Asthma and COPD Flashcards
are boys or girls more chance in childhood? puberty/
chance of remission?
Childhood: Boys>girls
Puberty/adulthood: women>men
1/3 will remission in children and 1/3 of those will remain remmissed throughout adult life
Prenatal asthma risk factors?
Prematurity
Ethnicity low SES stress C section Maternal smoking
Postnatal risk factors asthma?
levels of endotoxins and allergens within the home (dust mites)
Viral and bacterial infecctions
-RSV and adenovirus
air pollution
antibiotic
acetaminophen exposure
obesity
Clinical presentations of Asthma
Cough, recurrent wheezing, chest tightness and SOB
Worse at night, with excercise, viral infection, exposure to allergens and irritants, changes in the weather, laughing or crying stress
Does a normal Spirometry exclude the disease of asthma?
NO it does not!!
what are the spirometry reversibillity criteria
12% improvement of FEV1 over the baseline and a total improvement of at least 200ml
rule of 2s in asthma classifying?
to determine intermittent
symptoms less then 2 times a week
SABA less then 2 days a week
less then 2 nighttime awakenings
how to determine Mild persistent of asthma
> 2 days a week of symptoms
> 2 excaberations in 2 months
how to determine moderate persistence of Asthma
daily symptoms and use of SABA or limitation
how to determine severe persistence of asthma
Several times per day and extremely limited
What is the major goal of treatment and management of astham
Provide the best quality of life through minimizing disease symptoms and abolishing disease exacerbations
what is the asthma control test?
used to help patients to help determine if they need to ask the doctor about their asthma
How is intermittent asthma treated?
SABA as needed
How is mild perseistence asthma treated
low dose ICS
how is moderate persistent asthma treated?
low dose ICS and LABA
how is extreme persistent asthma treated
High dose ICS and LABA and maybe omalizumab
What to treat astma exacerbation?
Bronchodilators, systemic glucocorticoids and O2
is brestfeeding a preventative measure to asthma
yes
what is the most common cause pf COPD and what is the next?
smoking/exposure to tobacco
history of Tuberculosis
what are common symptoms to COPD acute exacerbations?
increased
- dyspnea
- sputum purulence
- cough
- wheezing
what are some major comorbidities of COPD
- CAD
- Arrhythmias
- HTN
- HF
- lung CA
- depression and anxiety
- metabolic syndrome
- osteoprosis
characteristics of a “Pink Puffer”
more emphysema
- low BMI
- less muscle mass
- hyperinflation
- low DLCO
- decreased excercise capacity
- worst health status
- decreased sRAGEs
characteristics of “Blue Bloater”
Less emphysema
- High BMI
- more metabolic co morbidities
- cardiac compromise
- OSA
- less hyperinflation
- increased excerbations
- normal DLCO
- high levels of inflammatory markers IL-6 and CRP
what are the spirometry results of COPD: FEV1/FVC ratio, FEV1, reversibillity
FEV1/FVC
