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Hospital Based Medicine And Surgery > L09: Asthma > Flashcards

L09: Asthma Flashcards

1
Q

What is asthma

A

A chronic inflammatory disorder characterised by bronchial hypersensitivity to a variety of stimuli and leads to airway obstruction

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2
Q

What is the pathophysiology of asthma

A

Inflammation that causes smooth muscle contraction, thickening of the airway wall, oedema, basement membrane thicekning and mucus in the airway

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3
Q

What inflammatory cells infiltrate in asthma

A

Cd4 t cell

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4
Q

What are the 2 types of triggers in asthma

A

Inducers

Provokes

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5
Q

What are inducers

A 
Dust
Animla fur
Mould
Aerosal such as perfumes
Bacterial infection
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6
Q

What are provokers

A

Cold

Stress

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7
Q

What are of asthma

A

Cough
Shortness of breath
Wheeze
Chest tightness

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8
Q

What clinical signs can you find in examination of asthma

A

Wheeze
Hyperinflated chest
No wheeze and silent chest- life threatening

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9
Q

What investigations can be carried out for athma

A

Chest x-ray
FBC
Peak flow
Spirometry

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10
Q

What can a peakflow show in astham

A

Diurinal variation- more thn 20% diurinal variation on 3 days per week overal several weeks or increase in peak flow with asthma treatment

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11
Q

What can a spirometry show in asthma

A

FEV1 increases more than 15% after single dose of short acting beta agonist

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12
Q

What approach do we use in asthma

A

Stepwise approach

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13
Q

What does the stepwise approach involve

A
  1. short acting beta agonist e.g salbutamol (reliever)
    Add on therapy:
  2. Add Low dose corticosteroid e.g beclometasone (regular preventer)
  3. Add leukotriene receptor antagonist e.g montelukast
  4. Add Long acting beta agonist e.g salmeterol
  5. Change low dose ICS and LABA to MART (ICS + fast acting LABA)
  6. Increase does of inhaled corticosteroid to medium dose 6. Increase dose of inhaled corticosteroid to high dose
  7. Specilaist therapy: Long acting muscarinic antagonist e.g tiotropium, oral steroids e.g prednisolone and monoclonal antibodies e,g omalizumab
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14
Q

What are the types of acute severe asthma

A

Moderate
Severe
Life threatening

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15
Q

What is moderate acute asthma

A

Increasing symptoms

PEFR 50-75%

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16
Q

What is severe asthma

A

PEFR 30-50%
Respiratory rate 25+
Heart rate 100bpm+
Inability to complete sentence in one breath

17
Q

What is life threatening asthma

A 
PEFR less than 33%
Sa02 less than 92%
Pao2 less than 8kpa
CHEST
Cyanosis
Hypotension
Exhaustion
Silent chest
Tachycardia
18
Q

What is the management of acute severe asthma

A 
O SHIT ME
Oxygen
Salbutomal
Hydrocortisone
Ipratropium
Theophylline
Magnesium sulfate
Escalate
19
Q

What is the aim for spo2 in asthma

A

More than 92%

20
Q

What is SABA used as

A

Reliever therapy when required

Hospital Based Medicine And Surgery (30 decks)

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