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MAP II Final > Asthma and Cystic Fibrosis > Flashcards

Asthma and Cystic Fibrosis Flashcards

1
Q

Obstructive disease

A

air gets trapped in lungs

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2
Q

Nonseptic obstructive diseases

A
  • less sputum

- emphysema, asthma, chronic bronchitis

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3
Q

Septic obstructive diseases

A
  • lots of sputum

- CF, bronchiectasis

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4
Q

Restrictive disease

A
  • loss of lung compliance and chest wall expansion

- decreased depth and increased rate of breathing

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5
Q

What is asthma?

A

reversible obstruction to airflow within the lungs

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6
Q

Risk factors of asthma?

A
  • childhood asthma
  • family history
  • atopy (allergic hypersensitivity)
  • maternal smoking
  • occupation/environmental exposures
  • secondary smoke
  • gender (women more likely)
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7
Q

Associations of asthma

A
  • increased in families with asthma or allergies
  • 1 parent: 1/3 chance
  • 2 parents: 7/10 chance
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8
Q

Signs and symptoms of asthma

A
  • wheezing: high pitched whistling sounds when breathing out

- cough, chest tightness, difficulty breathing

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9
Q

Symptoms may occur/worsen with what?

A
  • exercise
  • infection
  • animals/allergies
  • smoke
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10
Q

Pathophysiology of asthma

A
  • intermediate type hypersensitivity reaction
  • mast cells release histamine
  • cells of immune system stimulate airway
  • airway inflammation –> intermittent airflow obstruction –> bronchial hyper-responsiveness
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11
Q

Diagnosis of asthma (FEV1 and FEV1/FVC percentages)

A

Airway obstruction is episodic AND reversible

– Airway obstruction: FEV1 12% and 200 ml after short acting beta-2 agonist

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12
Q

Classification of severity of asthma: Severe persistent

A
  • Days with symptoms – continuous
  • Nights with symptoms – frequent
  • PEF or FEV1 30%
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13
Q

Classification of severity of asthma: Moderate persistent

A
  • Days with symptoms – daily
  • Nights with symptoms > or = 5/month
  • PEF or FEV1 > 60% and 30%
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14
Q

Classification of severity of asthma: Mild persistent

A
  • Days with symptoms – 3-6/week
  • Nights with symptoms – 3-4/month
  • PEF or FEV1 > or = 80%
  • PEF variability = 20-30%
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15
Q

Classification of severity of asthma: Mild intermittent

A
  • Days with symptoms or = 80%

- PEF variability

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16
Q

Common medications used to treat asthma (4)

A

a. Albuterol (B2 selective bronchodilator)
b. Atrovent (anticholinergic, prevents bronchoconstriction)
c. Salmeteral (Serovent; B2 bronchodilator)
d. Inhaled steroids (advair, flovent, symbicort)

17
Q

Persistent asthmas needs 2-step process….what is it?

A
  1. long-term control
    - - steroids, leukotriene agonists
    - - long acting beta agonist
  2. acute exacerbations
    - - albuterol or short acting beta agonist
18
Q

Asthma treatment goals

A
  • minimal symptoms day or night
  • near normal pulmonary function
  • no limitations on activity
  • aggressive treatment at first sign of worsening
  • minimal or no exacerbations
  • minimal albuterol use
  • minimal or no adverse effects of medications
19
Q

Consequences of asthma

A
  • comorbities (obesity, sinusitis, GERD, sleep apnea)
  • hyperexpansion of thorax
  • postural changes
  • decreased physical fitness/ restricted physical activity
  • increased hospitalization
20
Q

Exercise induced asthma

A

a. Airway drying –> hyperemia (increased blood flow) –> increased permeability –> swelling
b. Airway cooling –> hyperemia –> re-heat airway –> swelling

21
Q

Incidence of exercise induced asthma occurring normally and in cold weather?

A
  • Normally: 3-10%

- Cold weather: 35-50%

22
Q

Treatment for exercise induced asthma

A
  • Pre-treat with B-agonist before exercise
  • early and longer warm up
  • short exertion periods
23
Q

What is cystic fibrosis?

A

cogenital disease of exocrine glands (genetic – must inherit a gene from each parent)

24
Q

What is the gene for cystic fibrosis and what does it do?

A

CF Transmembrane Regulator (CFTR) Gene

a. Normally opens channel thru plasma membrane to allow chloride to pass thru

25
Q

Defect of CFTR gene in people with cystic fibrosis?

A

Defect = faulty movement of Na+ and Cl-

– Too much NaCl pulled into cells, leaving behind dry mucus in airways –> increased bacterial infection

26
Q

Consequences of cystic fibrosis

A
  1. mucus build up in airways –> severe lung infections
  2. Hypoxemia (low O2 in blood)
  3. Intestinal blockages (water and salt stay in cells)
  4. Pancreatic enzymes do not cross cell membrane
  5. Reproductive blockages
27
Q

Common infections of cystic fibrosis

A

staphylococcus aureus, pseudomonas aeruginosa

    • transmitted by respiratory or hand contact
    • usually colonize in lungs and difficult to eradicate
28
Q

Bronchiectasis

A

multiple infections in tubules of lungs = dilation/chronic stretching of bronchial walls

29
Q

Treatment of pulmonary infections from cystic fibrosis

A
  1. beta-agonist inhaled bronchodilator
  2. mucolytics – thins mucus (pulmozyme, guaifenesin)
  3. airway clearance (autogenic drainage, active cycle breathing, percussion)
  4. antibiotics (aminoglycosides, inhaled Tobramycin, azithromycin)
30
Q

Rheumatoid diseases in patients with CF (3)

A
  1. Cystic fibrosis arthropathy
  2. Hypertrophic pulmonary osteoarthropathy
  3. Osteoporosis

MAP II Final (9 decks)

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