Asthma

Question 1

Is asthma an obstructive or restrictive disease?

Answer 1

Obstructive

Question 2

What happens to the basement membrane in remodelling?

Answer 2

It thickens

Question 3

What happens to the submucosa in remodelling?

Answer 3

Collagen deposition

Question 4

What happens to smooth muscle in remodelling?

Answer 4

Hypertrophy

Question 5

Asthmatics usually have a productive cough with wheeze. True/False?

Answer 5

False

Cough is usually dry/non-productive

Question 6

What is wheeze?

Answer 6

High pitched expiratory sound

Question 7

List the British Thoracic Society drug guidelines for asthma treatment

Answer 7

1. SABA
2. • Inhaled steroid
3. +LTRA
4. ICS + LABA + LTRA
5. MART (ICS + LABA) +/- LTRA
6. • LAMA/ Theophylline

Question 8

CysLT antagonists (Montelukast) are more potent than inhaled steroids. True/False?

Answer 8

False

2nd line additive to inhaled steroid

Question 9

Cetirizine and Loratidine are sedative antihistamines. True/False?

Answer 9

False

They are non-sedative

Question 10

What do anti-IgE monoclonal antibody treatments (Omalizumab) do?

Answer 10

Prevent binding to IgE receptor and inhibit mediator release from basophils and mast cells

Question 11

What would be PEFR in moderate asthma?

Answer 11

Less than 80% predicted

Question 12

What would be PEFR in severe asthma?

Answer 12

Less than 50% predicted

Question 13

What would be PEFR in life threatening asthma?

Answer 13

Less than 30% predicted

Question 14

Outline management of acute severe asthma

Answer 14

Oxygen (40-60%)
Salbutamol (nebulised)
Hydrocortisone (IV)
Ipratropium (nebulised)
Theophylline (oral)
Magnesium sulphate (IV)
Anaesthetist!

Question 15

List features of an acute-severe asthma attack

Answer 15

Unable to finish sentences
PEFR less than 50% predicted
Tachycardia
RR more than 25 breaths/min

Question 16

List features of a life-threatening asthma attack

Answer 16

PEFR less than 30% predicted
Bradycardia, hypotension, silent chest
Exhaustion/confusion
Hypoxia, acidosis

Question 17

What drugs are used in the treatment of eosinophillic inflammation?

Answer 17

CCS

Cromones

Question 18

What drugs are used to stop the release of mediators, TH2 cytokines?

Answer 18

Anti-leukotrienes
Anti-histamines
Anti-IgE
Anti-IL5

Question 19

What drugs are used to treat twitchy SM?

Answer 19

Bronchodilators
B2 agonists
Muscarinic antagonists

Question 20

List some triggers of asthma

Answer 20

Cold air
Exercise
Emotion
Pollution
Smoking/ Passive smoking
Drugs - NSAIDS, B Blockers
Allergens

Question 21

List some features of asthma

Answer 21

Episodic SOB
Diurnal variation
Non-productive cough
Wheeze
Associated atopy
Family history

Question 22

List some tools used in the diagnosis of asthma

Answer 22

Peak flow
PFTs
Reversibility with salbutamol
Provocation testing