Asthma Flashcards Preview

Medicine > Asthma > Flashcards

Flashcards in Asthma Deck (50):
1

what are clues of asthma?

episodic
night time symptoms
abates spontaneously

2

what are common clear triggers for asthma?

dust, fumes, perfumes, cold air, cockroach, exercise

3

what is the DDx of night time cough?

asthma
CHF
GERD

4

what does aspirin rarely cause?

explosive asthma

5

at what age are most ppl diagnosed with asthma?

age of 7 (75% of the time)

6

what is methacholine challenge testing?

produces asthma attacks which rules out asthma

7

what can cause tracheal stenosis?

prolonged mechanical ventilation

8

when are we operating under negative pressure?

inhale

9

when are we operating under positive pressure?

exhale

10

in variable intrathoracic obstruction, when is the greatest deficit?

exhalation
(obstruction below the thoracic inlet)

11

in variable extrathoracic obstruction, when is the greatest deficit?

inhalation
(obstruction above the thoracic inlet)

12

what is the MCC of wheezing?

allergic rhinitis with post nasal drip

13

what is another common cause of wheezing?

GERD

14

what will you typically hear with ILD/pulmonary fibrosis?

fine crackles on inspiration

15

young hystrionic female who wheezes has what?

vocal cord dysfunction syndrome

16

what is a positive bronchodilator response?

12% or greater
increase of at least 200cc in FVC or FEV1

17

when would you use a peak expiratory flow monitor?

occupational asthma (look for difference b/w work and home)
scary asthma (don't have dyspnea so they can't tell when they are in trouble)-monitoring at home

18

what does exhaled nitric oxide tell you?

NO is a by product of an asthma related reaction and increased amounts indicates asthma

19

what labs do you order for asthma pts?

IgE, allergy testing (RAST panel), CBC (eosinophils)

20

what might you see on CXR with asthma pt?

normal
-used to exclude another problem

21

how would atelectasis appear on CXR?

white

22

what defines severe respiratory failure?

High respiratory rate combined with acidosis and normal pCO2

23

why are paralytics helpful?

ventilator can take complete control and less energy is going to the diaphragm to try to breathe

24

what can steroids plus paralytics cause?

critical illness polyneuropathy and myopathy

25

what is involved in vent management?

anything to prolong the expiratory time to decrease autopeep and subsequent barotrauma and improve hemodynamics

26

what is autoPEEP?

baseline volume of air needed to be maintained in order to allow continuous airway access

27

what is the underlying component of all COPD theray?

bronchodilate to allow air to get out of the lungs

28

what is the role of heliox?

prevents air turbulence in the vented pt

29

what is the role of nebulized heparin?

great anti-inflammatory

30

what is the overall approach to asthma txment?

monitor lung function serially
controlling triggers
meds

31

what are the goals of asthma therapy?

1. symptom free
2. use SABA < 2x per month

32

what is a common asthma trigger?

cleaning products

33

who should avoid non selective beta blockers?

asthma pts

34

what do sulfites do?

can be an asthma trigger

35

what is the step up/step down approach?

step up to get control
then once controlled, step down to get minimal amount of drug necessary to control sxs

36

what is the txment approach for mild persistent asthma?

low dose ICS (1st choice) OR leukotriene antagonist or theophylline

37

what is the txment approach for moderate persistent asthma?

low dose ICS/LABA (shown to do better) or medium dose ICS

38

what is the main pathophysiology of asthma?

small airways and inflammation

39

who has an increased risk of pneumonia?

ICS use in COPD pts
-not first line therapy for COPD pts b/c of this

40

what is the txment approach for severe persistent asthma?

high dose ICS/LABA, IgE to see if may benefit from omalizumab (xolair) infusions, daily or qod oral steroids, leukotriene antagonist

41

what are -MAB drugs?

mono clonal antibodies

42

what are less studied, but useful drugs for severe asthma?

methotrexate, cyclosporine, new meds against IL-5
clarithromycin, azithromycin
bronchial thermoplasty

43

when do you need to get a contrast CT/

only when you want to visual mediastinum

44

what is ABPA?

allergic bronchopulmonary aspergillosis

45

how do you treat ABPA?

high dose steroids with long taper and anti-fungal (itraconazole 1st choice)

46

what do p and c-ANCA characterize?

small vessel vasculitis

47

what is Churg-Strauss dz?

can occur in steroid dependent asthmatic
can occur when leukotriene antagonist as added to regimen

48

how will atelectasis look on xray?

wedge toward anterior

49

cardiac asthma you should think

mitral stenosis

50

what are classic findings of mitral stenosis

straight left heart border
large left atrium

Decks in Medicine Class (146):