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Harrison's Principles of Internal Medicine 20 > 281 - Asthma > Flashcards

281 - Asthma Flashcards

(65 cards)

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1
Q

Asthma is an __ disease.

A

obstructive

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2
Q

As developed countries become more ___, the number of asthma cases increases .

A

urban

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3
Q

The increase in __ disease is correlated with the increase in asthma.

A

allergic

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4
Q

The prevalence of __ and other allergic diseases has also increased over the same time, suggesting that the reasons for the increase are likely to be __ rather than confined to the lungs.

A

atopy

systemic

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5
Q

Asthma can appear at any age, but peaks at __, more in __ (in adults there is not difference between sexes).

A

3

boys

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6
Q

As the patients gets older, they become less __, but reverts at an __ age.

A

symptomatic

elder

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7
Q

What are the risk factors for mortality due to asthma?

A

uncontrolled with frequent use in bronchodilators
low compliance to ICS treatment
previous admission due to severe asthma

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8
Q

The main risk factor for asthma is ___.

A

atopy

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9
Q

__ infections (__) are common triggers for asthma __.

A

viral
RSV
exacerbation

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10
Q

Living with __ and __ are risk factors for asthma, removing them can improve the clinical symptoms.

A

mold

moisture

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11
Q

Low ___ diet were found to increase the risk for asthma.

A

antioxidant

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12
Q

Low vitamin __ intake is a risk factor for asthma.

A

D

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13
Q

__, mostly in __, is a risk factor for asthma.

A

obesity

women

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14
Q

Air __ (diesel/NO2) is a risk factor for asthma.

A

pollution

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15
Q

Suspect occupational exposure when symptoms improve during the __ and __.

A

weekends

holidays

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16
Q

Name 5 other risk factors for asthma:

A

SGA
young maternal age
duration of breast feeding
paracetamol intake at a young age

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17
Q

Non-atopic/intrinsic asthma will have negative __ test for common inhalant __, and normal __.

A

skin
allergens
IgE

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18
Q

Intrinsic asthma is more common in __ patients with nasal __ and __ sensitivity.

A

older
polyps
aspirin

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19
Q

Intrinsic asthma tend to have more __ symptoms .

A

severe

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20
Q

B blockers can be __ for asthma patients.

A

dangerous

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21
Q

Physical activity is a common __, mostly in __.

A

trigger

children

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22
Q

EIA=__

A

Exercise-induced asthma

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23
Q

EIA usually starts after the exercise is __, and relived __ minutes after.

A

over

30

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24
Q

__ and __ air is a trigger for asthma.

A

cold

dry

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25
How can you prevent EIA?
take Beta 2 agonist before exercise
26
Laughing is a __ for __.
trigger | asthma
27
Clinical deterioration can occur in women approaching their monthly __.
menses
28
__toxicosis and hypo__ can trigger asthma,
thyro | thyrodism
29
Mental __ can also worsen asthma.
stress
30
AHR-___
Airway Hyperresponsiveness
31
The typical symptoms in asthma: 3
wheezing dyspnea cough
32
Symptoms increase during the __, causing patients to __ early.
night | wakeup
33
Prodromal symptoms can start with an itching sensation below the __, discomfort sensation between the ___.
chin | scapula
34
Which pulmonary function test are decreased in asthma?
PEF FEV1/FVC FEV1
35
After SABA/ 2-4 weeks of OCS __ should improve by __% and 200 mL.
FEV1 12 200
36
What are the two treatment categories for asthma?
bronchodilators | controllers
37
Bronchodilators give __ relief to symptoms, but does not effect the __ process itself.
quick | inflammatory
38
What are the 3 categories of bronchodilators?
Beta 2 agonist anticholinergic theophylline
39
Beta 2 agonist is the most __ bronchodilator.
useful
40
SABA (__/__) are active for _-_ hours. They are good __ and for __.
albuterol/terbutaline 3-6 reliver EIA
41
LABA (__/__) are active for >_ hours, Since they do not affect the __, give together with __.
salmeterol/formoterol 12 inflammation ICS
42
Mention 3 common S/E for Beta 2 agonists:
tremor palpitation hypokalemia
43
In prolonged Beta 2 agonists use- __ will develop.
tolerance
44
LAMA-__
long acting muscarinic antagonists
45
ICS is the best __ therapy for asthma.
control
46
ICS reduce __
AHR (Airway Hyperresponsiveness)
47
ICS is the __ line of treatment. If uncontrolled- add __.
first | LABA
48
In acute severe asthma use __ .
IV OCS
49
PEF=__
Peak expiratory flow
50
Using a reliever for > __/week is a testimony for using __.
2 | controller
51
In patients with mild intermittent asthma- __ could be sufficient treatment
SABA
52
If controllers are required- use __ per day. If symptoms are relieved after 3 months, consider __ the dosage.
twice | decreasing
53
If after 3 months with ICS the symptoms are still uncontrolled- add __.
LABA
54
If symptoms are still uncontrolled (ICS+LABA), increase __ dosage.
ICS
55
If symptoms are still uncontrolled (maximal ICS+LABA), add __.
OCS
56
Name 3 clinical signs of acute severe asthma which do not improve under treatment:
chest discomfort wheezing dyspnea
57
In acute severe asthma patients will struggle to finish __, and may appear __.
sentences | cyanotic
58
When examining acute severe asthma patients may be suffering from hyper-__ and __
inflation | tachycardia
59
The ABG of patients with acute severe asthma will show- __ and decreased __ (due to hyperventilation).
hypoxemia | CO2
60
Acute severe asthma with normal/elevated PCO2 is an indication for an immanent ___ and requires ___ treatment, such as ___.
respiratory failure immediate prophylactic intubation
61
Acute severe asthma should be treated with high dose __, reaching > _% and ___.
oxygen 90 SABA
62
In severely ill acute asthma patients add ___. If there is not reaction- add __ inhaler.
IV beta 2 agonist | anticholinergic
63
If acute severe asthma patients do not respond to inhaler treatment- add slow drip of __.
aminophylline
64
__ sulfate is useful when added together with __.
magnesium | beta 2 agonist
65
Patients with COPD and asthma should be treated with triple treatment:
ICS + LABA + LAMA

Harrison's Principles of Internal Medicine 20 (163 decks)

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