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Cardioresp - Phase II > Asthma > Flashcards

Asthma Flashcards

1
Q

What are the features of a mild asthma attack?

A

PEFR >75%

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2
Q

What are the features of a moderate asthma attack?

A

PEFR 50-75%

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3
Q

What are the features of a severe asthma attack? (4)

A 
PEFR 33-50%
Cannot complete sentences in 1 breath
RR >25
HR >110
*Severe if any one of the following*
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4
Q

What are the features of a life threatening asthma attack? (11)

A

PEFR

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5
Q

What are the features of a near fatal asthma attack?

A

Features of severe + raised pCO2

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6
Q

What is the initial management of acute asthma?

A

A-E
SpO2 94-98%
ABG if sats

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7
Q

What is the additional management of an asthma attack if it is severe?

A

Add nebulised ipratropium bromide - 500 micrograms

Consider back to back salbutamol

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8
Q

What is the additional management of an asthma attack if it is life threatening or near fatal?

A

Urgent ITU assessment
Urgent portable CXR
IV aminophylline or theophylline
IV salbutamol if nebulised not effective
Be aware that aminophylline + salbutamol may increase risk of SVT
If still resistant, can use magnesium sulphate

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9
Q

What are some of the differentials for a wheeze?

A 
Asthma
Bronchitis - viral or bacterial
Pulmonary oedema
PE
GORD
Foreign body
Allergy
Vasculitis
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10
Q

What is the pathophysiology of asthma?

A 
Airway epithelial damage - BM thickening
Inflammatory reaction - TH2, mast cells, eosinophils.
Smooth muscle hyperplasia + hypertrophy
Increased mucus secreting goblet cells
Muscle plugging
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11
Q

What is the criteria for safe discharge post asthma attack?

A 
PEFR > 75%
Off nebulisers for 24 hours
Inpatient nurse r/v to assess inhaler technique
5 days oral prednisolone
GP f/u within 2 weeks
Resp clininc f/u appointment
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12
Q

What are the differentials of eosinophilia?

A 
Asthma
COPD
Hayfever/allergens
Allergic Bronchopulmonary Aspergillosis (ABPA)
Parasites
SLE
Lymphoma
Drugs - antibiotics especially
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13
Q

What is step 1 of the BTS asthma guidelines?

A

SABA PRN

Salbutamol

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14
Q

What is step 2 of the BTS asthma guidelines?

A

Add inhaled corticosteroid (400mcg)

Beclamethasone

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15
Q

What is step 3 of the BTS asthma guidelines?

A

Add LABA (salmeterol, formoterol)
Increase corticosteroids
Leukotriene receptor antagonists
Theophylline

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16
Q

What is step 4 of the BTS asthma guidelines?

A

Increase inhaler corticosteroids

Add 4th drug from theophylline, B2 agonist, Leukotriene receptor antagonists

17
Q

What is step 5 of the BTS asthma guidelines?

A

Refer for specialist care
Add oral steroids
Increase inhaled corticosteroids
Consider add on options

Cardioresp - Phase II (18 decks)

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