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C3 Didactics > asthma_brainscape_cards_comprehensive > Flashcards

asthma_brainscape_cards_comprehensive Flashcards

1
Q

How many people worldwide are affected by asthma?

A

~300 million

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2
Q

What percentage of the U.S. population had asthma as of 2012?

A

8% (~20 million people)

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3
Q

What is the global prevalence range of asthma?

A

5-16%

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4
Q

At what age can asthma occur?

A

Any age (childhood > adulthood)

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5
Q

How much does the U.S. spend annually on adult asthma?

A

$18 billion

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6
Q

How many physician office visits are related to asthma annually in the U.S.?

A

~10.5 million

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7
Q

How many ER visits are related to asthma annually in the U.S.?

A

~2 million

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8
Q

How many asthma-related deaths occur annually in the U.S.?

A

4000 deaths

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9
Q

What characterizes asthma’s pathophysiology?

A

Chronic and recurrent bronchial hyperresponsiveness and obstruction

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10
Q

What cells and mediators are involved in asthma inflammation?

A

CD4+ T cells, eosinophils, IgE, T-helper cells (TH2)

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11
Q

What is the role of IgE in asthma?

A

Regulates mast cell degranulation, leading to bronchospasm after antigen exposure

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12
Q

Is asthma inflammation reversible?

A

Yes, inflammation and bronchial constriction are reversible

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13
Q

What happens with recurrent airway inflammation in asthma?

A

Can lead to airway remodeling with permanent lung changes (mucosal cell hyperplasia, endothelial cell injury, subepithelial fibrosis)

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14
Q

What occupational exposures are risk factors for asthma?

A

Smoke, dust, fumes, dust-mites, pollen, dander, cold exposure, metals

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15
Q

What is the impact of obesity on asthma risk?

A

BMI > 30 kg/m2 increases incidence of asthma by 2-3x

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16
Q

What are the main risk factors for asthma?

A

Occupational exposure, smoking, obesity, allergic rhinitis, family history

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17
Q

What are common signs and symptoms of asthma?

A

Shortness of breath, cough (worse at night), wheezing, chest tightness

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18
Q

When does asthma-related wheezing most commonly occur?

A

More commonly during expiration

19
Q

Does the absence of wheezing exclude asthma?

A

No, it does not exclude the diagnosis

20
Q

What are severe symptoms indicating respiratory failure in asthma?

A

Prolonged expirations, increased work of breathing, retractions, lack of air movement, decreased breath sounds

21
Q

What historical points are important for hospitalized asthma patients?

A

Acute vs chronic symptoms, medication compliance, previous hospitalizations, intubation history, triggers

22
Q

What are risk factors for asthma-related death?

A

Previous severe exacerbation, multiple hospitalizations, high SABA usage, comorbidities, low socioeconomic status, psychosocial problems, psychiatric disease, illicit drug use

23
Q

What conditions are in the differential diagnosis of asthma in infants and children?

A

Allergic rhinitis, sinusitis, foreign body, viral bronchiolitis, cystic fibrosis, heart disease

24
Q

What conditions are in the differential diagnosis of asthma in adults?

A

COPD, CHF, pulmonary embolism, tumors, medication-induced (ACE inhibitors), vocal cord dysfunction

25
Q

What is the gold standard diagnostic test for asthma?

A

Spirometry demonstrating reversibility of airflow obstruction with bronchodilator

26
Q

What spirometry result indicates bronchodilator reversibility in asthma?

A

Improvement of ≥ 12% & 200 mL in FEV1 after treatment

27
Q

What does a positive methacholine test indicate in asthma?

A

A decrease in FEV1 by 20% with ≤ 8 mg/dl of methacholine

28
Q

What is the indication for using fractional exhaled nitric oxide (FeNO) in asthma?

A

To assist in diagnosis and monitor eosinophilic inflammation, especially in allergic asthma

29
Q

What findings on chest X-ray might you see during an asthma exacerbation?

A

Typically normal, but can show hyperinflation, bronchial wall thickening, hilar prominence

30
Q

What is the initial treatment for a mild to moderate asthma exacerbation?

A

Oxygen if needed (SaO2 ≥ 90%), albuterol (up to 3 doses in the first hour), corticosteroids if no immediate response to SABA

31
Q

What is the goal SaO2 during severe asthma exacerbation treatment?

A

SaO2 ≥ 90%

32
Q

What are the treatment options for severe asthma exacerbation?

A

Oxygen, albuterol, corticosteroids, consider adjunctive treatments (ipratropium, magnesium, heliox, non-invasive ventilation)

33
Q

What is the first-line treatment for intermittent asthma?

A

PRN SABA or ICS-Formoterol

34
Q

What is the preferred treatment for severe persistent asthma (Step 6)?

A

High Dose ICS + LABA + oral steroid (prednisone)

35
Q

What is the treatment approach for exercise-induced asthma?

A

Albuterol 15-30 min prior to exercise, montelukast (second-line), cromolyn sodium (alternative)

36
Q

What is the mechanism of omalizumab in asthma treatment?

A

Monoclonal antibody that prevents binding of IgE to receptors on basophils and mast cells

37
Q

What is the benefit of mepolizumab in asthma treatment?

A

Reduces ER visits and hospitalizations, particularly in patients with high blood eosinophil counts

38
Q

What is the mechanism of dupilumab in asthma treatment?

A

Anti-IL-4 receptor alpha-subunit monoclonal antibody that blocks IL-4 and IL-13 signaling in Th2 inflammation

39
Q

What percentage of asthma patients also have GERD?

A

20-80%

40
Q

What is the impact of pregnancy on asthma?

A

Symptoms worsen in 1/3 of patients, especially between 13-24 weeks

41
Q

What are the risks of poorly controlled asthma during pregnancy?

A

Preeclampsia, prematurity, decreased growth of child, cesarean delivery

42
Q

What percentage of patients with asthma experience exercise-induced asthma?

A

> 90%

43
Q

What are the diagnostic criteria for allergic bronchopulmonary aspergillosis (ABPA)?

A

(+) aspergillus skin test, increased IgE and/or IgG to Aspergillus, central bronchiectasis

44
Q

What is occupational asthma?

A

Asthma induced by workplace exposure in a patient without preexisting asthma

C3 Didactics (5 decks)

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