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Nelson - Allergic Disorders > Childhood Asthma > Flashcards

Childhood Asthma Flashcards

1
Q

A chronic inflammatory condition of the lung airways resulting in episodic airflow obstruction

A

Asthma

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2
Q

Risk factor for persistent asthma in childhood

A

1) Injurious viral infection of the airways that manifest as pneumonia or bronchiolitis 2) Allergen in children

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3
Q

Approximately 80% of all asthmatic patients report disease onset prior to age of

A

6 years

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4
Q

Major risk factors that predict asthma

A

1) Parent asthma 2) Inhalant allergen sensitization

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5
Q

Minor risk factors that predict asthma

A

1) Allergic rhinitis 2) Wheezing apart from colds 3) >/4% neutrophils 4) Food allergen sensitization

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6
Q

2 main types of childhood asthma

A

1) Recurrent wheezing in childhood 2) Chronic asthma associated with allergy 3) In females who are obese and had early onset puberty (11 y/o)

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7
Q

Recurrent wheezing in childhood is primarily triggered by

A

Common viral infections of the respiratory tract

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8
Q

Type of asthma that persists into later childhood and adulthood

A

Chronic asthma

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9
Q

Mc chronic symptoms of asthma

A

1) Dry coughing 2) Expiratory wheezing

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10
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Breathlessness while walking

A

Mild

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11
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Breathlesness at rest

A

Moderate-Severe

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12
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Sits upright

A

Severe

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13
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Prefers sitting

A

Moderate

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14
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Can lie down

A

Mild

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15
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Talks in phrases

A

Moderate

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16
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Talks in sentences

A

Mild

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17
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Talks in words

A

Severe

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18
Q

Mild vs Moderate vs Severe Asthma Exacerbation: May be agitated

A

Mild

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19
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Usually agitated

A

Moderate-Severe

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20
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Drowsy or confused

A

RESPIRATORY ARREST IMMINENT

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21
Q

Mild vs Moderate vs Severe Asthma Exacerbation: RR>30

A

Severe

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22
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Increased RR

A

Mild-Moderate

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23
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Use of accessory muscles/suprasternal retractions usually

A

Severe

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24
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Use of accessory muscles/suprasternal retractions commonly

A

Moderate

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25
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Use of accessory muscles/suprasternal retractions usually not

A

Mild

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26
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Paradoxical thoracoabdominal breathing

A

RESPIRATORY ARREST IMMINENT

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27
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Moderate, often end-expiratory wheeze

A

Mild

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28
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Wheeze loud throughout exhalation

A

Moderate

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29
Q

Mild vs Moderate vs Severe Asthma Exacerbation: ; Loud throught inhalation and exhalation

A

Severe

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30
Q

Mild vs Moderate vs Severe Asthma Exacerbation: No wheeze

A

RESPIRATORY ARREST IMMINENT

31
Q

Mild vs Moderate vs Severe Asthma Exacerbation: PR less than 100

32
Q

Mild vs Moderate vs Severe Asthma Exacerbation: PR 100-120

33
Q

Mild vs Moderate vs Severe Asthma Exacerbation: >120

34
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Bradycardia

A

Respiratory arrest imminent

35
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Pulsus paradoxus absent

A

Mild or respiratory arrest imminent

36
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Pulsus paradoxus may be present

37
Q

Mild vs Moderate vs Severe Asthma Exacerbation: Pulsus paradoxus often present

38
Q

Mild vs Moderate vs Severe Asthma Exacerbation: PEF >/70%

39
Q

Mild vs Moderate vs Severe Asthma Exacerbation: PEF less than 25%

A

Respiratory arrest imminent

40
Q

Mild vs Moderate vs Severe Asthma Exacerbation: PEF ~40-69%

41
Q

Mild vs Moderate vs Severe Asthma Exacerbation: PEF less than 40%

42
Q

Mild vs Moderate vs Severe Asthma Exacerbation: PEF response lasts less than 2 hours

