Case 2 Flashcards
What are the red flag symptoms for cough?
Cough Dry? Productive? Shortness of breath Exercise tolerance? At rest? Exertion? Chest pain Oedema Wheeze/chest tightness 🚩Hoarseness 6/52 Haemophysis 🚩 persistent cough in blood
What is diurnal variation in asthma?
Symptoms worse at night
What are the first line investigations for asthma?
FEV1:FVC ratio <70%
PEFR
CXR
FBC
What tests should be considered for asthma diagnosis? What may be available in the future?
Bronchial challenge test
Immunoassay for allergen specific IgE
Prick test
Future: exhaled NO2, sputum eosinophilia
What is the treatment for mild, exercise induced asthma?
Salbutamol PRN (short acting beta agonist)
What is the first line treatment for mild persistent asthma?
Beclomethasone BD (low dose corticosteroid) and Salbutamol PRN
What is the second line treatment for mild persistent asthma?
Leukotriene receptor antagonist Montelukast tablet
Salbutamol PRN
What are the 3 options for treatments for moderate persistent asthma?
Beclomethasone BD and Salmetarol BD and Salbutamol PR
OR
Medium dose Beclomethasone BD and Salbutamol PRN
2nd line
Beclomethasone BD and Montelukast and Salbutamol PRN
How does treatment of severe persistent asthma differ to moderate persistent?
Medium dose of beclomethasone in first line treatment and 2nd line
How is severe persistent and inadequate response asthma treated?
What is to be done if this fails?
High dose Becolmethasone and Salmetarol and Salbutamol and immunodilator
Add oral corticosteroid if above fails
In asthma, what leads to bronchial muscle contraction?
Hypertrophy and hyperplasia of smooth muscle
What is the cause pf mucosal swelling and inflammation in asthma?
Mast cell and basophil degranulation
Increased mucus production is due to…
Mucus plugging and goblet cell metaplasia
What is the cause of wheezing in asthma?
Narrowing and swelling together
The release of which mediators lead to contraction of muscle, increased vascular permeability and bronchial secretions?
Histamine from eosinophils, leukotrienes C4 D4 E4 and prostaglandin D2
