Chronic SOB Flashcards
Define asthma
Asthma is a chronic inflammatory airway disease characterised by intermittent airway obstruction and hyper-reactivity
Patient history of asthma (7)
Recurrent episodes
Variation (worst in morning & evening)
History of atopy
Family History
Smoker
Occupation
Pets
S/s of asthma (3)
Cough
Wheeze
SOB
What should be heard on auscultation of an asthmatic
Wheeze
Ix for asthma and diagnostic criteria
Spirometry - FEV1: FVC <70%
PEFR - PEFR varies by, or increases by >20%, for >3 days/week over several weeks - diagnosis can be aided by a PEFR diary
What is the Mx of asthma
In order: SABA SABA+ICS SABA+ICA+LTRA LABA+ICS±LTRA LABA+↑ICS±LTRA
Which SABA is used for asthma
Salbutamol
Which ICS are used for asthma (2)
Beclometasone, Budesonide
Which LTRA is used for asthma
Montelukast
Which LABA+ICS is used for asthma
Symbicort (Budesonide/Formoterol)
Which Oral CS is used for asthma
Prednisolone
What type of drug is salbutamol
Short acting beta2 agonist
What type of drug is beclometasone
ICS
What type of drug is budesonide
ICS
What type of drug is montelukast
Leukotriene receptor antagonist
What type of drug is symbicort
Long acting beta agonist budesonide and ICS formorterol
What type of drug is prednisolone
Oral CS
Which drugs are in Symbicort
Budesonide/Formoterol
What are the criteria for acute severe asthma
PEF - 33-50% best or predicted
RR - >25/min
HR - >110min
Inability to complete sentences in one breath
What are the criteria for life threatening asthma
PEF - <33% best or predicted
SpO2 - <92%
PaO2 - <8kPa
Normal - PaCO2
Quick way to distinguish moderate, acute severe, life threatening and near fatal asthma?
PEF 50-75% PEF 33-50% PEF <33% pCO2 Raised
Mx acute asthma
O2
Neb. salbutamol 5mg
Neb ipatropium bromide 0.5mg if acute-severe or life-threatening asthma with poor response to salbutamol
Oral prenisolone 40-50mg or IV hydrocortisone 100 100mg
IV MgSO4 + senior help
IV aminophylline
ITU + intubation
History of someone with COPD (4)
Age
FHx
Smoking status
Occupation
Presenting complaints of COPD (3)
SOB
Productive cough
Some wheeze
What is heard on auscultation of COPD (3)
Reduced air movement
Wheezing
Coarse crackles (hair-like crackles)
What is seen on general inspection of COPD (3)
Tar staining
Cyanosis
Barrel chest
What is felt on palpation of COPD (2)
Reduced expansion
Hyper-resonance (on percussion)
Does COPD cause clubbing
No