Asthma Flashcards

1
Q

is asthma an acute or chronic inflammatory condition of the airways

A

chronic

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2
Q

asthma is associated with the hyper responsiveness of the airways and variable flow obstruction, bronchial hyperreactvity is a key feature and results in what?

A

asthmatic response based on particular triggers

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3
Q

exposure to triggers causes constriction of airway smooth muscle which results in

A

bronchoconstriction

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4
Q

bronchoconstriction is a result of the activation of x nervous system

A

parasympathetic

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5
Q

bronchoconstriction causes the release of ach which activates the x receptors in airway smooth muscle

A

m3 muscarinic

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6
Q

what is consequence of activation of m3 muscarinic receptors

A

contraction of smooth muscles and constriction of diameter airway

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7
Q

inflammation results in the production of x and y in the airway

A

excess mucus and oedema

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8
Q

the combination of bronchoconstriction and inflammation results in the classic symptoms of asthma which are

A

breathlessness
cough
wheeze

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9
Q

frequency and severity of asthma symptoms can vary between the same person and among different people but often has diurnal variation, what is meant by this

A

increased symptoms at night and first thing in morning

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10
Q

asthma is diagnosed from an accurate clinical history which is used in conjunction with

A

objective diagnostic test

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11
Q

what is the purpose/ benefit of doing an objective diagnostic test for asthma diagnosis

A

provide evidence and allow for monitoring of progress and response to treatment

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12
Q

what different things should a clinical history check for

A

wheeze
cough breathlessness
variation in symptoms
triggers
personal or family history of atopic disorders

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13
Q

what procedure to listen for wheeze is an important part of the physical examination done alongside clinical history

A

chest auscultation

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14
Q

name some other objective tests that are used to investigate asthma

A

feno
spirometry
peak flow

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15
Q

FeNO (fractional exhaled nitric oxide) is a relatively new test, what does it measure and provide an indication of

A

measures level of no in exhaled breath and provides indication of eosinophilic inflammation in the lungs

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16
Q

name a test that can be used to facilitate an asthma diagnosis so that patients do not have to be referred to secondary care for additional testing such as spirometry

17
Q

a feno level above x ppb is considered to be a positive test and therefore supports a diagnosis of asthma

18
Q

name a test that can be used to look for eosinophilic inflammation in the lungs

19
Q

what rr would you expect to see in acute severe asthma

A

equal or more than 25 breaths/min

20
Q

what pulse rate would you expect to see in acute severe asthma

A

equal or more than 110 beats/min

21
Q

list some life threatening features of acute severe asthma

A

ox below 92
silent chest
cyanosis
poor resp effort
arrythmia
hypotension
exhaustion

22
Q

step 1 is regular preventor: low dose ICS, whats next?

A

add on
inhaled LABA

23
Q

step 2 additional controller therapies - consider what?

A

increasing ICS to med dose
or
add LTRA

… if no response to LABA, stop

24
Q

CHECK INHALER TECHNIQUE

ICS
combination
SABA
LAMA

25
when asthma control is poor patients should be stepped up but what should be checked before this
adherence inhaler technique potential triggers
26
name some identified triggers for asthma
allergens: moulds, pollen infectious agents: influenza drugs: nsaids, bb, prostaglandins occupational: latex hair colourants other: cold air stress
27
A patient is complaining of shortness of breath, what should you ask about in the clinical history to see if asthma is a possible differential diagnosis?
Clinical history should check for: wheeze, cough or breathlessness and any daily or seasonal variation in these symptoms any triggers that make symptoms worse a personal or family history of atopic disorders
28
When (and why) is magnesium used in the management of asthma?
in severe cases as adjunct to standard therapy as it has been shown to cause bronchial smooth muscle relaxation
29
what route is magnesium given in asthma? severe
10-20min IV infusion
30
why might magnesium be beneficial in acute asthma compared to a drug like theophylline
safe and inexpensive