Asthma Flashcards
(18 cards)
What are the classic symptoms of asthma?
intermittent dyspnea,
Dry/productive cough (usually worse at night)
wheezing (audible upper airway noises) brought on by triggers
What are the pathological characteristics of asthma?
Bronchial hyper-responsiveness and airway inflammation
What is “reactive airway disease”?
Imprecise term to describe cough and wheeze in children too young to definitively diagnosis asthma with PFTs
When is asthma most often diagnosed?
75% of cases before age 7, but can be present at any age
How do patients typically describe the sensation of asthma?
Chest tightness, chest heaviness
Rarely ever sharp chest pain
What distinguishes asthma from other airway diseases?
Episodic nature (Cough at night is characteristic) Characteristic triggers Personal / Family history of atopy (Allergies, asthma, eczema)
What are common allergens that cause asthma symptoms?
Dust mites Mold Animal fur Cockroaches Pollens
What are common triggers for asthma symptoms?
Inhaled allergens
Cold air
Exercise
Viral infections
What are characteristic physical exam findings of asthma?
Widespread, high-pitched, musical, expiratory wheezes (usually absent between exacerbations)
What physical exam findings may be found with other disorders associated with asthma?
Pale, swollen mucous membranes & posterior pharyngeal cobble-stoning (allergic rhinitis)
Flexural lichenified plaques (atopic dermatitis)
What proportion of children with atopic dermatitis go on to develop asthma?
1/3 will develop asthma
What findings on spirometry support the diagnosis of asthma?
Reduced FEV1/FVC ratio (obstructive pattern) Reversibility with bronchodilator Methacholine challenge (bronchoprovocation)
Below what FEV1/FVC ratio signifies an obstructive pattern?
0.7
What percent increase in FEV1 signifies a bronchodilator response?
12% increase in FEV1
What tests are used to diagnose asthma? What tests are used to monitor as outpatient?
Spirometry (with bronchoprovocation and bronchodilator response)
Peak Expiratory Flow Rate (PEFR)
What are the non-pharmacologic therapies for asthma management?
Trigger avoidance, asthma action plan, and proper inhaler technique
Describe proper MDI technique.
Prime inhaler (initial use or after not using for days)
– Spray ~4 times in air
Shake for 5 seconds
Press canister while breathing deeply and slowly
Take full breath and hold for 5 seconds
If steroid: rinse, gargle and spit water
Can you use the same spacer for different MDIs?
Yes
