RESP

Question 1

ASTHMA - what?

Answer 1

Episodic chronic inflammatory disorder of the airways

Question 2

ASTHMA - risks?

Answer 2

Hx atopy (allergies)
Low birth weight
Not breastfed
Allergen exposure (house dust mites, pollen, smoke)

Question 3

ASTHMA - sx?

Answer 3

Cough
Dyspnoea (SOB)
Wheeze / Chest tightness
Diurnal variation

Question 4

ASTHMA - ix?

Answer 4

FEV1 = ↓ (forced expiratory vol in 1 sec)
FVC = normal (forced vital capacity)
FEV1/FVC < 0.7
FeNO3 (fractional exhaled nitric oxide - indicates lung inflammation level)
Adults > 40 pbb (parts per billion)
Child > 35 pbb

Question 5

ASTHMA - tx?

Answer 5

Long Term
1. SABA (short acting beta agonist)
2. SABA + ICS (inhaled corticosteroid)
3. SABA + ICS + LTRA (leukotriene receptor antagonist)
4. SABA + ICS + LABA (child = stop LTRA, adult = continue LTRA if needed)

Acute
1. Oxygen
2. Salbutamol nebulisers
3. Ipratropium bromide nebulisers
4. Hydrocortisone IV OR Oral Prednisolone
5. IV Magnesium Sulphate
6. Aminophylline / IV Salbutamol
(BAD if pCO2 is normal = patient is tiring)