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01. Respiratory System - HP > Asthma > Flashcards

Asthma Flashcards

1
Q

What is asthma?

A

a disease characterise by an increased responsiveness of the airways to various stimuli and manifested by a widespread narrowing of the airways that changes in severity either spontaneously or as a result of therapy

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2
Q

What is the main symptom of asthma?

A

Wheezing

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3
Q

Is asthma restrictive or obstructive?

A

Obstructive

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4
Q

What is COPD?

A

Chronic, slowly progressive disorder that is characterised by airflow obstruction - does not change markedly over several months

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5
Q

Is asthma triggered by a stimulus or spontaneously?

A

Can be either

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6
Q

Is the airflow obstruction in asthma reversible?

A

Yes

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7
Q

If there is no wheeze can it be asthma?

A

No

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8
Q

What is dyspnoea?

A

Shortness of breath

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9
Q

What are the symptoms of asthma?

A 
Wheeze 
Short of breath 
Severity chest tightness 
Cough (usually dry) 
Sputum occasionally
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10
Q

Is asthma more common in boys or girls?

A

Boys

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11
Q

Is asthma more common in men or women?

A

Women

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12
Q

What is the prevalence of asthma in children?

A

10-15%

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13
Q

What is the prevalence of asthma in adults?

A

5-10%

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14
Q

What is wheezing?

A

A whistling sounds that occurs during breathing when the airways are narrowed

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15
Q

What is the character of a cough in asthma?

A

Dry

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16
Q

What are some potential triggers of asthma?

A 
Exercise
Cold air 
Smoke 
Perfume 
Grass pollen 
Pets
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17
Q

What are the obs taken in a patient with suspected asthma?

A

Ability to speak
Heart rate
Respiratory rate
O2 saturation

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18
Q

What is bronchospasm?

A

When the smooth muscle of the airways contract therefore narrowing the airways

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19
Q

What is bronchiectasis?

A

The abnormal widening of one or more airways

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20
Q

In bronchiectasis what is extra produced?

A

Extra mucus

Prone to infection

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21
Q

What other conditions can wheezing occur in?

A

Cystic fibrosis
An infection in the respiratory tract
Bronchiolitis
Bronchiectasis

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22
Q

What is peak flow investigation?

A

Patients are given a peak flow meter to use at home to encourage self monitoring
Record a peak flow diary
Doctor looks at the diary and looks to see if the range is out with 15%

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23
Q

In moderate asthma what is the PERF?

A

> 50-75%

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24
Q

In acute severe asthma what is the PERF?

A

33-50%

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25
Q

In life threatening asthma what is the PERF?

A

Less than 33%
Essentially None
Test not possible
As the person will not be able to breathe out

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26
Q

What are some of the symptoms of acute severe asthma?

A

Heart rate >110 bpm

Inability to complete sentences in one breath

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27
Q

What are the clinical signs of life threatening asthma?

A 
Altered consciousness 
Exhaustion 
Hypotension 
Cyanosis 
Silent chest 
Poor respiratory effort
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28
Q

What are the similarities between COPD and asthma?

A

Both involve small airways and cause airflow limitation
Both result from environment interaction
Both are usually characterised by mucus and bronchoconstriction

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29
Q

Why is asthma so important?

A

Because so many people suffer from the condition

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30
Q

Is asthma chronic or a one off condition?

A

Chronic

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31
Q

How does smoking link to asthma?

A

Maternal and grandmother smoking during pregnancy

32
Q

What are possible risk factors for asthma?

A

Obesity
Diet
Reduced exposure to microbes
Indoor pollution

33
Q

Is wheezing only present in asthma?

A

No it can be present in other conditions meaning it is important to differentiate it from other causes of wheeze

34
Q

Is the airflow obstruction in asthma reversible?

A

Yes

35
Q

Is wheezing more prominent when you breathe in or out with asthma?

A

Breathe out

36
Q

If the beta 2 agonist drugs work what is the likely diagnosis?

A

Asthma

37
Q

When should peak flow at home be measured?

A

In the morning and night

38
Q

If in doubt of an asthma patient what should be measured?

A

Blood gas

39
Q

What are the different types of asthma?

A

Occupational related
Allergy
Genetic

40
Q

What are some triggers for asthma?

