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Patho > asthma and cystic fibrosis > Flashcards

asthma and cystic fibrosis Flashcards

1
Q

Prevelence of asthma

A

Blacks more than whites
Hispanics get it most, but black women die from it most

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2
Q

Asthma definition

A

combo of bronchial hyperresponsiveness and reversible expiratory airflow limitation

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3
Q

asthma significance

A

more ppl are getting it, but less ppl are dying
-women get it more aft puberty

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4
Q

Asthma triggers

A

-acute infection: reduced airway diameter and increased inflammation
-viral stuff
-cockroaches
-any other allergy stuff
-any other artificial irritants

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5
Q

smoking and asthma

A

faster decline in lung func
increased sensitivity to triggers
-more visits to HCP
-worse response to treatment

21% of ppl with asthma keep smoking

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6
Q

exercise induced asthma/bronchospasm

A

airway obstruction from changes to mucosa from hypervntilation, cooling/rewarming air, and capillary leak

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7
Q

drugs and food to avoid with asthma

A

aspirin and NSAIDs
salicylic acid
BETA ADRENERGIC BLOCKERS
ACE inhibitors
Sulfite preservatives (fruit, beer, wine, salad bars)
yellow dye no. 5

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8
Q

correlation bt asthma and GERD

A

-reflux can trigger bronchoconstriction and aspiration

-asthma meds might worsen GERD symptoms (Beta agonists relax LES)

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9
Q

Is asthma genetic?

A

yea

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10
Q

Early phase response of asthma

A

right after exposure
mast cells release inflammatory mediators
-causes vasodilation and increased capillary permeability; itching; smooth muscle spasms/airway narrowing; goblet cell mucus production

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11
Q

Late phase response of asthma

A

inflammation finally
only happens in 50% of patients

use corticosteroids to treat

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12
Q

Remodeling

A

changes in bronchial wall f/ chronic inflammation
-fibrosis, smooth muscle hypertrophy, mucus hypersecretion, angiogenesis

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13
Q

manifestations

A

obvi- wheezing coughing, SOB, chest tightness

hyperinflation and long expiration from air trapping in narrow airways

Acute attack= wheezing (just on expiration at first, but on inspiration and expiration if it gets worse)

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14
Q

weird fact ab wheezing

A

mild attack = loud wheezing
severe attack = wheezing w/ forced expiration or not at all

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15
Q

what happens to pH in asthma?

A

alkalotic at first, but then becomes acidotic as patient tires

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16
Q

asthma compilcations

A

pneumonia
tension pneumothorax
status asthmaticus
ARF

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17
Q

status asthmaticus

A

super acute asthma attack
-hypoxia, hypercapnia, ARF
-big emergency

progresses to hypotension, bradycardia, and resp/card arrest

bronchodilators and corticosteroids don’t help

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18
Q

treatment of mild asthma attack

A

inhaled bronchodilator and oral corticosteroids
-monitor VS

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19
Q

Presentation of severe asthma attack

A

scared (agitated if hypoxemic)
-tachycardia and tachypnea
-accessory muscles
-PEFR < 50%

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20
Q

treatment of severe asthma attack

A

give O2 (get PaO2 > 60 and get SaO2 > 93%)
-monitor PEFR, ABG, VS
-bronchodilators and corticosteroids

SILENT CHEST IS EMERGENCY! –> GET HCP

21
Q

drugs for short term

A

Bronchodilators
-SABA (albuterol, lasts 4-8 hrs)
-Also inhaled anticholinergics (usually used w/ SABA)

Anti-inflammatory stuff
-IV corticosteroids

22
Q

Drugs for long terms

A

Bronchodilators
-LABA
-methylxanthines
-anticholinergics

Antiinflammatory
-oral or inhaled corticosteroids
-leukotriene modifiers
-anti-IgE

23
Q

Pros and cons of SABA

A

Pros
-stops mast cell’s inflammatory mediators
-can take b4 exercise

Cons
-if use too much, causes tremors, anxiety, tachycardia, palpitations, and nausea
-not long term

24
Q

LABA

A

e.g. Salmeterol r formoterol
used with ICS
-every 12 hrs
-not for acute attacks

25
Q

pros and cons of corticosteroids

A

Pros
-reduces bronchial hyperresponsiveness
-blocks late-phase respose
-stops inflammation
-good long term

Cons
-candidiasis
-hoarseness
-dry cough
***can get better w/ spacer and gargling

26
Q

oral vs inhaled corticosteroids

A

oral: use 1-2 weeks for chronic asthma

ICS: use long term on fixed schedule –> takes 24 hrs to work

27
Q

nonperscription combo drugs

A

OTC bronchodilators
-ephedrine and guaifenesin –> don’t use

*stimulate CV ad CNS

28
Q

Inhaler types

A

MDI
DPI
Nebulizers

29
Q

how much is too much inhaler?

A

no more than 2 canisters/month

30
Q

DPI pros and cons

A

Pros
-breath activated
-less coordination needed
-no spacer

Cons
-low FEV = inadequate inspiration
-can’t find all meds as DPIs
-powder can clump

31
Q

Nebulizers

A

turn meds into mist that’re given through face mask or mouth piece

-requires air compressor or O2 generator

32
Q

goal for PEFR

A

80% of personal best

33
Q

which organs does CF affect

A

lungs, pancreas/biliary duct, intestines

34
Q

which chromosome is fucked up in CF?

A

7 –> CFTR

35
Q

what essentially is CF?

A

inability to excrete NaCl –> excessive mucus formation –> clogged glands –> scarring –> organ failure

36
Q

CF sweat

A

super salty

37
Q

progression of CF in lungs

A

-start in lower regions, small airways –> move to bigger
-mucus becomes dry and tenacious
-cilia motility is decreased
-thick secretions in bronchioles cause scarring, air trapping, and hyperinflation

38
Q

common complications of CF

A

chroninc airway infections –> MDR pneumonia develops
-chronic inflammation of airways

39
Q

vasculature in CF

A

chronic hypoxia and arterial vasoconstriction leads to remodeling of blood vessels –> eventually pulmonary htn, enlarged arteries, and cor pulmonale

40
Q

pancreas stuff in CF

A

gets clogged up
-can’t secrete stuff for digestion –> lose nutrients
-combo type 1+2 diabetes due to impaired exocrine func

41
Q

GI stuff in CF

A

-liver enzymes go up –> cirrhosis
-gallstones, gerds, percreatitis
-portal hypertension
-DIOS = distal intestinal obstruction syndrome

42
Q

how to diagnose babies with cf

A

messed up stools
resp issues
fam history

43
Q

appearance and sex stuff with CF

A

prodruding abdomen, but emaciated extremeties

reproductie issues

44
Q

diagnostic study for CF

A

sweat test with pilocarpine (over 60 is positive)

45
Q

drugs to give CF ppl

A

bronchodilators
inhaled hypertonic saline (7%)
inhaled dornase alpha

***metiabolized way quicker in CF ppl than in normal ppl –> may need higher and longer doses

46
Q

how to treat pseudomonas

A

tobramycin

47
Q

how to deal with pneumothorax CF

A

-chest drainage
-possibly pleural sclerosis
-if hemoptysis, bronchial artery embolisation

48
Q

CF acute care

A

CPT
O2
antibiotics
corticosteroids
adequate nutrition

49
Q

exercise in CF

A

helpful for removing secretions, but kinda dangerous
-make sure to drink gatoade for fluid and electrolytes

Patho (44 decks)

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