Lecture 11 - Asthma Flashcards
Is asthma worse typically during the day or at night? If patients wake up with cough or wheezing, what does it suggest?
Typically worse at night.
If patients wake up with cough or wheezing, it likely indicates decreased control of the asthma.
The pathophysiology of Asthma includes ____ ____ hypertrophy. Asthma is also associated with _____ dermatitis.
Smooth muscle hypertrophy
Atopic dermatits
People with asthma may show differences in their ____ flow between the morning and night.
Peak flow
What is a bronchoprovocation study?
It involves giving the patient a progressively higher dose of a Cholinergic agonist to elicit bronchoconstriction from the patient. This test has a high NEGATIVE predictive value.
It’s important to note that Asthmatic responses can have an ____ response and _____ response (typically ___ hours after exposure to allergen.)
Acute response
Late response
4 hours
All patients whose asthma is not controlled should be on _____ ______ (-one and -nide or -lide suffixes).
Inhaled Corticosteroids (ICS)
Mild asthma (symptoms > 1 time per week) should be treated with ____ dose ICS.
Moderate (daily symptoms) should be treated with Low-moderate dose ICS + _____.
Severe asthma (continuous symptoms) should be treated with ___ dose ICS + _____.
Keep in mind Leukotriene Modifiers (LTMs –> look for -kast suffix)) can be used in place of _____. Also note that Anti-____ can be used in the treatment for Severe asthma.
Mild –> Low dose ICS
Moderate –> Low-moderate dose ICS + LABA
Severe –> High dose ICS + LABA
LTM can be used in place of LABA
Anti-IgE
LABA should never be given without _____.
ICS
If _______ are high in an asthma patient, they may be a good candidate for Mepolizumab, which blocks ___-5.
Eosinophils
IL-5
Systemic steroid use is indicated for _____ (acute or chronic?) exacerbation, and they are slow-acting.
Acute
Bronchial _______, which applies heat to the smooth muscle of the airway so it doesn’t contract as tightly, can be used for Refractory Asthma (unresponsive to all other treatments.)
Bronchial Thermoplasty
Rule of 2’s for asthma –> patients require ____ for control.
Two doses of beta agonists per ____.
Two nocturnal awakenings per ____.
Two unscheduled (emergent) visits per _____.
Two prednisone burst per ____.
ICS
Week
Month
Year
Year
