Bronchial Asthma Flashcards
Physiologic abnormalities in Bronchial Asthma
Airway hyperresponsiveness
Chronic airway inflammation
Variable expiratory outflow obstruction
Typical symptoms of Asthma
Wheezes
Shortness of breath
Chest tightness
Cough
***symptoms worse at night
Defined as cough with hyperactive airway
Cough variant asthma
Risk Factors for Asthma
Atopy - Major risk factor
Overweight
Family history
Exposure to allergens
Most common allergen trigger
Dust mite:
Dermatophagoides sp.
What is the most accurate test to confirm the diagnosis of asthma?
Pulmonary Function Tests or Spirometry
What is the most accurate test for asymptomatic patients in the diagnosis of asthma?
Methacholine/Histamine stimulation test
**setting of normal PFT
Triggers
Allergens
Exercise
Laughter
Cold air
Obstructive pattern in spirometry for asthma:
FEV1/FVC < 0.75-0.8
Reversibility criteria for variable expiratory airflow limitation:
- Reduced FEV1 that increases by 12% or atleast 200mL from baseline post-bronchodilator
- Reduced FEV1 that increases by 12% or atleast 200mL after 2-4 weeks of steroid trial (30-40mg prednisone or prednisolone)
- Decrease in FEV1 by 20% with Methacholine or Histamine stimulation test
Test for Airway Hyperresponsiveness
Methacholine or Histamine Stimulation Test
Flow-Volume Loop in Asthma shows:
Reduced PEF
Scalloped appearance
Relievers
ICS+Formoterol
SABA
SAMA
Methylxanthine
IV Corticosteroids for acute attacks
Controllers
ICS
LABA with ICS
Leukotriene Antagonist
Mast Cell stabilizers
Anti-IgE
Management for Acute Severe Attack
Treatment:
SABA
SAMA
IV Corticosteroids
O2
Mg SO4
Intubation**
Tests:
PEF
CXR
ABG
