Asthma

Question 1

What is the 3 factors that define asthma

Answer 1

1. Chronic airway inflammation
2. Bronchial hypersensitivity
3. Reversible airway obstruction

Question 2

What are some phenotypes of asthma

Answer 2

1. early onset allergic
2. Late onset eosinophilic
3. Exercise induced
4. Obesity
5. Neutrophilic

Question 3

What are some characteristic signs of asthma

Answer 3

1. May be worse at night or in the morning
2. Usually have triggers

Question 4

What are the findings on a spirometry for asthma

Answer 4

1. FEV1/FVC <70%
2. improve in FEV1 or FVC of 12% AND 200ml (or >10%)

Question 5

What are some findings on a PEF for asthma

Answer 5

1. Improvement of >20% or 60L/min after bronchodilator
2. PEF with significant daily variation of more than 20% (over 1 week, >10% of over 2 week)

Question 6

What are some tests for eosinophilic inflammation

Answer 6

1. FeNO
2. Blood eosinophil
3. Skin prick test

Question 7

What is the first step of treatment in asthma

Answer 7

ICS-formoterol

Question 7

If asthma is not able to be controlled by ICS formoterol, what is the next step

Answer 7

Add on LAMA (can be tiotropium or 3 in 1) and consider biologics

Question 8

In primary care, what is the management of mild to moderate asthma exacerbation

Answer 8

SABA 4-10 puff with spacer every 20 min for 1 hour + oral prednisolone 5-7 days

Question 9

How is mild to moderate asthma managed in ED

Answer 9

SABA with ipratropium bromide and oral corticosteroids

Question 10

how is severe asthma managed in ED

Answer 10

SABA + ipratropium bromide + oral or IV corticosteroids

May also consider IV magnesium