Case of the Week Flashcards
Define asthma.
Chronic inflammatory disorder - airway hyper-responsiveness characterised by recovery, spontaneous or with treatment.
What is the pathophysiology of asthma?
- Bronchial hyperactivity → bronchospasm
- Bronchial inflammation (eosinophilic)
What are the symptoms of asthma?
Wheeze, SOB, Cough, Chest tightness
What would the peak flow show for asthma?
Obstructive: FEV1/FVC <70%
FEV1 ≥ 12% post-bronchodilator
When is the peak flow highest for an asthmatic? And what is this variation called?
The peak flow is highest in the morning.
A hallmark of asthma is diurnal variation.
What are the signs seen in a severe asthma attack?
Tachypnoea
Hyper-expanded chest
Severe dyspnoea
Wheeze
What is the allergy test used for asthma?
Skin prick testing
Specific IgE in serum
Define Extrinsic asthma
IgE mediated
Atopic - hypersensitivity reaction occuring part of body not in contact with allergen
Occupational asthma
Define intrinsic asthma.
Non-immune mediated
Infection, cold, exercise, stress, irritants (ozone)
What type of hyper-sensitivity is asthma a part of? Name a few other conditions with the same hyper-sensitivity mechanism.
Type 1 Hypersensitivity - Immediate hypersensitivity to an allergen (IgE mediated)
Atopic dermatitis (eczema), Seasonal allergies, Allergic rhinitis, Anaphylaxis, Urticaria (hives)
How is asthma classified?
Intermittent ≥80% predicted PEF/FEV1
Mild Persistent ≥80% predicted with 20-30% variability
Moderate Persistent >60 to -80% predicted
Severe Persistent <60% predicted with >30% variability
Name three short acting β agonists.
All lead to smooth muscle relaxation:
Salbutamol - promotes cilia motility and stabilises mast cells
Ventolin
Terbutaline
Other than β agonists, name two other bronchodilators.
Aminophylline
Magnesium - for acute severe asthma
Name an ICS (inhaled corticosteroid) for asthma treatment.
And name another anti-inflammatory group used for asthma treatment.
Prednisolone
Leukotriene antagonists
