Respiratory: Asthma Flashcards
What is asthma?
A chronic inflammatory disorder of the airways resulting in reversible airway obstruction - inflammation, bronchoconstriction and mucus
What is the consequence of repetitive episodes of asthma?
The airway undergoes remodelling, there is damaged epithelium and increased smooth muscle thickness
What are some allergens that can trigger asthma?
Indoor allergens: pets, dust mites, mould
Outdoor allergens: pollens, tobacco smoke, pollutants
Others: Cold air, exercise, medications such as NSAIDs and beta blockers
What are some of the signs and symptoms of asthma?
Recurrent wheeze, breathlessness, chest tightness
Cough - dry, worse at night, exercise induced
Variable airflow obstruction
What is a wheeze?
A high pitched, expiratory musical sound from narrowed airways (compression or obstruction)
How can you assess difficulty in breathing?
In adults - measure RR and look for accessory muscle use
In children - recession of the IC muscles, nasal flaring, tracheal tug (because in children the skin and tissues are more pliable)
What is atopy?
A genetic tendency to develop allergies eg eczema, hayfever, allergies and asthma all grouped together
So look for these in PMH
What is the gold standard of diagnosis of asthma?
Spirometry however due to long waiting lists, it is more practical to give a months trial of bronchodilators and measure peak flows. If they help then continue to treat as asthma
How can you help pts to prevent asthma exacerbations?
Change bedding, pillows etc every few years
Get fresh air
Stop smoking
What is a short acting beta agonist?
Salbutamol inhaler (use with a spacer in children) If used more than 3x a week or there are nocturnal symptoms eg coughing or wheezing more than once a week need a preventer inhaler
What does the brown preventer inhaler do?
Contains a steroid to inhibit inflammatory cells and mediators.
Aims to prevent attacks rather than treat attacks
What is a long acting beta agonist?
Salmeterol inhaler
Has a slower onset of action so not used for acute asthma attacks
How would you treat a severe asthma attack?
- give oxygen
- give salbutamol and atrovent nebulisers back to back
- get IV access in case you need to give IV salbutamol
- be prepared to intubate and admit to ITU
What is the nature of the airflow obstruction in asthma\?
Restrictive
