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asthma and cystic fibrosis Flashcards

(49 cards)

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1
Q

Prevelence of asthma

A

Blacks more than whites
Hispanics get it most, but black women die from it most

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2
Q

Asthma definition

A

combo of bronchial hyperresponsiveness and reversible expiratory airflow limitation

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3
Q

asthma significance

A

more ppl are getting it, but less ppl are dying
-women get it more aft puberty

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4
Q

Asthma triggers

A

-acute infection: reduced airway diameter and increased inflammation
-viral stuff
-cockroaches
-any other allergy stuff
-any other artificial irritants

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5
Q

smoking and asthma

A

faster decline in lung func
increased sensitivity to triggers
-more visits to HCP
-worse response to treatment

21% of ppl with asthma keep smoking

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6
Q

exercise induced asthma/bronchospasm

A

airway obstruction from changes to mucosa from hypervntilation, cooling/rewarming air, and capillary leak

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7
Q

drugs and food to avoid with asthma

A

aspirin and NSAIDs
salicylic acid
BETA ADRENERGIC BLOCKERS
ACE inhibitors
Sulfite preservatives (fruit, beer, wine, salad bars)
yellow dye no. 5

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8
Q

correlation bt asthma and GERD

A

-reflux can trigger bronchoconstriction and aspiration

-asthma meds might worsen GERD symptoms (Beta agonists relax LES)

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9
Q

Is asthma genetic?

A

yea

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10
Q

Early phase response of asthma

A

right after exposure
mast cells release inflammatory mediators
-causes vasodilation and increased capillary permeability; itching; smooth muscle spasms/airway narrowing; goblet cell mucus production

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11
Q

Late phase response of asthma

A

inflammation finally
only happens in 50% of patients

use corticosteroids to treat

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12
Q

Remodeling

A

changes in bronchial wall f/ chronic inflammation
-fibrosis, smooth muscle hypertrophy, mucus hypersecretion, angiogenesis

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13
Q

manifestations

A

obvi- wheezing coughing, SOB, chest tightness

hyperinflation and long expiration from air trapping in narrow airways

Acute attack= wheezing (just on expiration at first, but on inspiration and expiration if it gets worse)

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14
Q

weird fact ab wheezing

A

mild attack = loud wheezing
severe attack = wheezing w/ forced expiration or not at all

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15
Q

what happens to pH in asthma?

A

alkalotic at first, but then becomes acidotic as patient tires

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16
Q

asthma compilcations

A

pneumonia
tension pneumothorax
status asthmaticus
ARF

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17
Q

status asthmaticus

A

super acute asthma attack
-hypoxia, hypercapnia, ARF
-big emergency

progresses to hypotension, bradycardia, and resp/card arrest

bronchodilators and corticosteroids don’t help

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18
Q

treatment of mild asthma attack

A

inhaled bronchodilator and oral corticosteroids
-monitor VS

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19
Q

Presentation of severe asthma attack

A

scared (agitated if hypoxemic)
-tachycardia and tachypnea
-accessory muscles
-PEFR < 50%

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20
Q

treatment of severe asthma attack

Study These Flashcards
A

give O2 (get PaO2 > 60 and get SaO2 > 93%)
-monitor PEFR, ABG, VS
-bronchodilators and corticosteroids

SILENT CHEST IS EMERGENCY! –> GET HCP

21
Q

drugs for short term

Study These Flashcards
A

Bronchodilators
-SABA (albuterol, lasts 4-8 hrs)
-Also inhaled anticholinergics (usually used w/ SABA)

Anti-inflammatory stuff
-IV corticosteroids

22
Q

Drugs for long terms

Study These Flashcards
A

Bronchodilators
-LABA
-methylxanthines
-anticholinergics

Antiinflammatory
-oral or inhaled corticosteroids
-leukotriene modifiers
-anti-IgE

23
Q

Pros and cons of SABA

Study These Flashcards
A

Pros
-stops mast cell’s inflammatory mediators
-can take b4 exercise

Cons
-if use too much, causes tremors, anxiety, tachycardia, palpitations, and nausea
-not long term

24
Q

LABA

Study These Flashcards
A

e.g. Salmeterol r formoterol
used with ICS
-every 12 hrs
-not for acute attacks

25
pros and cons of corticosteroids
Pros -reduces bronchial hyperresponsiveness -blocks late-phase respose -stops inflammation -good long term Cons -candidiasis -hoarseness -dry cough ***can get better w/ spacer and gargling
26
oral vs inhaled corticosteroids
oral: use 1-2 weeks for chronic asthma ICS: use long term on fixed schedule --> takes 24 hrs to work
27
nonperscription combo drugs
OTC bronchodilators -ephedrine and guaifenesin --> don't use *stimulate CV ad CNS
28
Inhaler types
MDI DPI Nebulizers
29
how much is too much inhaler?
no more than 2 canisters/month
30
DPI pros and cons
Pros -breath activated -less coordination needed -no spacer Cons -low FEV = inadequate inspiration -can't find all meds as DPIs -powder can clump
31
Nebulizers
turn meds into mist that're given through face mask or mouth piece -requires air compressor or O2 generator
32
goal for PEFR
80% of personal best
33
which organs does CF affect
lungs, pancreas/biliary duct, intestines
34
which chromosome is fucked up in CF?
#7 --> CFTR
35
what essentially is CF?
inability to excrete NaCl --> excessive mucus formation --> clogged glands --> scarring --> organ failure
36
CF sweat
super salty
37
progression of CF in lungs
-start in lower regions, small airways --> move to bigger -mucus becomes dry and tenacious -cilia motility is decreased -thick secretions in bronchioles cause scarring, air trapping, and hyperinflation
38
common complications of CF
chroninc airway infections --> MDR pneumonia develops -chronic inflammation of airways
39
vasculature in CF
chronic hypoxia and arterial vasoconstriction leads to remodeling of blood vessels --> eventually pulmonary htn, enlarged arteries, and cor pulmonale
40
pancreas stuff in CF
gets clogged up -can't secrete stuff for digestion --> lose nutrients -combo type 1+2 diabetes due to impaired exocrine func
41
GI stuff in CF
-liver enzymes go up --> cirrhosis -gallstones, gerds, percreatitis -portal hypertension -DIOS = distal intestinal obstruction syndrome
42
how to diagnose babies with cf
messed up stools resp issues fam history
43
appearance and sex stuff with CF
prodruding abdomen, but emaciated extremeties reproductie issues
44
diagnostic study for CF
sweat test with pilocarpine (over 60 is positive)
45
drugs to give CF ppl
bronchodilators inhaled hypertonic saline (7%) inhaled dornase alpha ***metiabolized way quicker in CF ppl than in normal ppl --> may need higher and longer doses
46
how to treat pseudomonas
tobramycin
47
how to deal with pneumothorax CF
-chest drainage -possibly pleural sclerosis -if hemoptysis, bronchial artery embolisation
48
CF acute care
CPT O2 antibiotics corticosteroids adequate nutrition
49
exercise in CF
helpful for removing secretions, but kinda dangerous -make sure to drink gatoade for fluid and electrolytes

Patho (44 decks)

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