RMS Quiz 1 - COPD & Asthma Therapeutics Flashcards
What does a spirometer do
Measures lung function
Before a spirometer test what should be avoided
SABA (salbutamol), SAMA (ipratropium), LABA (formetarol), LAMA (umeclidinium), alcohol, smoking, tight clothing and strenuous exercise
What’s FEV1 + normal value
How much air can be exhaled in the first second (abnormal if it’s less than 80% of FVC)
What’s FVC
Forced vital capacity, how much air a person can exhale (abnormal if it’s less than 80%? Apparently)
What’s an abnormal FEV1/FVC value
Less than 70%
What’s used to distinguish asthma or COPD
Bronchodilator reversibility test (bc asthma has reversible effects but COPD doesn’t), FeNO test, peak flow variability and bronchial challenge test
How does a bronchodilator reversibility test work
1) conduct lung function test (spirometer)
2) give patient bronchodilator e.g. blue inhaler and wait 15 mins then repeat spirometer test
If FEV1 improves by 12% OR MORE AND there’s an increase in lung volume of 200ml or more = asthma if both conditions are not met then it’s suggestive of COPD (FVC doesn’t change much bc it’s a ratio)
What’s the airway hyper-reactivity test
Giving patient irritant if FEV1 drops by 20% or more = positive result (asthmatics and non-asthmatics will react to the irritant but asthmatics more so)
What’s peak flow
Lung function test- blow into contraption as hard as possible. Highest score of 3 attempts is recorded
Can be used to assess lung function in asthmatic and COPD patients (NOT a diagnostic tool though). Height, sex and weight used to compare to predicted value
What’s the FeNO test + positive result
Measures airway inflammation (because asthma is a INFLAMMATORY condition) using fractional exhaled nitric oxide = FeNO. Positive result = 40ppb or more = asthma
It can also be used to check adherence to ICS (inhaled corticosteroids)
How is asthma diagnosed
Patient must have more than one of the following symptoms : wheezing, coughing, breathlessness, chest tightness
Then tests carried out in this order: FeNO, bronchodilator reversibility with spirometry, peak flow expiratory flow variability and bronchial challenge test
What are the 3 main characteristics of asthma
1) expiratory airflow limitation - obstruction due to mucus build up
2) bronchial hyper responsiveness
3) airway inflammation
What are the 2 main types of asthma
1) intrinsic asthma = non-allergic so not triggered by allergens so exercise or stress etc.. common in adults
2) extrinsic asthma = triggered by allergens so pet hair, dust, pollen… common in children
What’s the difference between asthma and COPD
Asthma = reversible so they’ll get attacks then restored lung function then attacks and so on …. But with COPD it’s irreversible damage and gradual deterioration so they’re function isn’t restored otherwise similar symptoms
What’s the antibody produced in response to extrinsic asthma
IgE
What cytokines are involved in asthma
IL4 and IL5
How is asthma treatment reviewed
Using ACQ-6 score, well controlled asthma = less than or equal 0.75 , poor control = 1.5 or more
What’s the FEV1/FVC ratio for COPD and is it heterogeneous or homogeneous
Less than 0.7 and it is heterogeneous
Risk factors for COPD
Smoking obvs, indoor air pollution (open fire of wood/coal), genetics and family history
How do you calculate COPD risk score
Smoking total pack years = (no. Of cigs per day X no. of smoking years)/20
How does COPD effect the body + what is used to assess severity of these effects
Causes mucus hyper-secretion, ciliary dysfunction (can’t efficiently sweep mucus away = build up), lung hyperinflation, pulmonary hypertension
CAT assessment identifies side effects and severity
Does FVC change for asthma and COPD patients
Nope value stays relatively the same
What device is used to assess which inhaler is best for a patient by checking their technique
In-check dial
What treatment is suitable for patients who have serious COPD
O2 delivery (if their arterial pO2 = less than 7.3KPa or if O2 sat is less than 88%) or surgery
