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Adult/Ped Med 3 > Asthma > Flashcards

Flashcards in Asthma Deck (32):
1

What is the path for asthma?

smooth muscle dysfunction, airway inflammation, airway remodeling.

2

What is the path for asthma?

smooth muscle dysfunction, airway inflammation, airway remodeling.

3

Risk factors for asthma?

being male less than 10, atopy, family history, minority in urban area, allergen exposure, PEF varies more than 20% in the morn w/o albuterol and in the afternoon with albeterol, and obesity!!!

4

what is the triad of symptoms?

cough, wheeze, SOB

5

what are additional asthma symptoms?

chest tightness, hemoptysis, expective cough, hyperventilation.

6

asthma: history

intermitten, seasonl waxing and waning of symptoms. Occurs more often at night. exacerbation of sympomts due to exposure: exercise, cold air, allergens, pollutants, smoke, URI, strong odors

7

asthma: findings

1)high-pitched wheezing. The presence or absence of wheezing is a poor indicator of severity of airflow obstruction. 2) use of accessory muscles 3) Eczema, atopic dermatitis.

8

What if asthma patient presents only with a cough, what should you consider?

post-nasal drip, GERD, post viral tussive syndrome, drug induced

9

What are the risk factors for DEATH??

past hx of sudden attacks, prior intubations, admission to ICU, two or more hospitalizations for asthma in past year, three or more ER visits in on year, LOW SES, More than 2 canisters per month of beta agonist, systemic corticosteroids (current or immediate withdrawal), illicit drug use, unable to ID severity.

10

What cells play a role in asthma?

t lymph, marcophages, neutrophils, epiltheial cells, mast cells, eosinophils.

11

Describe the morphological changes

smooth muscle HYPERTROPHY
Epithelial DAMAGE
Inflammatory cell INFILTRATES
Basement membrane THICKENING
Mucous Gland HYPERSECRETION
Vascular DILATION

12

Asthma: diagnosis

Spirometry will help determine airflow obstruction, and reversiblity of the airway.

1. Increase in 12% or more and 200mL in FEV1 after inhaling a short acting bronchodilator indicates SIGNFICANT reversibility
2. Histamine or Methacholine: increase until FEV1 drops 20% or more.

FEV declines in direct and linear proportion with clinical worsening of airways obstruction. and increases with treatment.

13

What if there was no signficant change of 12% or more?

still treat with bronchodilator for 6-8 weeks.

14

What should a normal FEV1/FVC be for someone with asthma?

greater than 75%. This indicates they can exhale up to 75% of their lung volume in the first second.

15

What should be considered in asthma control?

1. assesment and monitoring
2. education
3. control of envrionmental factors and comorbities
4. medications

16

What plays a role in assessment and monitoring of asthma?

severity, control, responsiveness, impairement, risk of adverse events

17

Asthma medications are in two general classes:

long term control and quick relief.

long term: corticosteroids (prednisone) or leukotrienes
short term: albuterol

18

Risk factors for asthma?

being male less than 10, atopy, family history, minority in urban area, allergen exposure, PEF varies more than 20% in the morn w/o albuterol and in the afternoon with albeterol, and obesity!!!

19

what is the triad of symptoms?

cough, wheeze, SOB

20

what are additional asthma symptoms?

chest tightness, hemoptysis, expective cough, hyperventilation.

21

asthma: history

intermitten, seasonl waxing and waning of symptoms. Occurs more often at night. exacerbation of sympomts due to exposure: exercise, cold air, allergens, pollutants, smoke, URI, strong odors

22

asthma: findings

1)high-pitched wheezing. The presence or absence of wheezing is a poor indicator of severity of airflow obstruction. 2) use of accessory muscles 3) Eczema, atopic dermatitis.

23

What if asthma patient presents only with a cough, what should you consider?

post-nasal drip, GERD, post viral tussive syndrome, drug induced

24

What are the risk factors for DEATH??

past hx of sudden attacks, prior intubations, admission to ICU, two or more hospitalizations for asthma in past year, three or more ER visits in on year, LOW SES, More than 2 canisters per month of beta agonist, systemic corticosteroids (current or immediate withdrawal), illicit drug use, unable to ID severity.

25

What cells play a role in asthma?

t lymph, marcophages, neutrophils, epiltheial cells, mast cells, eosinophils.

26

Describe the morphological changes

smooth muscle HYPERTROPHY
Epithelial DAMAGE
Inflammatory cell INFILTRATES
Basement membrane THICKENING
Mucous Gland HYPERSECRETION
Vascular DILATION

27

Asthma: diagnosis

Spirometry will help determine airflow obstruction, and reversiblity of the airway.

1. Increase in 12% or more and 200mL in FEV1 after inhaling a short acting bronchodilator indicates SIGNFICANT reversibility
2. Histamine or Methacholine: increase until FEV1 drops 20% or more.

FEV declines in direct and linear proportion with clinical worsening of airways obstruction. and increases with treatment.

28

What if there was no signficant change of 12% or more?

still treat with bronchodilator for 6-8 weeks.

29

What should a normal FEV1/FVC be for someone with asthma?

greater than 75%. This indicates they can exhale up to 75% of their lung volume in the first second.

30

What should be considered in asthma control?

1. assesment and monitoring
2. education
3. control of envrionmental factors and comorbities
4. medications

31

What plays a role in assessment and monitoring of asthma?

severity, control, responsiveness, impairement, risk of adverse events

32

Asthma medications are in two general classes:

long term control and quick relief.

long term: corticosteroids (prednisone) or leukotrienes
short term: albuterol