Asthma for the Clinician

Question 0

what three things describe an asthma airway

Answer 0

bronchoconstriction, oedema, mucous

Question 1

pathophysiology of asthma?

Answer 1

mast cell and eosinophil degranulation in response to allergin,

Question 2

what happens to airways in chronic inflammation from asthma

Answer 2

structural changes, epithelial damage

Question 3

what 3 things is involved in airway remodelling from Asthma?

Answer 3

smooth muscle hyperplasia
goblet cell hyperplasia
thickening of basement membrane

Question 4

is there a genetic predisposition for asthma?

Answer 4

polygenetic

Question 5

what is AHR? meaning?

Answer 5

airway hyperresponsiveness (Not asthma but more likely to develop)

Question 6

Name 9 triggers of asthma?

Answer 6

Allergens
Pollutants (smoke, fumes)
URTIs
Cold dry air
exercise
emotion/anxiety
food
meds
GORD

Question 7

that meds can trigger asthma?

Answer 7

aspirin

betablockers

Question 8

what kind of flow in a wheeze?

Answer 8

turbulent

Question 9

when do you see pulsus paradoxus? 2 times?

Answer 9

asthma

pericarditis

Question 10

how does normal airway air flow?

Answer 10

laminar

Question 11

how are breathsounds and heart sounds during asthma attack?

Answer 11

reduced

Question 12

how to confirm asthma with spirometry?

Answer 12

200ml or 12% improvement with bronchodilator

Question 13

how to confirm asthma with peak expiratory flow?

Answer 13

20% variation day to day

Question 14

what is spirometry is unremarkable for asthma?

Answer 14

bronchoprovocation test

Question 15

5 other causes of wheeze?

Answer 15

bronchitis
obstruction (tumour, foreign body)
COPD exacerbation
vocal cord dysfunction
heat

Question 16

how to tell is wheeze is a vocal cord dysfunction?

Answer 16

expiratory wheeze concentrated in the larynx

Question 17

why would you have inhaled corticosteroids to treat someone’s moderate asthma?

Answer 17

prevent airway remodelling and mucous secretion rather than just treating symptoms

Question 18

medications in asthma should follow which principles?

Answer 18

lowest dose to achieve suitable asthma control and minimal side effects

Question 19

what not to forget when treating asthma in adults to be patient focused?

Answer 19

psychosocial factors and education

Question 20

how NOT to give Beta 2 Agonist?

Answer 20

don’t give LABA alone

Question 21

when use combo inhalers?

Answer 21

if corticosteroids alone doesn’t work LABA/ICS

Question 22

when use leukotriene receptor antagonists?

Answer 22

children, with tablets, not really great for adults

Question 23

side effects of beta agonists and ICS?

Answer 23

palpatations for SABA/LABA

oral thrush for ICS

Question 24

what is ciclesonide used for?

Answer 24

ICS that’s less harsh on vocal cord, used for singers with asthma

Question 25

how to ask for adherence?

Answer 25

how often do you renew your script?

Question 26

how to treat severe life threatening asthma attack? 5 things

Answer 26

admit to ICU
oxygen
oral or IV prednisolone
SABA nebulized
supportive breathing
IV magnesium