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GP Conditions Year 4 > Asthma > Flashcards

Asthma Flashcards

1
Q

What is asthma?

A

chronic inflammatory condition of the airways causing episodic exacerbations of bronchoconstriction

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2
Q

bronchoconstriction

A

smooth muscles of airways contract

narrowing of airways

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3
Q

airway obstruction in asthma

A

reversible

responds to bronchodilators eg salbutamol

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4
Q

what is bronchoconstriction caused by?

A

hypersensitivity of the airways and can be triggered by environmental factors

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5
Q

typical triggers

A 
infection 
night time or early morning
exercise 
animals
cold/damp
dust 
strong emotions
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6
Q

presentation suggesting diagnosis of asthma

A 
episodic symptoms
diurnal variability - worse at night
dry cough with wheeze and SOB
history of other atopic conditions 
family history 
bilateral wheeze
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7
Q

atopic conditions

A

eczema, hayfever and food allergies

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8
Q

presentation indicating diagnosis other than asthma

A

wheeze related to coughs and colds - VIW
isolated/productive cough
no response to treatment
unilateral wheeze

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9
Q

first line investigations

A

fractional exhaled nitric oxide

spirometry with bronchodilator reversibility

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10
Q

further investigations

A

peak flow variability

direct bronchial challenge test

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11
Q

what do you use with direct bronchial challenge test?

A

histamine or metacholine

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12
Q

NICE guidelines asthma

A

Add SABA inhaler
add low dose ICS
add oral LTRA eg montelukast
Add LABA

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13
Q

Additional management of asthma

A

yearly flu jab
yearly asthma review
avoid smoking

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14
Q

Presentation of acute asthma

A

progressively worse SOB
fast resp rate
symmetrical expiratory wheeze on auscultation
reduced air entry

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15
Q

grading acute asthma - moderate

A

PEFR 50-75% predicted

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16
Q

grading acute asthma - severe

A

PEFR 33-50% predicted
resp rate >25
heart rate >110
unable to complete sentences

17
Q

grading acute asthma - life threatening

A

PEFR <33%
sats <92%
tired, no wheeze - silent chest
haemodynamic instability

18
Q

treating moderate acute asthma

A

nebulised beta 2 agonst - salbutamol 5mg
nebulised ipratropium bromide
steroids - oral prednisolone or IV hydrocortisone

19
Q

treating severe acute asthma

A

oxygen: maintain sats 94-98%
aminophylline infusion
consider IV salbutamol

20
Q

life threatening acute asthma

A

IV magensium sulphate infusion

intubation if severe

21
Q

ABGs in asthma

A

initially respiratory alkalosis as tachypnoea leads to CO2 drop
respiratory acidosis due to high CO2 is very bad sign

22
Q

monitoring acute asthma

A

resp rate, resp effort

peak flow, O2 sats, chest auscultation

23
Q

salbutamol and potassium

A

monitor serum potassium on salbutamol as can cause potassium to be absorbed from blood into cells and cause a fast heart rate

GP Conditions Year 4 (72 decks)

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