Hello Flashcards by Survey Stiles

What is the origin of the word ‘asthma’?

Greek origin meaning ‘panting’

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How does the 2024 GINA Global Strategy define asthma?

A heterogeneous disease characterized by chronic airway inflammation, respiratory symptoms, and variable expiratory airflow limitation

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What are the key features of asthma?

Chronic airway inflammation
Bronchial hyperresponsiveness
Airflow obstruction

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What is an asthma phenotype?

Recognizable clusters of demographic, clinical and/or pathophysiological characteristics

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What is the most easily recognized asthma phenotype?

Allergic asthma

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What age group is primarily affected by asthma?

Pediatric population, with most diagnosed by 5 years of age

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List some precipitating factors of acute asthma exacerbation.

Allergens
Family history
Occupational exposure
Viral respiratory infections
Exercise
Emotions
Exposure to irritants
Environmental changes
Drugs
Chronic rhinosinusitis
GERD
Obesity

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What are the main processes involved in the pathogenesis of asthma?

Inflammation and oedema
Airflow obstruction
Airway hyperresponsiveness
Airway remodeling

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What symptoms are commonly associated with asthma?

Wheezing
Shortness of breath
Chest tightness
Cough

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What are the two key characteristic features of asthma diagnosis according to GINA 2023?

History of respiratory symptoms
Variable expiratory airflow limitation

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What tests are used to diagnose asthma?

Lung function tests (Spirometry)
Peak expiratory flow rate (PEF)
Bronchoprovocation tests
Chest x-ray

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What does spirometry measure?

Maximal volume of air forcibly exhaled from the point of maximal inhalation (FVC) and the volume of air exhaled during the first second (FEV1)

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What are the classifications of asthma severity for patients ≥12 years old?

Intermittent
Mild persistent
Moderate persistent
Severe persistent

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What is the definition of bronchodilator reversibility in asthma?

Improvement in FEV1 of 12% or more, and an increase in volume of 200 ml or more

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What are the goals of asthma management?

Control of symptoms
Maintain normal activity levels
Minimize future risk of exacerbations

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List some non-pharmacologic treatments for asthma.

Allergen reduction/avoidance
Smoking cessation
Mold control
Indoor air quality improvement

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What are the two classes of asthma medications?

Controllers (long-term control medications)
Relievers (quick-relief medications)

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What are inhaled glucocorticoids used for in asthma treatment?

To block late-phase reaction to allergens, reduce bronchial hyperresponsiveness, and improve lung function

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True or False: Long-acting inhaled β2-agonists (LABAs) can be used as monotherapy for long-term control of asthma.

False

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What is the action of leukotriene modifiers in asthma management?

Block binding of leukotrienes to their receptor sites

What is the role of cromolyn sodium and nedocromil in asthma treatment?

Stabilize mast cells and prevent release of mediators

What is Omalizumab used for?

Adjunctive therapy for patients ≥12 years with allergies and severe persistent asthma

What are some examples of quick-relief medications for asthma?

Inhaled long-acting muscarinic antagonists (LAMAs)
Short-acting β2-agonists (SABAs)
Systemic corticosteroids

Fill in the blank: The volume of air expelling from the lungs in one quick exhalation is measured by _______.

Peak expiratory flow (PEF)

What is the typical range for normal peak flow in adults?

400 to 700 L/m

What should be monitored when using the 5-lipoxygenase inhibitor in asthma treatment?

Liver function

What is the significance of a positive methacholine bronchoprovocation test?

Diagnostic for the presence of airway hyperresponsiveness

What are short-acting β2-agonists (SABAs)?

Medications that relax bronchial smooth muscle, e.g., salbutamol, albuterol, levalbuterol, and pirbuterol.

What is the role of systemic corticosteroids in asthma treatment?

Used for moderate and severe exacerbations as adjunct to SABAs to enhance recovery and prevent recurrence.

When should ICS-containing medication be initiated according to the 2023 GINA and 2020 NAEPP guidelines?

As soon as a diagnosis of asthma is made, and in all patients with persistent asthma.

Why is ICS therapy preferred over theophylline or LTRAs?

More effective and the only treatment documented to reduce the risk of dying from asthma.

What should be done if a patient is not well-controlled after 2 to 6 weeks of therapy?

Evaluate and escalate treatment as needed.

What is the recommendation for patients with asthma regarding reliever inhalers?

All patients should have a reliever inhaler, either ICS-formoterol, ICS-SABA, or SABA.

True or False: SABA-only treatment is recommended for adults and adolescents with asthma.

False.

What risks are associated with SABA-only treatment?

Increased risk of exacerbations, lower lung function, and asthma-related death.

What is the definition of persistent asthma?

Need for β2 agonist three times/week or more, or 2 or more canisters a month, or 10-12 puffs/day.

What are the preferred long-term control medications for asthma?

ICS are the most potent and consistently effective long-term control medications.

What is the stepped approach in asthma management?

A method to manage persistent asthma according to severity and control needs.

What is the goal in the treatment of acute severe asthma?

Prevent death, relapse, and future severe airflow obstruction.

What should be included in the initial assessment of acute severe asthma?

History, physical examination, and objective assessments.

What are the zones in the written asthma action plan?

Green (doing well), Yellow (getting worse), Red (medical alert).

What is the recommended action for patients in the yellow zone?

Increase as-needed bronchodilator use and possibly begin prednisone if not improved.

What treatments are included in emergency treatment of acute exacerbations?

SABA, systemic corticosteroids, inhaled ipratropium, intravenous magnesium sulfate, and O2.

What indicators suggest a need for hospitalization during an asthma exacerbation?

Degree of respiratory distress, oxygen requirement, and frequency of inhaled β2-agonists.

What is the importance of patient education in asthma management?

Instructing on pathogenesis, medication use, recognizing triggers, and monitoring symptoms.

What does PEF stand for?

Peak Expiratory Flow.

Fill in the blank: Effective monitoring of asthma management is possible following _______.

[patient education].

What should be monitored in patients using β2-agonists?

Electrolytes for hypokalaemia and side effects.

What are common side effects of corticosteroids?

Hyperglycemia and hypertension.