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CCC - LM > Asthma & COPD > Flashcards

Asthma & COPD Flashcards

1
Q

Asthma affects what percentage of the population?

A

5-8%

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2
Q

How would you describe asthma to a parent?

A

In normal lungs, air moves in and out of the lungs through the airways.
Asthma is a reversible airway obstruction. This means certain triggers will cause the airways to become inflamed, making it more difficult for air to pass through, therefore making it difficult for your child to breathe. This causes some of the symptoms that he has been experiencing such as the breathlessness and wheeze

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3
Q

What are the 3 factors that contribute to airway narrowing in asthma?

A
  1. Bronchial mucosal contraction
  2. Mucosal inflammation - caused by mast cell and basophil degranulation
  3. Increased mucous production
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4
Q

What are some common drugs that can induce an asthma attack?

A

B-blockers
NSAIDs
Aspirin

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5
Q

When is a cough most likely to occur with someone who suffers from asthma?

A

At night

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6
Q

What are the 2 types of asthma?

Which is most common in what age group?

A

Extrinsic (causative agent) - child onset

Intrinsic (no causative agent) - adult onset

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7
Q

What are the common symptoms of asthma?

A 
Cough (nocturnal)
Rhinitis 
Diurnal variation 
Dyspnoea (exertional) 
Reflux - 60%
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8
Q

What does diurnal variation mean?

A

Fluctuates throughout the day

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9
Q

What are some risk factors for asthma?

A 
Maternal smoking
FH
Atopy
Eczema and hay fever
Inner city
High serum IgE - gene on ch2 (PHF11)
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10
Q

What are the acute symptoms of asthma?

A 
Hyper inflated chest
Inc. RR and HR
Polyphonic wheeze
Acute dyspnoea 
Increased percussion resonance
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11
Q

What investigations are necessary if suspecting adult asthma?

A

Skin prick test
Spirometry - FEV1/FVC > 70%
PEFR

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12
Q

In asthma, how would the peak flow after salbutamol compare to that before salbutamol

A

After salbutamol would have higher PEFR

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13
Q

What is the 2nd stage in management of adult asthma?

A

Add a LABA (salmeterol)

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14
Q

What is the 3rd stage in management of adult asthma?

A

Response to LABA: increase ICS dose

No response to LABA: stop LABA & increase ICS dose

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15
Q

What are the 4th, 5th & 6th stages of management in adult asthma?

A
  1. Increase dose of ICS up to 2000mcg/day
  2. Add LTRA/ SR theophylline, B agonist, LAMA
  3. Daily prednisolone & escalate
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16
Q

Other than A PEFR of 33-50%, what are the other symptoms of acute severe asthma?

A 
Inability to complete full sentences 
Intercostal recession 
HR ≥ 110
RR ≥ 25
SaO2 <92%
17
Q

What are the symptoms of life threatening asthma?

A 
Poor respiratory effort
Silent chest
Cyanosis 
Confusion/exhaustion 
PEFR <33%
SaO2 <92%
18
Q

What is the minimum age at which COPD can be diagnosed?

A

35

19
Q

What genetic mutation can cause COPD in the absence of a history of smoking?

A

Alpha 1 anti-trypsin

20
Q

How long must symptoms be present for to diagnose COPD?

A

≥3 months in 2 years

21
Q

What is the difference between chronic bronchitis & chronic emphysema

A

Bronchitis - increased mucous secretions blocking the airways - obstructive lung disease
Emphysema - widening of the alveolar air spaces - restrictive lung disease

22
Q

What is the gold standard test for COPD?

How is it conducted?

A

Spirometry - carried out 15-20 minutes after inhaling salbutamol

23
Q

What spirometry results would occur with COPD?

A

Reduced FEV1:FVC ratio <60%

FVC <0.7

24
Q

Does asthma or COPD exhibit diurnal variation?

A

Asthma

25
Q

What would be present on CxR with COPD?

A

Hyperinflation > 6 anterior ribs
Flattened hemidiaphragms
Large central pulmonary arteries
Bullae

26
Q

What may an FBC show in the presence of COPD?

A

Anaemia

Polycythaemia

27
Q

What scale is used to assess degree of breathlessness in COPD?

A

MRC dyspnea scale

1-5

28
Q

How do you calculate pack years?

A

no. of cigs per day/20 x no. of years smoked

29
Q

An FEV1 of what would indicate need for long term oxygen therapy?

A

<30%

30
Q

What should be offered to those with COPD as a reliever?

A

SABA - salbutamol
OR SAMA - ipratropium bromide
Still breathless - add LABA (Salmeterol)
Still breathless - ICS

31
Q

What mucolytic can be used for chronic productive cough?

A

Carbocisteine

32
Q

What is contained in a COPD rescue pack?

A

Bronchodilator
PO corticosteroids
Antibiotics

33
Q

What organism usually causes an exacerbation in COPD?
What antibiotic may be used to treat it?
What should also be given?

A

H. Influenzae

Amoxicillin - 500mg 5 days
OR doxycycline/erythromycin

Also give - prednisolone 30mg 7-14 days

34
Q

What is a cardiovascular complication of COPD?

A

Cor pulmonale

35
Q

How would you differentiate COPD from asthma?

A

Asthma has large response to broncodilators

Serial PEFR would show diurnal variation of ~20%

36
Q

How many hours should LTOT be used if required in COPD?

A

≥15 hours per day

CCC - LM (14 decks)

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