Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 Respiratory > Chronic asthma > Flashcards

Chronic asthma Flashcards

1
Q

Asthma

A

Episodic, reversible airway obstruction due to

bronchial hyper-reactivity to a variety of stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pathophysiology

A

Pathophysiology
Acute:
1. Mast cell-Ag interaction causing histamine release
2. Bronchoconstriction, mucus plugs, mucosal swelling

Chronic (12h)
- TH2 cells release IL-3,4,5 causing mast cell, eosinophil and
B cell recruitment
- Airway remodelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Precipitating factors

A 
Stress + emotion
Cold air 
Exercise 
Pollution 
Smoking 
Pollen 
Dust mites
Animals
Fungus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Atopy

A

Type 1 hypersensitivity reaction to variety of antigens

  • asthma
  • eczema
  • hayfever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Symptoms

A 
Cough - worse in morning and night 
Dry cough 
Wake up coughing 
Wheeze
Dyspnoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Signs

A

Tachypnoea, tachycardia

Widespread polyphonic wheeze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Investigations for asthma

A 
Respiratory exam 
Basic obs 
Bloods - FBC, eosinophils, IgE, 
Peak flow 
Spirometry 
CXR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Spirometry pattern

A

Obstructive:
- scalloping

FEV1/FVC < 0.7
Improves with bronchodilator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

General mx (TAME)

A 
Technique for inhaler use
Avoidance: allergens
Monitor: Peak flow diary (2-4x/d)
Educate:
- Liaise with specialist nurse
- Compliance
- Emergency action plan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Stepwise drug treatment

A

1 SABA PRN + low dose ICS

  1. Low dose ICS+ LABA (Fostair) + SABA

OR

  1. low dose ICS + LTRA + SABA prn
  2. Medium dose ICS/LABA + SABA
  3. High dose ICS/LABA + SABA
  4. Add on tiotropium
  5. Oral steroids: prednisolone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When to step up medication

A

If use >1/d or nocturnal symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

LTRA

A

Montelukast - mast cell stabiliser

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

SABA
LABA
SAMA
LAMA

A

SABA - salbutamol
LABA - salmeterol
SAMA - ipratropium bromide
LAMA - tiotropium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Adenosine receptor antagonist

A

Theophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Acute severe asthma

A

1 of:

  • PEFR - 33 - 50 %
  • RR >25
  • HR >110
  • Can’t complete sentence in one breath
  • SpO2 > 92%
  • Use of accessory muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Life threatening asthma

A

1 of:

  • PEFR <33%
  • SpO2 <92%, PaO2 <8kPa
  • Cyanosis
  • Hypotension
  • Exhaustion, confusion
  • Silent chest
17
Q

Admission criteria

A

Life-threatening attack
Feature of severe attack persisting despite initial tx

May discharge:

  • if PEFR > 75% 1h after initial Rx
  • stable on discharge meds for 24h
18
Q

Discharge plan

A

TAME pt.

PO steroids for 5d

GP appointment w/i 2 wk

Resp clinic appointment w/i 1mo

19
Q

Mx of severe asthma attack

A
  1. Sit up
  2. Oxygen 15L via non rebreathe mast - 94- 98%
  3. Salbutamol neb 5mg
  4. SAMA - ipratropium - - do not repeat within 4 hours
  5. Prednisolone PO - 40 - 50mg or Hydrocortisone IV if NBM -100mg

Life threatening:

  • ITU - if ventilation needed
  • Magnesium sulphate
  • Consider aminophylline
20
Q

Moderate asthma

A 
Normal speech 
No features of acute severe or life threatening asthma
PEFR 50 - 75%
RR < 25 
HR < 110
21
Q

Asthma follow up after discharge

A 
Within 2 days 
Continue prednisolone until recovery 
Review symptoms and check PEFR 
Check inhaler technique 
Modify treatment plan
22
Q

Asthma control

A 
No daytime symptoms 
No night awakening 
No need for rescue meds 
No exacerbations 
No limitation on activity 
Normal lung function
23
Q

When to do FeNO test

A

FeNO test for all new adult diagnoses of asthma, and for use in young patients where there is diagnostic uncertainty or negative spirometry/bronchodilator reversibility.

24
Q

When is a CXR done

A

If life threatening asthma
Suspected pneumothorax
Failure to respond to treatment

25
Q

Criteria for discharge

A

Stable on discharge medication for 12 - 24 hrs
Inhaler technique has been checked
PEFR > 75% of best or predicted

26
Q

Risk factors

A 
FHx 
Atopy 
Low birth weight 
Maternal smoking 
Pollution
27
Q

Advice when taking ICS

A

Salty gargle after as can cause oral candidiasis

Taken everyday regardless of symptoms

Year 3 Respiratory (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions