Asthma and Allergy Flashcards
(87 cards)
1
Q
upper airway
A
nasal cavity –> pharynx –> larynx
2
Q
lower airway
A
trachea –> primary bronchi –> lungs
3
Q
classification of airway diseases
A
- infectious diseases
- obstructive lung diseases
- chronic obstructive pulmonary disease (COPD)
4
Q
what are the two subtypes of infectious diseases?
A
- upper respiratory tract infections
2. lower respiratory tract infections
5
Q
upper respiratory tract infections
A
- common cold
2. sinusitis
6
Q
lower respiratory tract infections
A
- respiratory syncytial virus (RSV)
- tuberculosis (TB)
- pneumonia
- cough
7
Q
obstructive lung diseases
A
- lung cancer
2. asthma
8
Q
COPD
A
- emphysema
2. bronchitis
9
Q
asthma
A
chronic inflammatory disease of the airways with the following clinical features…
10
Q
what are the clinical features of asthma?
A
- episodic or chronic symptoms of airway obstruction
- bronchial hyper-responsiveness to triggers
- evidence of at least partial reversibility of airway obstruction
- alternative diagnoses have been excluded
11
Q
etiology of asthma
A
specific cause of childhood asthma is unknown but it appears to be multifactorial
12
Q
environmental exposures that causes asthma
A
- allergens
- infections
- microbes
- pollutants
- stress
13
Q
biologic and genetic risks that causes asthma
A
- immune system
2. lung
14
Q
which is the most common chronic medical condition of childhood, causing significant morbidity?
A
asthma
15
Q
approximately how many children have asthma?
A
6.3 million children (9%)
16
Q
T/F: females have more childhood asthma
A
false, males > females
17
Q
T/F: females have more adult asthma
A
true, females > males
18
Q
T/F: higher SES people have more asthma
A
false, low SES > high SES
19
Q
T/F: people in urban areas have more asthma
A
true, urban > suburban
20
Q
which race has more people with asthma?
A
African-American
21
Q
what percent of asthmatics report onset of asthma prior to age 5?
A
80%
22
Q
what is the leading cause of hospitalizations?
A
asthma
23
Q
what are the two main types of childhood asthma?
A
- Type 1
2. Type 2
24
Q
type 1 childhood asthma
A
recurrent wheezing in early childhood
25
what triggers type 1 childhood asthma?
primarily triggered by common viral infections of the respiratory tract
26
type 2 childhood asthma
chronic asthma associated with allergy that PERSISTS into late childhood and often adulthood
27
pathogenesis of asthma
1. airflow obstruction from bronchoconstriction
2. inflammation (mixed with eosinophils), edema, and mucus
3. production of pro-allergic, pro-inflammatory cytokines
4. mediation of inflammatory process by chemokines
28
what are the 2 trigger types?
1. extrinsic (allergic) asthma
| 2. intrinsic (non-allergic/idiopathic) asthma
29
extrinsic (allergic) asthma
triggered activation of mast cells and histamine degranulation following exposure to allergens (dust, pollen, pet, dander, mold, food allergies)
30
intrinsic (non-allergic/idiopathic) asthma
1. tobacco smoke
2. air pollution
3. strong fumes/odors
4. chemicals in air
5. respiratory infections
6. exercise
7. cold air
8. anxiety
9. stress
10. gastroesophageal reflux disease
11. aspirin
12. NSAID meds
31
what percent of asthmatics have both tigger types?
10%
32
type of medications for asthmatics
1. rescue medications
| 2. controller medications
33
rescue medications
1. short-acting beta-agonist
| 2. anticholinergics
34
short-acting beta-agonist
albuterol (Proventil)
35
T/F: rescue medications should ALWAYS be brought to a dental appointment
true
36
controller medications
1. corticosteroids inhalers
2. systemic steroids
3. leukotriene receptor antagonists
4. oral xanthine
37
signs and symptoms of asthma attack
1. intermittent dry coughing
2. expiratory wheezing
3. shortness of breath
4. tightness of chest
5. symptoms often worse at night or early morning
6. daytime symptoms often linked to physical activities or play
7. hx of limitation of physical activities, fatigue
38
comorbidities of asthma
1. allergic rhinitis (hay fever)
2. chronic sinusitis
3. gastroesophageal reflux disease (GERD)
4. food allergies
5. atopic dermatitis, eczema
39
oral conditions and astham
1. candidiasis
2. gingivitis
3. chapped lips, coated tongue
4. decreased salivary flow rates
5. tooth erosion
6. possible dental caries
7. traumatic lesions
8. halitosis
40
what causes candidiasis in asthmatic pts?
steroid inhalers
41
what causes gingivities in asthmatic pts?
mouth breathing
42
what causes decreased salivary flow rates in asthmatic pts?
beta-adrenergic inhalers
43
what causes tooth erosion in asthmatic pts?
reflux disease
44
what causes traumatic lesions in asthmatic pts?
from inhalers, coughing, vomiting
45
what causes halitosis in asthmatic pts?
sinusitis, rhinitis
46
what factors can cause candida albicans in asthmatic pts?
