DSA 1 Asthma & COPD Flashcards
In childhood, which sex has a higher rate of asthma?
boys
In adulthood, which sex has a higher rate of asthma?
women, because men have higher rates of remission
What are prenatal risk factors for the child developing asthma?
- low socioeconomic status
- stress
- Cesarean section
- tobacco use
- prematurity (most significant risk factor)
What are postnatal risk factors for developing asthma?
- endotoxins and allergens in the home
- viral and bacterial infxns (ex: RSV, adenovirus)
- air pollution
- abx use
- acetaminophen exposure
- obesity
What type of airway inflammation is present in asthma?
T2-type inflammation
What kinds of cells are in the inflammatory infiltrate of asthma?
- eosinophils
- mast cells
What happens as a result of defective resolution of the asthma process?
airway remodeling
- increased smooth muscle
- increased mucus cells
- increased mucus production
What is the clinical presentation of asthma?
- cough
- wheezing
- chest tightness
- shortness of breath
(worse at night, w/ exercise, infxns, irritants, laughing)
What is seen on spirometry of asthma?
- FEV1 < 80% predicted
- FEV1/FVC < 75%
-reversibility (12% improvement in FEV1 and absolute volume increase of 200 mL after bronchodilator)
True or False: normal spirometry rules out asthma
False; it just means the airways were fxning normally at time of the test
-if you’re still suspicious of asthma, try doing a methacholine challenge
What is the main goal of asthma?
-reduce acute exacerbations b/c they’re the riskiest complication
What qualifications are needed to diagnose mild persistent asthma over intermittent asthma?
- symptoms >2 days/wk (but not daily)
- awaken at night > 2 days/wk
- use of rescue inhaler w/ SABA > 2 days/wk
- 2+ exacerbations in 6mos
What is the major difference between mild persistent asthma and moderate persistent asthma?
- daily symptoms
- daily use of rescue inhaler w/SABA
What is the major difference between moderate persistent asthma and severe persistent asthma?
- symptoms throughout the day
- use of rescue inhaler w/ SABA multiple times daily
What is a concern for patients and their use of inhalers?
-they need to be using it correctly
What is the major goal of creating an asthma action plan with the patient?
- individualized approach
- provide the best quality of life
- minimize symptoms
- minimize exacerbations
What piece of equipment can asthmatics use to assess their condition?
peak flow meter
-take a deep breath, blow out hard and fast
What test can be given to assess whether the patient’s asthma is well-controlled?
Asthma Control Test (ACT)
- 5 questions
- patient self administers
- score < 19 means asthma may not be controlled
What are complications of asthma?
- poor quality of life
- PNA
- PTX
- exacerbations
- respiratory failure
What measures can be taken to prevent asthma?
- being breastfed
- avoid tobacco smoke exposure
- prevent obesity
- adequate vitamin D
- vaccinations
Risk of death from COPD is higher in which sex?
men
What risk factor has the strongest association with mortality from COPD?
poverty
What are the risk factors for COPD?
- smoking (most common cause)
- Hx of TB
What are the main pathological features of COPD?
- obstructive bronchiolitis
- emphysems
- mucus hypersecretion
