Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Asthma RCM week 1 > Asthma: diagnosis, monitoring, pathophysiology, and management > Flashcards

Asthma: diagnosis, monitoring, pathophysiology, and management Flashcards

1
Q

What is asthma defined by

A

Reversible increases in airway resistance, involving bronco constriction and inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is asthma characterized by

A

Reversible decreases in the FEV1:FVC (less than 70-80% suggests increases airway resistance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is FEV1

A

Amount of air a person can force out of their lungs in 1 second

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is FVC

A

Forced vital capacity (total amount of air exhaled)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How can you also see if a person has asthma (another diagnostic test)

A

Measure their PEF (peak expiratory flow)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the PEF like in an asthma patient

A

Variable- which is improved with a Beta2 agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is PEF

A

Maximum velocity of a person’s expired air (peak expiratory flow)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is COPD

A

Chronic obstructive pulmonary disease

-chronic bronchitis+ emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is chronic bronchitis

A

Increased mucus, airway obstruction, intercurrent infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is emphysema

A

Destruction alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the FEv1 like in a person with COPD

A

Reduced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the PEF like in a person with COPD

A

Little variation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is chronic bronchitis and emphysema mostly caused by

A

90% caused by smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which nervous system is used to relax airways

A

Sympathetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does the sympathetic nervous system relax the airways

A

Release of circulating adrenaline acting on beta2-adrenoreceptors on bronchial smooth muscle and activates them to cause relaxation (bronchodilation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does parasympathetic nervous system cause the constriction of airways

A
  • vagus nerve releases acetylcholine at the ganglia

- Binds to muscarinic receptors which activates it and causes constriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How else is acetylcholine released to cause muscle constriction

A

End organ of tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How else does sympathetic nervous system control bronchial calibre

A

Sympathetic fibers release NA which acts on adrenoreceptots on parasympathetic ganglia to inhibit transmission

-Beta2 adrenoceptors also are on mucus glands to inhibit secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What nerves do airways have

A

sensory nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What happens if dust gets in airway

A

Stimulates sensory nerve, which then causes bronchoconstriction (reflex response locally) (cough reflex)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are asthmatic attacks genetically provoked by

A
  • allergens
  • cold air
  • viral infections
  • smoking
  • exercise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the phases of an asthma attack

A

-May be characterized by Early phase followed by Late phase (which is more inflammatory)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Clinical features of asthma

A

-wheezing
-breathlessness
-tight chest
-cough (worse at night/exercise)
(nocturnal in children)
-Decreases in FEV1, reversed by a Beta2 agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Once a stimulus is detected, what happens in lungs

A

-mast cells, mononuclear cells, release mediators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the mediators that the mast cells and mononuclear cells release
Spasmogens (immediate response) which constrict the airways and cause bronchospasm Chemotaxins (signals to white blood cells which tell them to go to the lungs and cause the Late phase (inflammation)
26
Examples of spasmogens
Histimine Prostaglandin D2 Leukotrienes C4 and D4 Platelet activating factor (PAF)
27
How are prostaglandins Made
In the cell membranes, we all have arachidonic acid. Via the COX pathway, it is metabolized to prostaglandin
28
What is the role of prostaglandin
Bronchoconstrictor
29
How are leukotrienes made
Arachidonic acid goes down the LOX pathway to form leukotrienes
30
What are leukotrienes used for
Spasmogens, and are also inflammatory
31
What is histamine released by
Mast cells
32
Examples of chemotaxins and their role
- Leukotriene B4, PAF - leads to Late Phase - Attract leukocytes, especially eosinophils and mononuclear cells - Leads to inflammation and airway hyper-reactivity
33
What do bronchodilator reverse and what phase is this
Bronchospasm (early phase)
34
What kind of relief do bronchodilators provide
Rapid relief
35
What other drugs can be used and what is this used for
-preventers used to prevent an attack
36
What is the drug used as a Beta2 adrenoceptor agonist
Salbutamol
37
When is salbutamol used
Agent of first choice
38
What does salbutamol do
Increases FEV1 - Binds to Beta 2 adrenoceptors on smooth muscle - Produced G protein - This G proteins activates Adenylylcyclase which is an enzyme which leads to the production of cAMP (second messenger) which causes muscle relaxation
39
What is cAMP broken down into
PDE into AMP -stops action of cAMP
40
Long term effect of beta2 agonist
Leads to the lessened responsiveness of the beta2 adrenoceptors which makes the drug less effective
41
What drugs are used as a preventative measure and for long term control
Long acting beta agonists (LABA)
42
Example of a LABA
Salmetarol
43
What does salmetarol do
Dilate the airways for 12 hours so is used for long term control overnight
44
What are the two theories of action of xanthines
- Adenosine receptor antagonists | - Phosphodiesterase inhibitors
45
The are xanthines used
In an emergency (intravenous insertion in an emergency)
46
What do xanthines do when inhabiting phosphodiesterase inhibitors
Xanthines PDE which means that the breakdown of cAMP is inhibited and so the action of cAMP is prolonged and so theres more muscle relaxation by the action of salbutamol
47
What are muscarinic M-receptor antagonists mostly used in
COPD (limited value in asthma)
48
What do muscarinic M-receptor antagonists do
Block parasympathetic bronchoconstriction
49
Example of muscarinic M-antgonists
Tiotropium
50
Side effects of muscarinic M-antagonists
- Dry mouth - constipation - Blurred vision because you're blocking parasympathetic nervousb system
51
How to reduce musarinicM- antagonist side effects
Inhale the drug
52
What are anti-inflammatory agents used as
Preventative measure THEY DO NOT REVERSE AN ATTACK
53
Drug name used as an anti-inflammatory agent
Corticosteroids | -eg beclometasone (brown inhaler)
54
What do corticosteroids do
1) Go into the cell because its lipid soluble 2) Activate intracellular receptors 3) Intracellular-drug complex goes to nucleus 4) Tells nucleus which bits of DNA to produce mRNA for 5) mRNA comes out of the nucleus and codes for protein Lipocortin/Annexin A1 6) Lipocortin/annexin A1 inhibits phospholipase A2 which is used to synthesize arachidonic acid (which produces leukotrienes and prostaglandins which inflame the airways)
55
What are steroids given with and why
Beta 2 agonists to reduce the receptor down-regulation
56
Side effects of steroids taken - orally - Inhaled (and how to prevent this)
Orally- Adrenal suppression | Inhalation- Throat infections, hoarseness (so wash mouth out afterwards)
57
What is salmetarol
Beta 2 agonist
58
What are leukotriene receptor agonists (LTRAs) used for
Block the action of leukotrienes -preventative and bronchodilators
59
Example of a leukotriene receptor antagonist drug
Montelukast
60
Initial line of treatment for an asthma patient
Short acting Beta2 agonist (salbutamol) plus a regular inhaled steroid (beclametasone)
61
If patient's asthma is not sufficiently controlled by first line of treatment, what do you use next -and if this fails?
Trial of LABA (or LTRA or xanthine if this fails) -Increase dose of inhaled steroid
62
If the patients asthma is not controlled by increasing dose of inhaled steroid?
Add oral steroid
63
How to know whether to go to next line of treatment
If salbutamol is used >2 times a week
64
When is a spacer device used (the bottle)
- In patients with poor technique | - Reduce steroid impaction
65
What should you use before a steroid and what to do after steroids
Bronchodilator -wash mouth out

Asthma RCM week 1 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions