Respiratory conditions - asthma & COPD Flashcards

1
Q

What is asthma

A

reversible airflow obstruction

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2
Q

What are the 3 main things that make up the mechanism of asthma

A
  • Airway smooth muscle constriction
  • Inflammation of the mucosa leading to swelling
  • Increased mucus secretions
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3
Q

What are symptoms of asthma

A
  • Cough
  • Wheeze
  • Shortness of breath
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4
Q

What sort of response does asthma have

A

biphasic

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5
Q

What is meant by biphasic response in asthma

A

the mediators produced in an asthma work at different times creating 2 phases

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6
Q

Why is the biphasic response in asthma so relevant

A

it means a patient should also take their steroid inhaler as well as their beta 2 agonist during their asthma attack as this will help prevent the second phase

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7
Q

What does the drug regimen for asthma depend on

A

severity

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8
Q

What are the drugs that may be prescribed for asthma

A
  • Occasional B agonist only
  • Low dose inhaled steroid or sodium cromoglycate nedocromil
  • High dose inhaled steroid
  • Long acting B-agonist, theophylline and antimuscarinic drugs
  • Oral steroid
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9
Q

What indicates severe asthma when taking a history

A

hospitalisation for asthma

oral steroid in MH

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10
Q

What is the dental relevance of patients taking steroid inhalers for asthma

A

high risk for oral candida infections

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11
Q

In the emergency setting, if the patient was to show an inability to complete sentences in one breath, what should we suspect

A

an acute severe asthma attack

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12
Q

If we are suspecting a severe asthma attack, what should we check

A

heart rate & respiratory rate

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13
Q

In an acute severe asthma attack, what would we expect the respiratory rate to be

A

>25 breaths per minute

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14
Q

In an acute severe asthma attack, what would we expect the heart rate to be

A

expecting tachycardia

>110 BPM

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15
Q

What respiratory rate would indicate to us that this is life threatening asthma, not just a severe asthma attack

A

respiratory rate is less than 8 per minute

may see cyanosis

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16
Q

What heart rate would indicate life threatening asthma

A

<50 BPM (bradycardia)

17
Q

What symptoms may we see in a patient who is experiencing life threatening asthma

A

exhaustion, confusion, decreased consciousness

18
Q

How should we manage a patient who is experiencing an acute asthma attack

A

oxygen

bronchodilator

if not responding within 5 minutes call 999

19
Q

What is COPD

A

mixed airway reversible obstruction PLUS destructive lung disease

20
Q

What is emphysema

A

destruction of the alveoli and the dilation of others to fill the space

21
Q

What are causes of COPD

A

smoking

environmental lung damage

hereditary emphysema

22
Q

What is hereditary emphysema

A

lacks the enzymes to maintain the integrity of the alveoli (called alpha1 antitrypsin deficiency)

23
Q

What drugs would we expect someone who has COPD to be on

A
  • Long acting bronchodilator
  • Inhaled steroids
  • Systemic steroids
  • Oxygen support
24
Q

In the emergency setting, why must we be careful with oxygen when treating patients with COPD

A

hypoxia drives ventilation in patients with COPD, may decrease their respiratory rate

if administering, keep an eye on respiratory rate