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Pulmonary > PAHTOPHYS: Asthma > Flashcards

PAHTOPHYS: Asthma Flashcards

1
Q

What is asthma?

A

chronic inflammatory disorder of the airways, characterized by episodic, reversible bronchospasm resulting from exaggerated bronchoconstrictor response to various stimuli

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2
Q

What group has the highest death rate in asthma?

A

black race is associated with higher risk of asthma death

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3
Q

How is asthma classified at diagnosis?

A

Intermittent

Persistent

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4
Q

How is Intermittent asthma treated?

A

As needed albuterol

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5
Q

What drugs are added on if asthma is persistent?

A 
Inhaled steroids (mild)
LABAs (moderate)
Leukotriene modifiers (severe)
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6
Q

What is the most common type of asthma? Who gets it?

A

Extrinsic asthma (IgE mediated response to environmental allergens) is common in children.

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7
Q

What is intrinsic asthma?

A

Adult-onset asthma triggered by respiratory infection and is NOT allergy mediated (skin antigen test is usually negative)

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8
Q

What types of drugs induce asthma?

A

Aspirin and NSAIDs (inhibit COX which shunts arachadonic acid metabolism toward leukotrienes)

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9
Q

What is first line therapy for drug-induced asthma?

A

Monteleukast

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10
Q

What is occupational asthma?

A

2-10% of adult onset asthma due to repeated exposure and sensitization to fumes, organic and chemical dusts, and gases at the workplace

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11
Q

What is exercise-induced asthma?

A

Asthma symptoms that occur usually immediately after exercise (5-10 minutes after)

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12
Q

What causes exercise-induced asthma?

A

cooling and mucosal drying of airways during exercise is thought to trigger mast cells to release histamine

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13
Q

How do you treat exercise-induced asthma?

A

Pre-treatment with cromolyn or beta-agonist

Slow warm up period

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14
Q

What may be a presentation of asthma that is not necessarily expected?

A

cough (due to irritants)

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15
Q

Why do people get nocturnal asthma?

A

decline in circulating catecholamines and cortisol

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16
Q

What is ABPA?

A

Allergic bronchopulmonary aspergillosis (asthma due to the fungi that leads to an IgE-mediated reaction)

17
Q

What are diagnostic criteria of ABPA?

A

Poorly controlled asthma
Eosinophilia
IgE increased

18
Q

How do you treat ABPA?

A

Prednisone (antifungals do not really help, need to wipe out eosinophils!)

19
Q

What does aspergillosis fumigatus look like?

A

acute angle (looks like As)

20
Q

What is airway hyper-responsiveness?

A

exaggerated bronchoconstrictive response by the airways to a variety of stimuli (that cause airflow obstruction)

21
Q

What is the neural mechanism in asthmatics that is partially responsible for bronchospasm?

A

Elevated parasympathetic tone and reflex bronchosonstriction

22
Q

What interleukin is relevent in asthma inflammation? COPD?

A

IL-5

IL-8 in COPD

23
Q

During exacerbation, what cell type is most numerous in asthmatics? In COPD patients?

A

Asthma= neutrophilic
COPD= eosinophilic
(opposite of inflammation type!)

24
Q

Why might viral tracheobronchitis be confused with asthma?

A

it leads to post-infectious bronchial hyperresponsiveness for up to 6 weeks

25
Q

Death from asthma is usually related to what?

A

diffuse mucous plugging in the airways

26
Q

Why do asthmatics have highest PEFR at 4pm and lowest at 4am?

A

decline of circulating catecholamines nd cortisol

27
Q

What diurnal variation is considered diagnostic for asthma?

A

PEFR > 20% varied

28
Q

True or false: methacholine challenge test has a high positive predictive value.

A

FALSE: it has a high negative predictive value (so it is good for RULING OUT asthma)

29
Q

What asthma treatment should NOT be used?

A

primatene mist (epinephrine)

30
Q

what asthma treatment has increased mortality association adn should be used cautiously?

A

LABAs

Pulmonary (34 decks)

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