1. immature immune system
2. abx
3. steroid inhalers
4. maternal infection
5. pacifiers
47
clinical features of candida albicans
1. creamy white plaques able to be wiped off
| 2. red patches that burn
48
tx for candida albicans
antifungal agents
49
different type of candidiasis
1. erythematous candidiasis
2. burning, fissured tongue
3. angular cheilitis
50
key questions to ask an asthmatic patient
1. what type of asthma do you have?
2. how severe is the asthma?
3. if drug-induced, which medicines are triggers?
4. when was your last attack?
5. do you have a cold or have you been sick recently?
6. were you hospitalized for the attacks? when?
7. what treatment are you receiving?
8. do you have a bronchodilator with you?
9. have you ever needed epinephrine to stop the attack?
51
key questions to ask the physician
1. are the medications that should be avoided as triggers?
2. what is the severity level of the patient's asthma?
3. have the attacks been so bad that the child needed epinephrine or had to go to the emergency department?
4. is the patient on corticosteroids? is the patient likely to be adrenal suppressed?
52
oral disease prevention
1. good oral hygiene
2. age-appropriate use of fluorides
3. healthy non-cariogenic diet
4. avoidance of acidogenic drink consumption following inhaler, especially at night-time when salivary flow rate is negligible
5. drink or rinse with water after inhaler use
53
T/F: meds should be taken prior to dental appointment
true
54
T/F: you should consult and MD if the asthmatic pt is on systemic steroids
true
55
when should you postpone tx for a asthmatic pt?
1. frequent severe attacks
2. nocturnal wheezing
3. sick
4. poor pulmonary fxn
56
what percent of asthmatics are allergic to aspirin or NSAIDS?
4%
57
T/F: aspirin or NSAIDS can be given to asthmatics
false, can't
58
what should be prescribed for pain for asthmatics?
acetaminophen
59
T/F: nitrous oxide analgesis is useful for mild to moderate cases
true
60
T/F: dental procedures, materials may trigger an asthma attack
true
61
what can be used to decrease aerosols during a dental procedure?
rubber dam
62
T/F: you should always be prepared to manage an acute asthma attack
true
63
how many children have food allergies?
6 million children
64
etiology of a food allergy
aberrant immune response caused by exposure to specific food protein
65
T/F: food allergies may be IgE-mediated, cell mediated or both
true
66
what are the common food allergens in children?
1. eggs
2. peanuts
3. cow's milk
4. soy
5. tree nuts
6. fish
7. shellfish
67
the common food allergen in children list accounts for what percent of food allergens?
90%
68
which common food allergens can persist to adulthood?
1. peanuts
2. tree nuts
3. fish
4. shellfish
69
gastrointestinal signs of food allergies
1. nausea, vomiting
2. diarrhea
3. abdominal pain
70
respiratory signs of food allergies
1. sneezing
2. rhinorrhea
3. nasal pruritus
4. bronchoconstriction
5. laryngeal edema
71
oral and cutaneous rxns to food allergies
1. urticaria (hives)
2. atopic dermatitis (eczema)
3. angioedema
4. oral allergy syndrome (edema and pruritus)
72
angioedema
diffuse soft tissue swelling
73
cause of angioedema
Ig-E mediated hypersensitivity due to foods or drugs
74
common sites for angioedema
1. extremeties
| 2. face (lips, tongue, eyelids)
75
serious sites for angioedema
1. oropharynx
| 2. larynx
76
clinical features of angioedema
1. rapid swelling
2. eryhema and itching
3. dyspnea
4. dysphagia
5. hoarseness
77
tx for angioedema
1. antihistamines
2. epinephrine
3. steroids
78
T/F: angioedema may be fatal
true
79
what is oral allergy syndrome (OAS) also referred to as?
pollen associated FA syndrome
80
what causes OAS
localized IgE mediated allergy usually to raw fruits and vegetables
81
OAS most commonly affects what type of patients?
patients who are allergic to pollens
82
T/F: OAS is usually restricted to the oral cavity
true
83
clinical manifestation of OAS`
after contact of fruit or vegetable...
1. rapid onset of itching with or without swelling, and/or tingling
2. occasionally a sensation of pruritus in the ear and/or tightness in the throat
84
T/F: symptoms of OAS are long-lived
false, short-lived
85
diagnosis of OAS
1. thorough hx taking
2. temporal association
3. clinical features
4. reproducibility of symptoms on every exposure
5. skin-prick-tests or blood test confirmation
86
temporal association time association
within 2-6 hours of ingestion
87
dental considerations for OAS
1. discuss major food allergens when making dietary recommendations
2. dental products may contain allergens
3. severe peanut allergies may develop to air-borne food allergens, including dental office
4. patient should carry epi-pen at all times
