 18

1. Inhaled and systemic corticosteroids
2. Leukotriene receptor antagonists
3. Long acting ß2 agonists
4. Sustained released theophyllines
5. Anti- IgE

Question 19

What are the 2 categories of anti-asthmatic agents?

Answer 19

1. Bronchodilators
2. Anti-inflammatories

Question 20

How are bronchidilators classified? 4

Answer 20

1. ß2 receptor agonists (LABA and SABA)
2. Xathnine derivatives
3. Muscarinic receptors antagonists
4. Cysteinyl leukotriene receptor antagonists

Question 21

What the short acting ß2 agonists? 3

S F T

Answer 21

1. Salbutamol
2. Feneterol
3. Terbutaline

Question 22

What the long acting ß2 agonists? 3

S F V

Answer 22

1. Salmeterol
2. Formoterol
3. Vilanterol