Asthma exacerbation

Question 1

Differential for wheezing, SOB, tachycardia, tachypnea

Answer 1

Asthma exacerbation
Viral URI
Pneumonia
PE
Bronchitis

Question 2

How do you evaluate a patient presenting with wheezing, SOB, tachycardia, tachypnea?

Answer 2

Vitals
pulse ox
Peak expiratory flow meter

Question 3

How do you triage patients with asthma symptoms based on FEV1 levels?

Answer 3

FEV1 >70% can be managed outpatient

FEV1 <70% should be sent to hospital

Question 4

What is the management for FEV1 50-70%?

Answer 4

Continous monitoring of O2 and vitals
Continuous fetal heart monitoring
Oxygen by face mask
Albuterol 10mg/hr
If inadequate response ipatropium bromide 5000mcg q 20min
If inadequate response oral steroids

Question 5

What is the management for FEV1 <50%?

Answer 5

Represents impending respiratory failure
ICU admission
Intubate with 100% ventilator support
Nebulized albuterol, ipatropium bromide , systemic steroids
Continuous monitoring of O2 and vitals
Continuous fetal heart monitoring

Question 6

What are the effects of steroid for asthma exacerbation treatment on the pregnancy?

Answer 6

Maternal effects= increase risk of preeclampsia and preterm birth

Fetal= increase risk of cleft lip/palate, IUGR

Question 7

What pregnant women should be treated for the flu?

Answer 7

Any pregnant women who has symptoms suspicious of the flu including productive cough with fever

Question 8

What is the treatment for flu in pregnancy?

Answer 8

Oseltamivir 75mg BID for 5 days