Asthma & Bronchospastic Diseases Flashcards Preview

AP: Cumulative > Asthma & Bronchospastic Diseases > Flashcards

Flashcards in Asthma & Bronchospastic Diseases Deck (40):
1

True or false: Asthma is a chronic inflammatory disorder

True

2

Asthma is underdiagnosed in what population?

Elderly

3

What is the primary contributor to fatal asthma?

Airway remodeling

4

What are some important preoperative considerations for the management of asthma patients?

Asthma related history: medicine**, triggers, hospitalizations

Other history: GERD, smoking, URIs etc

5

What type of test is used to assess occult bronchospasm and measure lung function?

Spirometry

6

Which lung volume Is the most reproducible PFT parameter?

FEV

7

What test is a better indicator of small airway involvement and is effort dependent?

FEF 25-75% spirometry

8

What will the arterial blood gas results look like in a patient with severe asthma?

Hypercarbia and hypoxia are indicative of severe disease

9

List a few of the precipitating causes of asthma

Allergens
Pharmacologic agents
Infections
Exercise
Emotional stress

10

30 to 80% of asthma patients also have what other exacerbating disease?

GERD

11

How does GERD Cause asthma or bronchospasms?

Aspiration of refluxed gastric contents

12

What are some common symptoms associated with aspirin induced asthma?

rhinitis and nasal polyps (70-80%)

13

The usage of what common drug during pregnancy is associated with childhood asthma?

Acetaminophen

14

25% of asthmatics smoke. why is this important?

They're at increased risk of laryngeal and bronchial reactivity and they have a reduced response to corticosteroids

15

How long before surgery do you have to stop smoking before there will be decreased airway reactivity?

7 days

16

How long before surgery do you have to stop smoking before they will be reduced post-operative respiratory complications?

4 weeks

17

Chronic use of what illegal substance can cause hypersensitivity pneumonitis?

Crack

18

Isolated use of what illegal substance is a bronchodilator?

THC, marijuana, Mary Jane, weed, pot, reefer. Call it what you will. Shit stinks.

19

What additives in wine can trigger bronchospasm?

Sulfites

20

What is the most common cause of an upper respiratory infection?

Viral infection

21

What impact do URIs have on asthmatics?

Asthmatics suffer greater increase in airway reactivity

22

The risk of asthma increases by what percent per unit BMI?

7%

23

What are some important anesthetic considerations for patients with asthma?

Additional albuterol
Anti-cholinergic
Corticosteroids
Benzodiazepines
Avoid histamine releasing agents (morphine)
Treat GERD
Judicious use of NSAIDs

24

If feasible, what type of anesthesia is ideal for asthmatics?

Regional

25

Which induction agent depresses airway reflexes effectively?

Propofol

26

Which induction agent can depress neural airway reflexes but can also increase secretions?

Ketamine

27

True or false: There is no conclusive evidence that IV lidocaine alone protects against intubation induced bronchospasm

True

28

All volatile anesthetics have what effect on airways

Bronchodilators

29

Which volatile anesthetic elicits the least amount of airway reactivity at lower doses?

Sevoflurane

30

Why should you be judicious when using cholinesterase inhibitors?

They can increase secretions and promote bronchospasm

31

What is the most common cause of perioperative bronchospasm?

In adequate depth of anesthesia

32

How is a Perioperative bronchospasm treated?

Confirm diagnosis
Deepen anesthesia
Adjust ventilation
Pharmacologic therapy

33

What type of pharmacologic therapy is used in the treatment of chronic asthma?

Corticosteroids

34

What type of pharmacologic therapy is used in the treatment of acute asthma?

Beta-2 adrenergic agonists

35

Inhaled corticosteroids require how long to work?

3-4 weeks

36

What are the onset and peak times in minutes for beta-2 adrenergic agonists?

Onset: 1-5 mins
Peak: 30-60 mins

37

What are some possible side effects of beta-2 adrenergic agonists?

"The asthma paradox"
Tolerance and tachyphylaxis
Cardiovascular effects (hyper)
Metabolic effects (hypo)

38

How do muscarinic antagonists work?

Block muscarinic receptors in smooth muscle
-Decrease vagal tone
-Direct bronchodilating effects

39

Which drug was formulated for asthma in 1922 and has since been replaced by beta agonist and glucocorticoids?

Theophylline

40

What is the link between asthma and magnesium?

Severe magnesium deficiency can cause bronchospasm

Magnesium is a proven bronchodilator