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Respiratory > Asthma > Flashcards

Asthma Flashcards

1
Q

What is asthma?

A

chronic inflammatory disorder of the airways secondary to hypersensitivity.

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2
Q

What factors increase the risk of developing asthma?

A
  • personal or family history of atopy
  • antenatal factors (maternal smoking, viral infection during pregnancy - especially RSV)
  • Low birth weight
  • not being breastfed
  • smoking around child
  • exposure to high conc. of allergens
  • air pollution
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3
Q

What other IgE-mediated atropic conditions do people with asthma also often suffer from?

A
  • Atopic dermatitis (eczema)

- allergic Rhinitis (hay fever)

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4
Q

What drug are some asthma patients sensitive to?

A

Aspirin

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5
Q

What do patient most sensitive to asthma often suffer from?

A

Nasal polyps

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6
Q

What are symptoms of Asthma?

A
  • Cough: often worse at night
  • dyspnoea
  • ‘wheeze’
  • ‘chest tightness’
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7
Q

What are signs of Asthma?

A
  • expiratory wheeze on auscultation

- reduced peak expiratory flow rate (PEFR)

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8
Q

What is spirometry?

A

a test which measure the amount (volume) and speed (flow) of air during exhalation and inhalation.

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9
Q

What is spirometry helpful in?

A

categorising respiratory disorders as either obstructive (where there is obstruction to airflow, examples include bronchoconstriction in asthma) or restrictive (where there is restriction to the lungs, examples include lung fibrosis)

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10
Q

What is FEV1?

A

Forced expiratory volume - volume that has been exhaled at the end of the first second of forced expiration.

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11
Q

What is FVC?

A

Forced Vital capacity - volume that has been exhaled after a maximal expiration following a full inspiration.

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12
Q

What are typical spirometry results in an asthma patient?

A
  • FEV1: significantly reduced
  • FVC: Normal
  • FEV1% (FEV1/FVC): <70%
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13
Q

What else might be exhaled in asthma patients?

A

Fraction exhaled nitric oxide (FeNO)

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14
Q

What is the correlation between NO and Asthma and why?

A

Levels of NO typically correlate with levels of inflammation as one of the types of NOS is inducible (iNOS) and levels tend to rise in inflammatory cells, particularly eosinophils.

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15
Q

What other investigation may be considered, especially in older patients or those with a history of smoking?

A

Chest X-ray

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16
Q

What is the first-line drug to be used in the management of asthma? What is an example of such drug?

A

Short-acting beta-agonist (SABA) e.g. salbutamol

17
Q

When are SABA drugs used?

A

Typically when patient develops symptoms

18
Q

How do SABA drugs work?

A

Relax the smooth muscle of airways

19
Q

What is a side-effect of SABA drugs?

A

Tremor

20
Q

What drugs are given to patients whose asthma is not controlled by SABA alone?

A

inhaled corticosteroids (ICS)

21
Q

What are examples of ICS?

A
  • Beclomethasone dipropionate

- Fluticasone propinate

22
Q

When are ICS taken?

A

Taken everyday, regardless of whether patient has symptoms or not.

23
Q

What are side effects of ICS?

A

oral candidiasis and stunted growth in children

24
Q

When are LABA’s taken?

A

Everyday, regardless of whether a patient has symptoms.

25
Q

What is an example of a LABA?

A

Salmeterol

26
Q

What is an example of a Leukotriene receptor antagonist?

A

Monteleukast

27
Q

When are Leukotriene receptor antagonists used?

A

in the management of stable adult asthma for adults not controlled with a SABA+ICS

28
Q

How are Leukotriene receptor antagonists taken?

A

Orally

29
Q

What are oral corticosteroids used to treat?

A

acute asthma attacks

30
Q

What may oral corticosteroids affect?

A

growth if used in young children

31
Q

What is an example of an oral corticosteroid?

A

Prednisolone

32
Q

Maintenance and reliever therapy (MART) is offered to patients with?

A

poorly controlled asthma

33
Q

What is MART?

A

A form of combined ICS and LABA treatment in which a single inhaler containing both ICS and fast-acting LABA, is used for both daily maintenance therapy and the relief of symptoms.

Respiratory (12 decks)

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