Peds Asthma Flashcards
What is the purpose of a spacer with an albuterol inhaler?
Improves deposition in the airways
What is the use of a neb?
For younger kids less than 5 yo
What are the drugs that are used for asthma?
Beta agonist with ipratropium bromide
When are steroids indicated for asthma?
Exacerbations
What is the use of fluticasone?
Long term control of asthma
When is a CXR indicated for asthma exacerbation? What if this is normal?
If not better after 3 albuterol nebs.
Continue if normal
How many times should beta agonists/ipratropium be given prior to changing to something else? What should be done next?
x3, then switch to a continuous administration of beta agonist, and steroids
What happens to the lungs with chronic asthma?
- Flattening of the diaphragm
- Hyperinflation of the lungs
In whom is asthma more common? (3)
- Blacks
- Hispanics
- Inner city
What are the trends of asthma?
Increasing incidence
What indicated poor control of asthma?
- 2 or more hospitalizations in the past year
- more than 3 ED visits in the past year
- More than 2 canisters/month
What are transient wheezers?
Pts who wheeze secondary to a LRTI prior to age 3, but then resolve
Who are nonatopic wheezers? What is the relation between these patients and RSV?
Patients who have increased airway reactivity and continue to wheee after 3 years of age, but may resolve over time
Have an increased incidence of RSV
Who are atopic wheezers? What ab levels are elevated in this group? What are their lung functions like?
Pts with a family h/o asthma and are likely to have asthma
Elevated IgE
More profound lung function deficits
What percent of children’s asthma resolved by adulthood?
60%
What percent of asthmatic children convert to severe asthma in adulthood
30%
What are the ideas behind the hygiene hypothesis?
Absence of exposure increases Th2 responsiveness
How do you diagnose asthma? (3)
- Recurrent episodes of airway hyperresponsiveness and obstruction
- Partially reversible
- Exclude other diagnoses
True or false: coughing may be the only symptom of asthma
True
What is the usual wheezing type with asthma? Is this always present?
Expiratory
Not always present
What are the two major meds that exacerbate asthma?
NSAIDs
Beta blockers
Why does ASA cause asthma exacerbation?
Shunts arachidonic acid to leukotrienes, which increases bronchoconstriction
What happens to the expiratory phase with asthma?
Prolonged
What is pulsus paradoxus?
an abnormally large decrease (10 mmHg) in systolic blood pressure and pulse wave amplitude during inspiration