Pulmonary - Asthma

Question 1

What is the global intiative definition for asthma?

Answer 1

As a chronic airway inflammation

hx of respiratory sx like wheezes, SOB, chest tightness and cough that vary over time and in intensity
- toegher with variable expiratory airflow limitations

Question 2

What are the sx of asthma?

Answer 2

wheezing
SOB
chest tighness
fatigue during exercise
poor athletic performance
avoiding activity
coughing - worse at night and early morning

Question 3

Since asthma is an inflammatory response, the trigger leads to?

Answer 3

• narrow airways = bronchospasm
• increased secretions
• resistance to airflow and airtrapping on exhalation = hyperinflation

Question 4

The medium-sized bronchi sustain the most what?

Answer 4

most pronounced physiological effects of the inflammation that’s associated with asthma

Question 5

Over time, what does chronic inflammation lead to?

Answer 5

Remodeling of the airways

Question 6

What are the risk factors of asthma?

Answer 6

• genetics
• sex
• environmental factors
• infections
• allergens
• obesity

Environmental - like smoke

allergens - house dust mites, mold

Question 7

How does obesity increase the risk of asthma?

Answer 7

Due to the likely involvement of the inflammatory process in the lungs, adipose tissue and/or immune system

sx appear to be harder to control and responsiveness to standard pharm therapies are reduced

Question 8

How is asthma diagnosed?

Answer 8

with spirometry
- because of the provocation with bronchoconstrictor agents and with bronchodilators for comparison

Question 9

How is asthma diagnosis confirmed?

Answer 9

improvements in the sx with medical management with over time and repeated testing

results are reversible which helps guarantee asthma

Question 10

What is the clinical presentation of asthma?

Answer 10

Decreased FEV1
Increased RV and FRC

Question 11

What are the results of peak-flow meter indicate?

Answer 11

Green 80-100 = normal
Yellow 50-80 = airways are narrowing and treatment is warranted
Red < 50 = medical emergency

Question 12

Asthma Severity

Intermittent

Answer 12

< 2x/wk - exacerbations are rare, nighttime sx

< 2x/month - does not interfere with normal activities

normal spirometry (>80%) when NOT having attack

Question 13

Asthma Severity

Mild persistent

Answer 13

sx > 2x/wk

night time sx 3-4/months

attacks are more severe or interfere with activities

normal spirometry (>80%) when not having attack

Question 14

Asthma Severity

Moderate persistent

Answer 14

Daily sx and use of daily meds

nighttime sx > 1x/wk but not daily

interferes with daily activities

abnormal spirometry > 60% but < 80%

Question 15

Asthma Severity

Severe persistent

Answer 15

Continous sx day and night (night often every night)

activity is severely limited

exacerbations are frequent

abnormal spirometry 60% or less

Question 16

What is the medical management of asthma?

Answer 16

prevention - avoiding triggers and reduce exposure

emphasis on long-term control

pharmacologic therapy

50% of children with asthma will have sx as an adult

Pharm - anti-inflammatory, bronchodilators or combo meds

Question 17

What is the clinical presentation of asthma?

Answer 17

• observe altered breathing pattern
• lung auscultation
• report dyspnea on exertion
• bouts of coughing (especially at night and lingering viral infection)
• accessory muscle use - pursed lip breathing
• postural changes (forward leaning)

Question 18

What are some components of patient hx/interview that needs to be addressed?

Answer 18

• any major sx
• possible flare ups
• improvements
• nighttime sx
• what happens when it gets cold
• how it impacts

Question 19

What are the lifestyle modifications for asthma?

Answer 19

healthy diet
sleep patterns
reduce exposure to irritants
hydration
healthy weight
regular physical activity
annual flu shot

Question 20

What are the educational and preventative strategies for asthma?

Answer 20

• Lifestyle modifications
• minimize exposure to environmental irritants
• household modifications
• exercise-induced asthma

Question 21

What are some household modifications?

Answer 21

Molds
pets
wash bedding regularly
HEPA filters
sanitize regularly with stuffed toys
choose proper cleaning products

Question 22

What are the exercise modifications for people with asthma?

Answer 22

• important to warm up before any intense aerobic activity
• adequate hydration
• masks or scarf covering nose/mouth with outdoor cold weather exposure

Question 23

What are the COPD implications for PT treatment?

Answer 23

• begin once medication regimen is stable
• secretion clearance
• controlled breathing
• exercise and strength training
• thoracic stretching
• postural reeducation
• patient education and home program

Question 24

What is the effects of aerobic exercise on asthma?

Answer 24

Helps with control and lung function but not airway inflammation

Question 25

What is the physiological effects of aerobic exercise?

Answer 25

reduced BHR and serum proinflammatory cytokines and improved QoL and asthma exacerbation in patients with moderate or severe asthma

Question 26

What type of exercise helps with asthma control?

Answer 26

Low volume HITT