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Respiratory > Peds Asthma > Flashcards

Peds Asthma Flashcards

1
Q

What is the purpose of a spacer with an albuterol inhaler?

A

Improves deposition in the airways

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2
Q

What is the use of a neb?

A

For younger kids less than 5 yo

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3
Q

What are the drugs that are used for asthma?

A

Beta agonist with ipratropium bromide

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4
Q

When are steroids indicated for asthma?

A

Exacerbations

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5
Q

What is the use of fluticasone?

A

Long term control of asthma

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6
Q

When is a CXR indicated for asthma exacerbation? What if this is normal?

A

If not better after 3 albuterol nebs.

Continue if normal

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7
Q

How many times should beta agonists/ipratropium be given prior to changing to something else? What should be done next?

A

x3, then switch to a continuous administration of beta agonist, and steroids

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8
Q

What happens to the lungs with chronic asthma?

A
  • Flattening of the diaphragm

- Hyperinflation of the lungs

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9
Q

In whom is asthma more common? (3)

A
  • Blacks
  • Hispanics
  • Inner city
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10
Q

What are the trends of asthma?

A

Increasing incidence

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11
Q

What indicated poor control of asthma?

A
  • 2 or more hospitalizations in the past year
  • more than 3 ED visits in the past year
  • More than 2 canisters/month
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12
Q

What are transient wheezers?

A

Pts who wheeze secondary to a LRTI prior to age 3, but then resolve

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13
Q

Who are nonatopic wheezers? What is the relation between these patients and RSV?

A

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

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14
Q

Who are atopic wheezers? What ab levels are elevated in this group? What are their lung functions like?

A

Pts with a family h/o asthma and are likely to have asthma

Elevated IgE
More profound lung function deficits

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15
Q

What percent of children’s asthma resolved by adulthood?

A

60%

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16
Q

What percent of asthmatic children convert to severe asthma in adulthood

A

30%

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17
Q

What are the ideas behind the hygiene hypothesis?

A

Absence of exposure increases Th2 responsiveness

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18
Q

How do you diagnose asthma? (3)

A
  • Recurrent episodes of airway hyperresponsiveness and obstruction
  • Partially reversible
  • Exclude other diagnoses
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19
Q

True or false: coughing may be the only symptom of asthma

A

True

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20
Q

What is the usual wheezing type with asthma? Is this always present?

A

Expiratory

Not always present

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21
Q

What are the two major meds that exacerbate asthma?

A

NSAIDs

Beta blockers

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22
Q

Why does ASA cause asthma exacerbation?

A

Shunts arachidonic acid to leukotrienes, which increases bronchoconstriction

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23
Q

What happens to the expiratory phase with asthma?

A

Prolonged

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24
Q

What is pulsus paradoxus?

A

an abnormally large decrease (10 mmHg) in systolic blood pressure and pulse wave amplitude during inspiration

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25
Q

What causes the palpable liver and spleen with asthma?

A

Hyperinflation of the lungs

26
Q

What is the obstructive pattern of spirometry (values)?

A

FEV1 less than 0.8

FEV1/FVC less than 65%

27
Q

How helpful are labs with asthma? What will these show?

A

Not at all.

Elevated IgE
Eosinophilia

28
Q

What are the CXR findings with asthma? (4)

A
  • hyperinflation
  • Peribronchial thickening
  • atelectasis
  • pneumothorax
29
Q

What are the defining characteristics of a psychogenic cough?

A
  • Will completely disappear at night

- Increased with attention to cough

30
Q

What age group is most commonly affected with vocal cord dysfunction?

A

Adolescents

31
Q

What is vocal cord dysfunction?

A

Paradoxical movement of the vocal cords during inspiration

32
Q

What are the PFT findings of vocal cord dysfunction?

A

Flat inspiratory loop on PFTs, with no response to asthma meds

33
Q

What are the four types of asthma?

A
  • intermittent
  • mild persistent
  • moderate
  • severe persistent
34
Q

At what point do you put kids on inhaled steroids?

A

More than mild persistent asthma

35
Q

How do you categorize asthma severity? (4)

A
  • Frequency/ssx
  • Frequency of beta 2 agonist use
  • Degree of interference with activity
  • PFTs
36
Q

What are the characteristics of intermittent asthma, and is appropriate for PRN beta 2 agonist use? (days/week and nighttime ssx)

A
  • Less than 2 days per week

- No nighttime ssx

37
Q

What are the characteristics of mild persistent asthma?

A
  • 3-6 days/week
  • 1-2 night time
  • minor limitation
38
Q

What is the treatment for mild persistent asthma?

A

low dose ICS

39
Q

What are the FEV1 and FEV1/FVC for intermittent asthma kids? MIld persistent

A

LFEV1 greater than 80 for both

FEV1/FVC greater than 85 for intermittent, greater than 80 for mild persistent

40
Q

What are the prophylactic treatment for asthma? (3)

A
  • Flu vaccine
  • smoking cessation
  • Treat comorbidities
41
Q

True or false: all patients with persistent symptoms should be started on long term controller medications

42
Q

Do antileukotrienes take the place of ICS?

43
Q

How long does it take for ICS to take full effect?

44
Q

Why do you need to rinse and spit after ICS use?

A

May develop thrush

45
Q

What is the use of leukotriene modifiers?

A

Alternative treatment for mild, persistent asthma

46
Q

Do LABAs work acutely?

47
Q

What is the severe side effect of LABAs?

A

Sudden cardiac death

48
Q

What are the side effects of SABAs?

A
  • Tachycardia
  • Tremor
  • Irritability
  • Hypokalemia
49
Q

When are anticholinergics used for asthma?

A

Used in the ED only

50
Q

Are SABAs okay to be used scheduled daily?

51
Q

What are the indications for systemic corticosteroids?

A

Moderate to severe asthma exacerbation

52
Q

True or false: IV and PO corticosteroids are equally efficacious in treating asthma

53
Q

How do you monitor asthma?

54
Q

Wheezing before 3 years of age is associated with what?

55
Q

Children with (__) or more episodes of wheezing/year are more likely to develop asthma?

A

More than 4

56
Q

Major or minor risk factor for asthma: Parental h/o asthma

57
Q

Major or minor risk factor for asthma: h/o atopic dermatitis

58
Q

Major or minor risk factor for asthma: sensitization to foods

59
Q

Major or minor risk factor for asthma: greater than 4 % eosinophils

60
Q

Major or minor risk factor for asthma: Wheezing not associated with URIs

61
Q

Major or minor risk factor for asthma: sensitization to aeroallergens

Respiratory (34 decks)

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