Clinical features of Astma in childhood and treatment Flashcards
what part of the airway responds to stimuli in astma
bronchi and tranchea
what are the general symptons of astma
wheezing, coughing, shortness of breath, chest tightening
When are asthma symptoms worse
start or end of the day
what percent of children and adults have astma
children 10-15
adults 5-10
what is the most common gender to have asthma in children and adults
children - male
adults - female
what is the total cost of astma in the UK
around 2.5 billion annualy ( this includes lost productivity and benefits)(
what happens to the airway during an asthma attach
the smooth musles tirghnes, there is air trapped in the aveoli
atropy
the bodys predistription to develop allerigic diseases such as asthma , alleric rhinitis and atopic dermitis
it is the predistion to produce ige in response to a change in the external environment
what heridetry factor increases risk of astma
if aperivous family member has had astma or a atopic disease
what facgorsdoes maternal smoking in pregnacy have
fev1, wheezing illness, airway responsivness, asthma
epigenetic
study of how disease and enviroment can cause changes to how you genes work
can you grandmother smoking effect you
yes, it can turn on certain genes which can be passed to the mother
what occupations can make you more likley to have asthma, which substances do theyinvolvle
crab/proawns, amalzye/ subtilisin, antibions/ salbutamol, grains, rat urine protines, welding solder flux, twin pack paint
what are personal risk factor for astma
obesity, vitamen e, c and d defincies, hygenie hypothiesins
what sort of variations do you see in asthma
daily
weekly
annualy
daily, nocturnal/ early morning
weekly - better at weekends and holiday
manually - envirometna allergens
what can trigger an astma attachk
exercise, cold air , cigarette smoke, perfumes, utis, pets, tree and grass pollen , food , drugs
what is pmh for astma
chilhood astma, borochis or wehhes, eczema or hayfever
perinatal medical history
what is inclued in drug history
current inhalerous, complinace
b blockers, aspirin, ns aids
effect of prevous drus/ inhaliors
what is included in family history
asthma ns other atopic diseases
what is inclueded in social history
tobacco, recriota drus, vaping
pets
occupation
psycological astma
what are signs that someone may not have astma
finger clubing, cervial lymphadenopathy
stridor
asymmetical epanisino, dull percussion note - collapsed lung
crepiations - brochiates
what can cause generalised airflow obstuction
copd -
bronchioaties,
cycstic fibrosis
what can causes strider
tumour
foreing bodys
main way to test for astma
spirometry with it less than being 40% fev/fvc
how do co levels differ for people with asthma and copd
higher in people with copd due to them less able to bind it to there blood cells due to destruced alveoi
how to teste response to broncidliation
test baseline 15 before salubamol and 15 after salbulatom, see 12% increase in baseline at least
how to test response to steriods
do it after two weeks
do baseline before starting
this sepaerts copid
use corticosteroids
what pattern are you looking for in airflow overtime with peak flow
sawtooth pattern due to dips in moring and evenings
what differene is sinee in exhaled nitic oxicd for astmatic
significatly hgiher
how do histamine and methachoine testo for atmat
they can reduce fev/fvc and thus indicate astma as induce astma attack
what blood test can be done to dected astma
total and specifc ige
full blod cout including eosionphilia
what may be seen in a chest xray
hyperinflation, hyperlucent
what are teh main symotes of moderate astma attach
able to spea full senacts
heart rate less tah 110
rr less than 25
higher fev/fvc of around 50-75%
sa02 greater than 92%
pa02 greater than 8kpa (60mmhg
main symptones of moderate astma attack
Able to speak, complete sentences
HR < 110
RR < 25
PEF 50 - 75% predicted or best
SaO2 ≥ 92% (no need for ABG)
PaO2 ≥ 8kPa
main symptons of severe astma
Inability to complete sentences in one breath
HR ≥110
RR ≥25
PEF 33 - 50% predicted or best
SaO2 ≥ 92%
PaO2 ≥ 8kPa
main symptons of life threathing astma
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)
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main symptons of near fatal astma
Raised PaCO2
Need for mechanical ventilation
what are the aims of treatment for astma
no daytime symptons, no nighttime symptoms, no astma attacks, no limitatins on activity and exercise and a normal lung function
mimical side effects of medication
best ways to control astma theraputily
exercise, weight managment, stoping smoking
astma action plan
a document which all people with astma should carry, describes normal peak flow, which is there preventer oand deliver inhalier, who to call in an emergency and emercenty steps
What is a pmdi
a metered inhalier - normal inhaleir - gives certin dose
what is the puprose of a space
it diffuses the medcaiton into a tube for those who can have medication normally due to not being able to coordinate breath sounds
what are dpi
dry powerderd inhaliors - need a certian level of inspiration for these to work
what form of inhalior can salbutamol work in and what is its function
mdi and dpi, function as a reliver
what form can terbutaline work in and what is its purpose
a dpi, reliver
what are oral ways to reduce astma
leukotriene receptor antagoinsit
theophylline
prednisolone
what are specialist options to reduce astma
omalizumab (anti ige)
mepolizumab (anti interleukin 5)
bronchial thermoplasty
what are some hospialt resatmens for severe astma attach
iv steriods, iv magnesium, iv amiophylline
what are some of the effects of iv magnesium
feeling of incontentice,
what is a severe conditoin which you risk developing if you have asthma attack
pneumothorax
what type of steriods are used daily for asthma as preventos
corticol
what is the order of treatment for astma
cortical steriods, then laba, thne increase ibs, or add ltra or stop laba if non functional then refer for specialised