43
Q

Mild vs Moderate vs Severe Asthma Exacerbation: PaO2 >/60mmHg

44
Q

Mild vs Moderate vs Severe Asthma Exacerbation: PaO2 less than 60%

45
Q

Mild vs Moderate vs Severe Asthma Exacerbation: PaO2 normal

46
Q

Mild vs Moderate vs Severe Asthma Exacerbation: PCO2 >/42mmHg

47
Q

Mild vs Moderate vs Severe Asthma Exacerbation: PCO2 less than 42 mmHg

A

Mild or Moderate

48
Q

Mild vs Moderate vs Severe Asthma Exacerbation: SaO2 90-95%

49
Q

Mild vs Moderate vs Severe Asthma Exacerbation: SaO2 >95%

50
Q

Mild vs Moderate vs Severe Asthma Exacerbation: SaO2 less than 90%

51
Q

Objective measure of airflow limitation

A

Spirometry

52
Q

Spirometry is feasible only in children at what age

53
Q

If the FEV1 is within ___%, then the highest of 3 attempts is used

54
Q

An FEV1/FVC ratio of ___ indicates significant airflow obstruction

A

Less than 0.80

55
Q

Bronchodilator response with asthma

A

FEV1 >/12% and >/200mL

56
Q

Components of asthma assessment and monitoring

A

1) Disease activity 2) Control 3) Responsiveness to therapy

57
Q

Refers to the intrinsic intensity of the disease (asthma) which directs the initial level of therapy and assessed only once

A

Severity (Intermittent; mild, moderate, or severe persistent)

58
Q

Degree to which symptoms, ongoing functional impairments, and risk of adverse events are minimized and goals of therapy are met

A

Asthma control (well-controlled, not well-controlled, poorly-controlled)

59
Q

Components of asthma management

A

1) Assessment and monitoring of activity 2) Provision of education to enhance knowledge and skills for self-management 3) Identification and management of precipitating factors and co-morbid conditions 4) Appropriate selection of medications

60
Q

Components of asthma severity

A

1) Daytime symptoms 2) Nighttime awakenings 3) SABA use 4) Interference with normal activity 5) Lung function (FEV1 and FEV1: FVC) 6) Exacerbations requiring systemic steroids

61
Q

Preferred treatment for all patients with persistent asthma

A

Daily ICS therapy

62
Q

If a child has had well-controlled asthma for at least ___ months, guidelines suggest decreasing dose or number of child’s controller meds

63
Q

MC encountered adverse events of ICS

A

LOCAL: 1) Oral candidiasis 2) Dysphonia

64
Q

MOA of Zileuton

A

Leukotriene synthesis inhibitor

65
Q

Zileuton is not approved for children less than or equal to ___ y/o

66
Q

MOA of Omalizumab

A

Monoclonal Ab that binds IgE thereby preventing its binding to the high-affinity IgE receptor and blocking IgE-mediated allergic response

67
Q

Define status asthmaticus

A

A severe exacerbation of asthma that does not improve with standard therapy

68
Q

Best predictor of future life-threatening asthma exacerbations or a fatal asthma episode

A

Severe asthma exacerbation resulting in respi distress, hypoxia, hospitalization, and/or respi failure

69
Q

Home “rescue” medication for asthma

A

Inhaled SABA q20min x 3

70
Q

If the child has incomplete response to rescue medications (SABA q20mins x 3), what to do next

A

Short course oral ICS therapy (Prednisone 1-2 mkday) for 4 days in addition to inhaled beta agonist therapy

71
Q

Discharge criteria for asthma

A

1) Sustained improvement of symptoms 2) Normal PE 3) PEF >70% of predicted or personal best 4) O2sat >92% on RA for 4 hours

72
Q

Predictive of asthma persistence in adulthood

A

Asthma severity by 7-10 years old

73
Q

Prolonged breastfeeding of how many months is found to reduce likelihood of asthma development

A

> 4 months

Nelson - Allergic Disorders (7 decks)

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