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Respiratory System > Bronchial Asthma > Flashcards

Bronchial Asthma Flashcards

1
Q

What are the types of asthma

A

-extrinsic
-intrinsic

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2
Q

What is the cause of extrinsic asthma

A

-allergy reaction
-hypersensitivity type 1
-igE mediated

(notes; ttt: omalizumab because it acts against igE)

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3
Q

What are the triggers of intrinsic asthma

A

-aspirin
-exercise
-stress

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4
Q

Definition of bronchial asthma

A

-it is a chronic inflammatory lung disease
-with bronchoconstriction and mucus secretion

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5
Q

What is the clinical triads of bronchial asthma

A

-wheezing
-cough
-paroxysmal dyspnea

It may also come with pleuritic chest pain

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6
Q

What are the characteristics of bronchial asthma

A

-obstruction
-inflammation
-hyper-responsiveness

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7
Q

List down the causes of bronchial asthma

A

-atopy
-family history and genetic
-activity: exercise-induced asthma
-drug: aspirin-induced asthma
-lifestyle: stress and obesity

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8
Q

What is the most common cause of bronchial asthma

A

-atopic asthma

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9
Q

During atopic asthma, what other features that may accompany the condition

A

-eczema
-hay fever
-allergic conjunctivitis

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10
Q

What is the purpose of asthma phenotyping

A

-to classify the asthma based on
-its age of onset
-atopic/non atopic

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11
Q

The major criteria of allergic asthma

A

-atopic dermatitis (eczema)
-parental asthma
-aeroallergen

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12
Q

The minor criteria of allergic asthma

A

-peripheral eosinophils > 4%
-wheezing
-food allergens

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13
Q

The causative agent of Allergic Bronchopulmonary Aspargellosis (ABPA)

A

Aspergillus fumigatus

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14
Q

What is the histological features of ABPA

A

-the presence of septae hyphae in the bronchus

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15
Q

What are the clinical features of ABPA

A

-bronchial obstruction due to mucoid impaction
-peripheral eosinophils
-IgE elevation

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16
Q

What are the clinical features of Aspirin-induced asthma

A

-nasal polyps
-elevation of the urinary leukotrienes

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17
Q

What are the general signs of bronchial asthma

A

-tachypnea
-tachycardia
-pulsus paradoxus

(Notes; pulsus paradoxus means increase of the pressure during inspiration)

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18
Q

What will be observed during inspection of bronchial asthma

A

-hyperinflated chest
-skin retraction over the intercostal space
-prolonged expiration
-use of accessory muscle

19
Q

What will be observed during palpation of bronchial asthma

A

-decrease of tvf
-due to air trapping

20
Q

What will be observed during percussion of bronchial asthma

A

-hyperresonant
-due to air trapping

21
Q

What will be observed during auscultation of bronchial asthma

A

-wheezing
-diminished vesicular sound

22
Q

What is different of Asthma and COPD regarding its agent

A

-sensitising agent
-noxious agent

23
Q

What is different of Asthma and COPD regarding its inflammation reaction

A

-CD4 and eosinophils
-CD8, macrophage and neutrophils

24
Q

What is different of Asthma and COPD regarding airway limitation

A

-reversible
-irreversible

25
Q

What are the DD of bronchial asthma that also causes asthmatic syndrome

A

-cardiac asthma
-renal asthma
-fibrosing asthma
-loeffler’s syndrome (parasitic infection)
-polyarteritis nodosa
-carcinoid tumour

26
Q

What are the DD of bronchial asthma that also causes paroxysmal dyspnea

A

-tetany
-mediastinal syndrome
-myasthenia crises
-poisoning
-hysterical

27
Q

What is status asthmaticus

A

-it is a severe and progressive attack of asthma
-that lasts for more than 6 hours
-with failure of therapy

28
Q

What are the general signs of status asthmaticus

A

-tachypnea
-tachycardia
-pulsus paradoxus
-decrease BP
-cyanosis
-increase of CO2

29
Q

Why the blood pressure decreases in status asthmaticus

A

-due to increase of intra-thoracic pressure leads to decrease of venous return

30
Q

What are the complications of the bronchial asthma

A

-status asthmaticus
-COPD
-respiratory failure
-corpulmonale
-pneumothorax

31
Q

What are the severity of bronchial asthma

A

-intermittent
-mild persistent
-moderate persistent
-severe persistent

32
Q

Describe intermittent severity of bronchial asthma regarding;
-days of symptoms
-use of SABA
-night awakening
-FEV1 value
-FEV1 variability

A

-≤2 days/week
-≤2days/week
-<2 times/month
-≥80%
-<20%

33
Q

Describe mild persistent severity of bronchial asthma regarding;
-days of symptoms
-use of SABA
-night awakening
-FEV1 value
-FEV1 variability

A

->2 days/week (not daily)
->2 days/week (not daily)
-3-4 times/month
-≥80%
-<20-30%

34
Q

Describe moderate persistent severity of bronchial asthma regarding;
-days of symptoms
-use of SABA
-night awakening
-FEV1 value
-FEV1 variability

A

-daily
->once/week (not nightly)
->once/week (not nightly)
-60-80%
->30%

35
Q

Describe severe persistent severity of bronchial asthma regarding;
-days of symptoms
-use of SABA
-night awakening
-FEV1 value
-FEV1 variability

A

-daily
-daily
-daily
-≤60%
->30%

36
Q

What are the types of bronchodilators used in the treatment of bronchial asthma

A

-b2 agonist
-anticholinergic (m3 antagonist)
-methylxanthine

37
Q

What are the types of anti-inflammatory used in the treatment of bronchial asthma

A

-corticosteroid
-leukotriene inhibitor (montelukas)
-anti-histamine

38
Q

What is the long term management of bronchial asthma

A

-avoidance of the triggers
-inhaled corticosteroids

39
Q

What is the step 1 treatment plan for bronchial asthma

A

-SABA when needed
-Na chromoglycate 1 hour before exercise

(Notes: Na chromoglycate is a mast cell stabilizer)

40
Q

What is the step 2 treatment plan for bronchial asthma

A

-SABA when needed but not more than 3-4 times
-daily ICS
-LABA only for night symptoms

41
Q

What is the step 3 treatment plan for bronchial asthma

A

-daily SABA
-daily ICS
-LABA or SR aminophylline for night symptoms

42
Q

What is the step 4 treatment plan for bronchial asthma

A

-inhaled SABA when needed
-daily ICS
-LABA or SR theophylline
-oral steroid on alternate days in the morning

43
Q

What is the treatment plan for acute exacerbation of asthma

A

-O2 supply
-inhaled SABA
-anticholinergic

44
Q

What are the criteria of ICU of acute asthmatic exacerbation

A

-PCO2>40
-PEF<25%

Respiratory System (15 decks)

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