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Year 1- Respiratory > Clinical Features of Asthma in Adults > Flashcards

Clinical Features of Asthma in Adults Flashcards

1
Q

Asthma leads to what two things happening in the body?

A

Widespread narrowing of airways
Increased airway reactivity

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2
Q

What can increased airway reactivity lead to?

A

Airways narrowing- either in response to stimuli or occurring spontaneously.

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3
Q

What is atopy?

A

The body’s predisposition to develop an antibody called IgE (immunoglobulin E) in response to exposure to environmental allergens.
It is a inheritable trait.

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4
Q

Give some examples of atopic diseases.

A

Allergic rhinitis, asthma, hay fever and eczema.

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5
Q

What increases the risk of asthma?

A

If a first degree family member has asthma or another atopic disease.

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6
Q

Why does smoking while pregnant increase the child’s chances of having asthma?

A

It decreases the child’s FEV1
Increases the likelihood of wheezy illness
Increases airway responsiveness

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7
Q

Describe epigenetic phenomena in terms of risks of asthma due to smoking in previous generations.

A

Even if your grandmother smoked, it still increases your chances of developing asthma as the environmental trigger of tobacco switches on genes which increase chances of asthma.

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8
Q

What is occupational asthma caused by?

A

Exposure to different allergens and their effects.

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9
Q

Name three jobs were occupational asthma is more likely to occur.

A

Baker
Builder
Shellfish workers

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10
Q

What is the most important clinical part when diagnosing someone w asthma?

A

Their history

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11
Q

What are the main symptoms of those with asthma?

A

Wheeze
Cough
Chest tightness
Breathlessness

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12
Q

What colour can sputum brought up by asthmatic patients be?

A

Green or yellow but important to note that this doesn’t always mean there is a viral or bacterial infection.

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13
Q

Discuss variation of asthma throughout the day.

A

Symptoms may be worse or better at night or early morning

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14
Q

Discuss weekly variation of asthma.

A

May be different at the weekends
May vary depend on occupation
May be better on holidays

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15
Q

Discuss annual variation of asthma.

A

Asthma may be better/worse at certain times of the year.

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16
Q

List some of the different trigger for individuals with cancer (differ in every individual).

A

Exercise
Cold air
Cigarette smoke
Perfumes/strong scents
Pets
Tree/grass pollen
Drugs
Foods

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17
Q

In the diagnosis of asthma in adults, what is one thing you should ask about in past medical history?

A

Childhood asthma/hay fever/ eczema/ wheeze etc.

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18
Q

In the diagnosis of asthma in adults, what is one thing you should ask about in drugs and medication?

A

If they are on any of the following-
-Inhalers
-Beta blockers
-Aspirin

Double check what the effects were of the previous drugs listed.

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19
Q

In the diagnosis of asthma in adults, what is one thing you should ask about in family medical history?

A

If any family members have a history of asthma/related diseases.

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20
Q

In the diagnosis of asthma in adults, what is one thing you should ask about in social history?

A

Smoking
Pets
Occupation, past and present
Psychological aspects- e.g. stress makes asthma worse

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21
Q

Clinical examination is not always helpful in diagnosis of asthma but what should you look out for?

A

Breathlessness on excretion
Wheeze
Hyperinflated chest

22
Q

List some symptoms which may indicate that the patient does not have asthma.

A

Finger clubbing
Stridor (high-pitched, turbulent sound on inhale and exhale)
Asymmetrical expansion, dull percussion note
Crepitations

23
Q

List some other causes of wheezing/breathlessness/cough.

A

Generalised airflow obstruction
-COPD (irreversible AFO)
-Bronchiectasis
-Cystic Fibrosis

Localised airway obstruction (inspiratory stridor= large airways)
-Tumour
-Foreign body

Cardiac

24
Q

Which evidence may you be looking for in investigations if you’re not sure if a patient has asthma or not?

A

Airflow obstruction
Variability and/ or reversibility of airflow obstruction

25
Q

What is the main test used to help come up with a diagnosis of asthma?

A

Spirometry

26
Q

Which tests may you perform if there is a obstructed spirometry i.e. FEV1/FVC<70%,
FEV1<80% predicted

A

Full pulmonary function tests
Reversibility tests

27
Q

What happens in full pulmonary function testing?

A

Gas transfer test which measures the gas transfer of carbon monoxide to haemoglobin.

28
Q

Which two respiratory conditions can full pulmonary function testing be useful to differentiate?

A

Asthma and COPD

29
Q

What happens in reversibility to bronchodilator?

A

Check the FEV1 before and after for 15 minutes after either inhaled or nebulized dose of salbutamol to look for improvement
Significant improvement is consistent with asthma

30
Q

When investigating the variability of airway obstruction, how often are patients asked to measure their peak flow?

A

Twice daily for two weeks

31
Q

Name three chemicals a patient might be asked to breathe in as part of an airways responsiveness test.

A

Methacholine
Histamine
Mannitol

32
Q

What would be looked out for when doing chest xrays when concerned about asthma?

A

Hyperinflated, hyperlucent lung fields.

33
Q

What other causes of symptoms of a chest x-ray when concerned about asthma would need to be excluded?

A

No effusion, collapse, opacities, interstitial changes

34
Q

What does skin pricking tell us about those who are suspected to have asthma?

A

Their atopic status.

35
Q

What total and specific IgE tell us about those who are suspected to have asthma?

A

Their atopic status

36
Q

What are the four rankings of asthma attack.

A

Moderate
Severe
Life threatening
Near fatal

37
Q

In those with moderate asthma, what is their speaking ability like?

A

Able to speak in complete sentences

38
Q

In those with moderate asthma, what is their HR like?

A

<110

39
Q

In those with moderate asthma, what is their RR like?

A

<25 b/m

40
Q

In those with moderate asthma, what is their PEF like?

A

50-75% predicted or best

41
Q

In those with moderate asthma, what is their oxygen saturation?

A

92% or more

42
Q

In those with moderate asthma, what is their arterial pressure of oxygen be?

A

> 8kPa

43
Q

In those with severe asthma, what is their speaking ability like?

A

Unable to complete a sentence in one breath

44
Q

In those with severe asthma, what is their HR?

A

> 110

45
Q

In those with severe asthma, what is their RR?

A

> 25

46
Q

In those with severe asthma, what is their PEF?

A

33-50% predicted or best

47
Q

In those with severe asthma, what is their oxygen saturation?

A

92% or more

48
Q

In those with severe asthma, what is their arterial partial pressure of oxygen?

A

> 8kPa

49
Q

Name some of the symptoms that if a patient has at least one, it is classified as life threatening asthma.

A

Grunting
Impaired consciousness, confusion, exhaustion
Bradycardia/ arrhythmia/ hypotension
PEF < 33% predicted or best
Cyanosis
Silent chest
Poor respiratory effort
SaO2 < 92% (definitely needs blood gas!)
PaO2 < 8kPa
PaCO2 normal (4.6 - 6.0kPa)

50
Q

Name two symptoms in which the asthma is classified as near fatal.

A

Raised PaCO2
Need for mechanical ventilation

Year 1- Respiratory (36 decks)

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