Asthma megadeck

Question 1

is childhood asthma more common in males or females?

Answer 1

males

Question 2

is adulthood asthma more common in males or females?

Answer 2

females

Question 3

what is the strongest risk factor for asthma?

Answer 3

personal familial atopic tendency

Question 4

what are the three proven risk factors for asthma?

Answer 4

genetics, occupation, smoking

Question 5

what is the ‘grandmother effect’?

Answer 5

maternal grandmother’s smoking habits affect probability of asthma

Question 6

what are some symptoms that may indicate the patient does NOT have asthma?

Answer 6

clubbing
stridor
asymmetrical expansion
dull percussion
crepitations

Question 7

when investigating for asthma, what would you expect to see on a full blood count?

Answer 7

eosinophilia (atopy)

Question 8

what would you see in someone having a moderate asthma attack?

Answer 8

able to speak complete sentences
HR < 110
RR < 25
PEF (peak expiratory flow) 50-75% predicted or best
SaO2 > 92% (no need for ABG)
PaO2 > 8kPa

Question 9

what would you see in someone having a severe asthma attack?

Answer 9

any one of:
unable to speak, unable to complete sentences
HR > 110
RR > 25
PEF (peak expiratory flow) 33-50% predicted or best
SaO2 > 92%
PaO2 > 8kPa

Question 10

what would you see in someone having a life threatening asthma attack?

Answer 10

any one of:
grunting
impaired consciousness, confusion, exhaustion
HR > 130 or bradycardic
hypoventilating
PEF (peak expiratory flow) < 33% predicted or best
cyanosis
SaO2 < 92%
PaO2 < 8kPa
PaCO2 normal (4.6-6.0kPa)

Question 11

what (one) sign would you see in someone having a near fatal asthma attack?

Answer 11

raised PaCO2

Question 12

no wheeze?

Answer 12

no asthma!

Question 13

is asthma reversible?

Answer 13

yes

Question 14

is asthma variable?

Answer 14

yes

Question 15

how do you test for false positive in treatment?

Answer 15

‘inhaler holiday’

Question 16

is there a definitive test for asthma?

Answer 16

no

Question 17

what are the goals of asthma treatment?

Answer 17

minimal symptoms during day and night
minimal need for reliever medication
no attacks (exacerbations)
no limitation of physical activity

Question 18

what does SANE stand for?

Answer 18

Short acting beta agonist / week
Absence school / nursery
Nocturnal symptoms / week
Exertional symptoms / week

Question 19

if asthma is not well controlled, what are the first questions that need to be asked?

Answer 19

are the taking the treatment?
are the taking the treatment correctly?
do they have asthma?
should you increase the dose?

Question 20

what is step 1?

Answer 20

short acting beta agonists

Question 21

what is step 2?

Answer 21

regular preventer - low dose ICS

LTRA in < 5s

Question 22

when should step 2 be implemented?

Answer 22

using inhaled B2 agonists three times a week or more

symptomatic three times a week or more, or waking one night in a week

Question 23

what is step 3?

Answer 23

add on preventer - LABA / LTRA / increase ICS dose

Question 24

what does MDI stand for?

Answer 24

Metered Dose Inhaler

Question 25

give some examples of SABAs

Answer 25

salbutamol

terbutaline

Question 26

give some examples of ICSs

Answer 26

beclomethasone
budesonide
fluticasone
ciclesonide
mometasone

Question 27

was there really any point in making this deck

Answer 27

nope