Respiratory Check Flashcards
Important features of history for asthma
Daytime symptoms Night time symptoms Triggers Frequency Cough history Smoking history Atopy history Family history Hospital admissions
Ddx of sob in young male
Poor cardiovascular fitness Asthma Bronciectasis Copd Pulmonary embolism Inhaled foreign body Pleural effusion Pulmonary fibrosis Rhinitis Cardivascular disease
Symptoms likely to explain asthma
Wheeze Sob Chest tightness Cough Seasonal symptoms Worse at night Histroy of allergies Triggers by exercise cold air, irritants, Family histroy of asthma Childhood symptoms
Symptoms less like of asthma
Dizziness light headed Isolated cough nonother symtpsm Chronic sputum Change in voice Heavy smoker
Define asthma
Respiratory symtoms- wheeze, sob, tightness cough
Variation over time
Excessive variation in expiratory airflow on spirometry
Spiromtry finding for asthma
Obstructive airways; Fev1% 《 80%
Mild 60-80
Moderate 40-60
Severe <40
FEv1 lowet than predicted value for age and height, sex and ethnicity
Airway variability
>200ml
>12 %
Interpret findings
FEV 1 68% pre
FEv 1 81% post
Reverisble by more than 12%
Increase by >200ml
Initial management of asthma
Initial management of asthma 1. Reliever 2. Preventer 3. Flare up plan 4 asthma action plan Review correct inhaler a technique Educate on asthma and purpose of medications Keep up-to-date with immunisations
When to consider a ics?
Symptoms twice a month
Waking due to asthma symptoms at least once during the past month
Oral steroids required for asthma flareup in the last 12 months
How would you assess control of asthma
Review of daytime symptoms
Review of nighttime symptoms
Reliever use
Limitation of activities
What are the most common problems in the asthma management
Sub optimal adhearance medications
Poor incorrect inhaler technique
How would you approach optimising his asthma management
Review with GP/ nurse to provide education
check correct usage of inhaler and explain the use of asthma action plan
Regular spirometry
Asthma cycle of care
Chronic disease management Medicare
Features on history to diagnose bronchiectasis
Cough Purpwnt discharge lasting months to years not improving after treatment for asthma or Copd Blood streaked sputum Shortness of breath Pleuritic chest pain Systemically features favour week
Initial investigationsfor chronic productive cough
Chest x-ray Sputum MCS Bloods HRCT Spirometry
Further investigations for bronchiectasis
Referral to respiratory physician
Full blood examination
Immunoglobulin level
Lung function test
