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Flashcards in 2 - asthma Deck (14)
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1
Q

asthma: definition

A

chronic inflammatory pulmonary disorder that is characterized by reversible obstruction of airways

2
Q

changes in airway morphology in asthma?

A

mucous gland hypertrophy, edema, thickening of basement membrane, epithelial damage, airway smooth muscle becomes hyper-responsive. inflammatory cell infiltration. vascular dilation.

3
Q

what test can be used to look at airway hyper reactivity?

A

methacholine: increase concentration and look at reduction in FEV1% –> cut off at 20%

4
Q

immunologic mechanisms in asthma: what are the cells involved? difference in children vs. adults?

A

mast cells. macrophages, eosinophils. adults = more neutrophils and less responsive to anti-inflammatories.

5
Q

risk factors for asthma

A

maternal smoking. atophy. family history. males more than females if <14, females more if >14. pollution like NO2, ozone. obesity. viral infections maybe

6
Q

children and wheezing? how does that related to asthma?

A

50% of all children wheeze by age 6 –> some will never wheeze again, some will develop asthma. 50% children with asthma will outgrow it

7
Q

predictors of poor outcomes in asthma?

A

persistent symptoms, long duration. high levels of hyper reactivity. decreased inhaled corticosteroid use. environmental smoke. females;.

8
Q

examples of asthma triggers

A

allergens. resp infections. strong expression of emotion like laughing or crying. vigorous exercise. cold air. dust, air pollution. cigarette smoke. drugs. pets. household products.

9
Q

cardinal symptoms that suggest asthma: 3?

A

cough (exp after exertion, cold air, at night, after colds and paroxysmla). wheezing. breathlessness.

10
Q

asthma management continuum

A

confirm diagnosis, do environmental control, education, written action plan. fast acting bronchodilator on demand. inhaled corticosteroids. then can add: LABA, LTRA, prednisone with increasing severitys

11
Q

benefits of ICS? delay in ICS therapy associated with?

A

best efficacy for asthma therapy: improves lung function, decreases B2 agonist usage, decreases mortality/hospitalization, airway hyper responsiveness, etc. associated with decreased ultimate lung function

12
Q

benefits vs. risks of using corticosteroids for asthma

A

+: reduces inflammation, most effective long term control medication, decreases morbidity and mortality. -: risks are dose, drug and route dependent

13
Q

long term use of ICS and growth?

A

poorly controlled asthma more detrimental to growth than long term ICS use

14
Q

LABA: examples? use?

A

salmerterol, formoterol: add to inhaled steroid therapy = more effective than increasing dose of steroid