A 
Pets
Cold 
Dust 
Exercise 
Perfume 
Food 
Allergens 
Occupationally related
41
Q

Does physical examination aid in the diagnosis of asthma?

A

Not really

42
Q

What are some useful but not diagnostic investigations for asthma?

A

CXR
Skin pricking test
Specific and total IgE
FBC - eosinophilia

43
Q

Will eosinophilia be present in COPD patients or in asthma patients?

A

Asthma patients

44
Q

What 2 techniques can be used to measure lung function?

A

Spirometry

Peak Flow

45
Q

Why are lung function test carried out before and after taking a bronchodilator?

A

To check the reversibility of the airflow obstruction

If the use of a bronchodilator improves symptoms and lung function it is likely you have asthma

46
Q

What can a nitric oxide test indicate for asthma?

A

High NO exhaled levels can sometimes be present in patients presenting with asthma

47
Q

Is occupational asthma common or uncommon in children?

A

uncommon

48
Q

Describe moderate asthma?

A

Able to speak and complete sentences
HR<110
RR<25
PERF 50-75%

49
Q

Describe severe asthma?

A 
Any of 
Unable to speak 
HR>110 
RR>25
PERF - 33-50%
50
Q

Describe life threatening asthma?

A 
any of 
grunting 
impaired consciousness 
HR>130
Cyanosis 
PaO2 is low 
But PCO2 is normal
51
Q

What is the main indication of near fatal asthma?

A

High PCO2

52
Q

Describe a cough in a child with asthma?

A

Dry
Nocturnal
Exertional

53
Q

If a child is wheezing but does not respond to treatment what is the diagnosis?

A

Viral induced wheeze

54
Q

is asthma more common in under 18 months or over 5 years old?

A

Over 5

55
Q

If you think its asthma

but you are not sure…

A

Give a short course of inhaled steroids

and see if you have a cure

56
Q

What 2 main groups of drugs are given to asthma patients?

A

Anti-inflammatorys

Bronchodilators

57
Q

What medication should you never give to an asthma patient?

A

Beta blockers

58
Q

What are some pharmacological solutions to asthma?

A 
Weight loss if BMI >30 
Vaccines - yearly for flu and pneumonia 
Allergen avoidance 
Smoking cessation 
Physiotherapy
59
Q

What does MDI stand for?

A

Metered does inhalers

60
Q

Why are MDI great for treating asthma?

A

Deliver small amounts of the drug
Delivered straight to the target organ - lungs
Onset of effect is faster
Minimal systemic exposure - especially because they’re steroids

61
Q

Who can find it difficult to use an inhaler device?

A

The young
Old
Uncoordinated

62
Q

What device can be used to aid with the use of an inhaler?

A

Spacer

63
Q

What is defined as the complete control of asthma?

A 
No daytime symptoms 
No night time disruption 
No need to reuse medication 
No asthma attacks 
No limitations on activities
64
Q

What is a reliever?

A

SABA

Blue inhaler

65
Q

What is the most prescribed drug in the UK?

A

Salbutamol

66
Q

Should you start on high or low doses of reliever inhalers?

A

Low

67
Q

What is an ICS?

A

Inhaled corticosteroids

68
Q

What do ICS do?

A

They work to prevent the onset of asthma symptoms

69
Q

What is a common ICS prescribed?

A

Beclomethasone

70
Q

when do you start a patient on preventers?

A

When using reliever x3 times a week
Waking one night a week or more due to asthma
Requiring oral steroid for an exacerbation in the past 2 years
Often symptomatic

71
Q

Which LAB is commonly used?

A

Fostair

72
Q

What is the 5 step asthma treatment plan?

A 
Reliever SABA 
Add a preventer
Add a LABA 
Add an anti-muscarinic 
Oral steroids
73
Q

What inhalers will you be prescribing as an FY1?

A

Inhaled steroids
SABA
ICS
LABA

74
Q

What should you always have prescribed before starting a patient on LABA treatment?

A

ICS preventer

75
Q

Is there a cure for asthma?

A

No

76
Q

What is the maximum dose of inhale that can be given to children?

A

800 microg

77
Q

What CANNOT be prescribed to children?

A

Oral steroids

01. Respiratory System - HP (82 decks)

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