Module 3 EB Asthma Flashcards
Essentials of asthma diagnosis (5)
-Episodic or chronic symptoms of wheezing, dyspnea, or cough
-Symptoms frequently worse at night or in the early morning
-Prolonged expiration and diffuse wheezes on physical exam
-Limitation of airflow on PFT or positive bronchoprovocation challenge
-Reversibility of airflow obstruction either spontaneously or following bronchodilator tx
Which sex is asthma more common in for the following age groups:
-children
-adults
-males (<14yrs)
-women
Which ethnicity has highest hospitalization rates related to asthma?
blacks (and children)
Which ethnicity has the highest death rate? (ages?)
blacks (ages 15-24yrs)
Asthma triggers
-Common allergens (4)
-Nonspecific precipitants (8)
-Exposures (3)
-house dust mites, cockroaches, cat dander, seasonal pollens
-exercise, URI, rhinosinusitis, postnasal drip, aspiration, GERD, exposure to cold air, stress
-tobacco, crack cocaine, meth (increases sx and need for meds, decreases lung function)
Asthma triggers
-Air pollution (how it impacts sx)
-Meds
-Occupational asthma (when may asthma sx occur d/t these triggers?)
-precipitates sx, increased ED visits/hospitalizations
-aspirin/NSAIDs/Tartrazine dyes - selected individuals experience sx
-triggered by various agents in the work place; may occur weeks-years after initial exposure
Catamenial asthma
women; occurs at predictable times during menstrual cycle
Exercise-induced bronchoconstriction
-def
-peak of EIB
-when does it resolve by?
-during exercise, or within 3 minutes after it ends
-peaks within 10-15min
-resolves by 60min
Cardiac asthma
-def
wheezing d/t decompensated HF
Cough-variant asthma
-def
cough is present instead of wheezing
Asthma
-def
-characterized by:
-chronic disorder of the airways
-bronchoconstriction, airway inflammation, reversible airflow limitation
common patho findings associated with asthma
-what type of inflammatory cells infiltrate the airway
-eosinophils, neutrophils, and lymphocytes (T-cells)
common patho findings associated with asthma
-what do goblet cells cause?
goblet cell hyperplasia leads to plugging small airways with mucus
common patho findings associated with asthma
-what deposits beneath basement membrane?
collagen
common patho findings associated with asthma
-what occurs to bronchial smooth muscle?
hypertrophy
common patho findings associated with asthma
-what type of edema occurs?
airway edema
common patho findings associated with asthma
-what cells are activated?
mast cell
common patho findings associated with asthma
-what occurs to epithelium?
denudation of airway epithelium
IgE role in asthma
central role in allergic asthma
IL-5 role in asthma
promotes eosinophilic inflammation
Predisposing factors for asthma (5)
-genetic predisposition : family hx or allergies, asthma
-obesity: 2nd leading cause
-Atopy: strongest predictor of asthma (genetic tendency to develop allergic disease such as allergic rhinitis, asthma, and atopic dermatitis - eczema)
-Tobacco exposure (2nd hand smoke in kids)
-RSV or other viruses during infancy
what is the strongest predictor of asthma?
atopy: genetic tendency to develop allergic disease such as allergic rhinitis, asthma, and atopic dermatitis - eczema
how quickly to asthma sx develop after exposure?
-immediate or 4-6hrs after exposure (late asthmatic response)
lifestyle modifications related to asthma (11)
-no smoking around child
-pets
-humidity (keep at <50%)
-Keep windows closed (air conditioner has air filter)
-eliminate carpeting in bedroom
-limit stuffed toys (wash weekly in hot water)
-encase pillows and mattress in dust-mite proof covering (wash bedding weekly)
-control indoor pests (cockroaches)
-avoid outdoor activities when air pollution index is high
-avoid beta blockers & sulfite-containing foods
-get annual influenza vaccine