Asthma

Question 1

What is Asthma?

Answer 1

Reversible Inflammatory Airway Obstruction

Question 2

Symptoms of Asthma?

Answer 2

Dyspnoea, Cough, Polyphonic Wheeze + Tight chest

Episodic, varies day to day.

Question 3

Investigation for Asthma?

Answer 3

1) Respiratory Examination
2) Spirometry OR Peak Flow if moderate/high risk
3) FEV1 : FVC Ratio <0.7, reversed by SABA.

Question 4

Management of Chronic Asthma?

Answer 4

1) SABA
2) Inhaled Corticosteroid
3) Enhance dose/muscarinic antagonist
4) Oral Steroid + Specialist referral

Question 5

Signs of Mild Asthma Exacerbation?

Answer 5

Worsening symptoms, SpO2 >92%, RR <30 (adults) Eating/talking well

Question 6

Signs of Severe Asthma Exacerbation?

Answer 6

SpO2 <92%, Peak Flow 33-50% normal, RR > 30 (adults), Audible Wheeze, Tachycardia

Question 7

Sign of Life-threatening Asthma Exacerbation?

Answer 7

Peak Flow <33%, Loss of consciousness, Silent Chest, cyanosis

Question 8

Managing Mild Exacerbation of Asthma?

Answer 8

1) History - baselines, current medication, past episodes

2) Salbutamol + ICS 14 days

Question 9

Managing Severe Exacerbation of Asthma?

Answer 9

1) History - baselines, current medication, past episodes
2) O2
3) Salbutamol (Neb) + Hydrocortisone (IV)
4) Ipratropium (Neb) + Magnesium (IV)

Question 10

Managing Life-Threatening Asthma Exacerbation?

Answer 10

1) History - baselines, current medication, past episodes
O SHIT ME
2) O2
3) Salbutamol (Neb) + Hydrocortisone (IV)
4) Ipratropium (Neb) + Theophylline (Neb)
5) Magnesium (IV) + Escalate