Asthma for the Clinician Flashcards
what three things describe an asthma airway
bronchoconstriction, oedema, mucous
pathophysiology of asthma?
mast cell and eosinophil degranulation in response to allergin,
what happens to airways in chronic inflammation from asthma
structural changes, epithelial damage
what 3 things is involved in airway remodelling from Asthma?
smooth muscle hyperplasia
goblet cell hyperplasia
thickening of basement membrane
is there a genetic predisposition for asthma?
polygenetic
what is AHR? meaning?
airway hyperresponsiveness (Not asthma but more likely to develop)
Name 9 triggers of asthma?
Allergens Pollutants (smoke, fumes) URTIs Cold dry air exercise emotion/anxiety food meds GORD
that meds can trigger asthma?
aspirin
betablockers
what kind of flow in a wheeze?
turbulent
when do you see pulsus paradoxus? 2 times?
asthma
pericarditis
how does normal airway air flow?
laminar
how are breathsounds and heart sounds during asthma attack?
reduced
how to confirm asthma with spirometry?
200ml or 12% improvement with bronchodilator
how to confirm asthma with peak expiratory flow?
20% variation day to day
what is spirometry is unremarkable for asthma?
bronchoprovocation test
5 other causes of wheeze?
bronchitis obstruction (tumour, foreign body) COPD exacerbation vocal cord dysfunction heat
how to tell is wheeze is a vocal cord dysfunction?
expiratory wheeze concentrated in the larynx
why would you have inhaled corticosteroids to treat someone’s moderate asthma?
prevent airway remodelling and mucous secretion rather than just treating symptoms
medications in asthma should follow which principles?
lowest dose to achieve suitable asthma control and minimal side effects
what not to forget when treating asthma in adults to be patient focused?
psychosocial factors and education
how NOT to give Beta 2 Agonist?
don’t give LABA alone
when use combo inhalers?
if corticosteroids alone doesn’t work LABA/ICS
when use leukotriene receptor antagonists?
children, with tablets, not really great for adults
side effects of beta agonists and ICS?
palpatations for SABA/LABA
oral thrush for ICS
what is ciclesonide used for?
ICS that’s less harsh on vocal cord, used for singers with asthma
how to ask for adherence?
how often do you renew your script?
how to treat severe life threatening asthma attack? 5 things
admit to ICU oxygen oral or IV prednisolone SABA nebulized supportive breathing IV magnesium
