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IRM > L10 - Airway diseases > Flashcards

L10 - Airway diseases Flashcards

1
Q

What are some examples of basic lung function tests?

A
  1. Spirometry
  2. FEV1/FVC < 0.7 = airflow obstruction
  3. Restriction = normal or inc FEV1/ FVC tends to impair FVC>FEV1
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2
Q

What is asthma/

A
  • A chronic inflammatory disorder of the airways leading to airflow obstruction
  • Reversible
  • Variable airflow obstruction
  • Diurnal variability > 20% in PEFR
  • Airway hyper-responsiveness
  • Ass with atopy in some cases such as eczema or hay fever
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3
Q

What are some symptoms of asthma?

A
  • Coughing
  • Wheezing
  • Chest tightness
  • Shortness of breath
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4
Q

What happens during an asthma attack?

A

Airway is narrowed, which is caused by:

  • Smooth muscle contraction around the airways
  • Swelling of inner lining (epithelium)
  • Inc in mucus prod
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5
Q

What does it mean to have a good asthma control?

A
  • No daytime symptoms
  • No night time awakenings due to asthma
  • No need for reliever medication (blue inhaler)
  • No exacerbations
  • No limitation of physical activity
  • Normal lung function (FEV1) and/ or PEF_>80% predicted or best
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6
Q

What could be some triggers of asthma?

A
  • Allergens: mould, dust, pollen or food
  • Irritants: secondhand smoke, aerosols, volatile organic compounds, particulates
  • Viral resp infections
  • Changes in weather: cold air, humidity or wind
  • Exercise
  • Endocrine factors: menstruation or pregnancy
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7
Q

What is occupational asthma?

A

Asthma caused by breathing in particular substance/ chemicals whilst at work

  • Isocyanates (used in paint, varnishes, plastics and insulation)
  • Colophony (soldering)
  • Proteolytic enzymes (cleaners)
  • Flour dust (bakers)
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8
Q

How could you determine whether someone has occupational asthma?

A

Tell patient to keep a peak flow diary/ monitor, therefore will be able to identify when peak flow is greatest/ lowest

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9
Q

What should a written asthma management plan include?

A
  1. Identification of asthma triggers + ways to reduce/ avoid exposure to them
  2. Medication - when to use and how to use
  3. Peak flow monitoring
  4. Emergency plan
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10
Q

What are the different inhaled asthma therapies available?

A
  1. Beta-2 agonist
  2. Corticosteroids
  3. Nebuliser if severe (but avoid if can)
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11
Q

What is step 1 in the stepwise approach to asthma medication?

A

SABA such as salbutamol

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12
Q

What is step 2 in the stepwise approach to asthma medication?

A
  • Inhalation steroids 200-800ug/ day

- Start dose 400ug/day

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13
Q

What is step 3 in the stepwise approach to asthma medication?

A 
- Add LABA 
Good response = cont
Poor response = inc steroid dose
No response = stop and inc steroid
- Formoterol/ ICS can be used as sole therapy instead
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14
Q

What is step 4 in the stepwise approach to asthma medication?

A
  • Inc steroid up to 2000ug/day

- Try leukotriene receptor antagonist or theophylline

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15
Q

What is step 5 in the stepwise approach to asthma medication?

A
  • Steroid tablets (not good, try to move down steps if possible)
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16
Q

What are some adverse effects of oral corticosteroids?

A
  • Osteoporosis (thinning of bones)
  • Skin thinning
  • Inc risk of infection
  • Diabetes
  • Weight gain
  • Hypertension
17
Q

What are some adverse effects of oral corticosteroids?

A
  • Osteoporosis (thinning of bones)
  • Skin thinning
  • Inc risk of infection
  • Diabetes
  • Weight gain
  • Hypertension
18
Q

What are some newer interventions to treat asthma which does not include steroids or beta agonists?

A
  • Anti-IgE interventions

- Omaluzimab

19
Q

What is COPD?

A

Airflow obstruction that is not fully reversible

20
Q

What are the airflow limitations caused by COPD?

A
  • Airway inflammation
  • Systemic components
  • Structural changes
  • Bronchospasm
  • Mucociliary dysfunction
21
Q

Describe the differences between COPD and asthma in these clinical features: smoker or ex-smoker

A 
COPD = Nearly all 
Asthma = Possibly
22
Q

Describe the differences between COPD and asthma in these clinical features: symptoms under age 35

A 
COPD = Rare 
Asthma = Often
23
Q

Describe the differences between COPD and asthma in these clinical features: chronic productive cough

A 
COPD = Common 
Asthma = Uncommon
24
Q

Describe the differences between COPD and asthma in these clinical features: breathlessness

A 
COPD = Persistent and progressive 
Asthma = Variable
25
Q

Describe the differences between COPD and asthma in these clinical features: night time waking with breathlessness and or wheeze

A 
COPD = Uncommon
Asthma = Common
26
Q

Describe the differences between COPD and asthma in these clinical features: significant diurnal or day to day variability of symptoms

A 
COPD = Uncommon
Asthma = Common
27
Q

How could you manage COPD?

A
  1. Maximise bronchodilation

2. Add inhaled steroid in selected patients

28
Q

What are other physiological tests that you can do to test for COPD?

A
  • Lung volumes
  • ## Gas transfer
29
Q

What are other physiological tests that you can do to test for COPD?

A
  • Lung volumes
  • ## Gas transfer

IRM (21 decks)

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