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AP II > Asthma & Bronchospastic Diseases > Flashcards

Asthma & Bronchospastic Diseases Flashcards

1
Q

True or false: Asthma is a chronic inflammatory disorder

A

True

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2
Q

Asthma is underdiagnosed in what population?

A

Elderly

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3
Q

What is the primary contributor to fatal asthma?

A

Airway remodeling

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4
Q

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

A

Asthma related history: medicine**, triggers, hospitalizations

Other history: GERD, smoking, URIs etc

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5
Q

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

A

Spirometry

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6
Q

Which lung volume Is the most reproducible PFT parameter?

A

FEV

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7
Q

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

A

FEF 25-75% spirometry

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8
Q

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

A

Hypercarbia and hypoxia are indicative of severe disease

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9
Q

List a few of the precipitating causes of asthma

A 
Allergens
Pharmacologic agents
Infections
Exercise
Emotional stress
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10
Q

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

A

GERD

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11
Q

How does GERD Cause asthma or bronchospasms?

A

Aspiration of refluxed gastric contents

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12
Q

What are some common symptoms associated with aspirin induced asthma?

A

rhinitis and nasal polyps (70-80%)

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13
Q

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

A

Acetaminophen

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14
Q

25% of asthmatics smoke. why is this important?

A

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

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15
Q

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

A

7 days

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16
Q

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

A

4 weeks

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17
Q

Chronic use of what illegal substance can cause hypersensitivity pneumonitis?

A

Crack

18
Q

Isolated use of what illegal substance is a bronchodilator?

A

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

19
Q

What additives in wine can trigger bronchospasm?

A

Sulfites

20
Q

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

A

Viral infection

21
Q

What impact do URIs have on asthmatics?

A

Asthmatics suffer greater increase in airway reactivity

22
Q

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

A

7%

23
Q

What are some important anesthetic considerations for patients with asthma?

A 
Additional albuterol
Anti-cholinergic
Corticosteroids
Benzodiazepines
Avoid histamine releasing agents (morphine)
Treat GERD
Judicious use of NSAIDs
24
Q

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

A

Regional

25
Q

Which induction agent depresses airway reflexes effectively?

A

Propofol

26
Q

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

A

Ketamine

27
Q

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

A

True

28
Q

All volatile anesthetics have what effect on airways

A

Bronchodilators

29
Q

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

A

Sevoflurane

30
Q

Why should you be judicious when using cholinesterase inhibitors?

A

They can increase secretions and promote bronchospasm

31
Q

What is the most common cause of perioperative bronchospasm?

A

In adequate depth of anesthesia

32
Q

How is a Perioperative bronchospasm treated?

A

Confirm diagnosis
Deepen anesthesia
Adjust ventilation
Pharmacologic therapy

33
Q

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

A

Corticosteroids

34
Q

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

A

Beta-2 adrenergic agonists

35
Q

Inhaled corticosteroids require how long to work?

A

3-4 weeks

36
Q

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

A

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

37
Q

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

A 
"The asthma paradox"
Tolerance and tachyphylaxis
Cardiovascular effects (hyper)
Metabolic effects (hypo)
38
Q

How do muscarinic antagonists work?

A

Block muscarinic receptors in smooth muscle

  • Decrease vagal tone
  • Direct bronchodilating effects
39
Q

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

A

Theophylline

40
Q

What is the link between asthma and magnesium?

A

Severe magnesium deficiency can cause bronchospasm

Magnesium is a proven bronchodilator

AP II (32 decks)

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