Asthma for the Clinician Flashcards Preview

Jason's MD2 Core Conditions > Asthma for the Clinician > Flashcards

Flashcards in Asthma for the Clinician Deck (27)
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0
Q

what three things describe an asthma airway

A

bronchoconstriction, oedema, mucous

1
Q

pathophysiology of asthma?

A

mast cell and eosinophil degranulation in response to allergin,

2
Q

what happens to airways in chronic inflammation from asthma

A

structural changes, epithelial damage

3
Q

what 3 things is involved in airway remodelling from Asthma?

A

smooth muscle hyperplasia
goblet cell hyperplasia
thickening of basement membrane

4
Q

is there a genetic predisposition for asthma?

A

polygenetic

5
Q

what is AHR? meaning?

A

airway hyperresponsiveness (Not asthma but more likely to develop)

6
Q

Name 9 triggers of asthma?

A
Allergens
Pollutants (smoke, fumes)
URTIs
Cold dry air
exercise
emotion/anxiety
food
meds
GORD
7
Q

that meds can trigger asthma?

A

aspirin

betablockers

8
Q

what kind of flow in a wheeze?

A

turbulent

9
Q

when do you see pulsus paradoxus? 2 times?

A

asthma

pericarditis

10
Q

how does normal airway air flow?

A

laminar

11
Q

how are breathsounds and heart sounds during asthma attack?

A

reduced

12
Q

how to confirm asthma with spirometry?

A

200ml or 12% improvement with bronchodilator

13
Q

how to confirm asthma with peak expiratory flow?

A

20% variation day to day

14
Q

what is spirometry is unremarkable for asthma?

A

bronchoprovocation test

15
Q

5 other causes of wheeze?

A
bronchitis
obstruction (tumour, foreign body)
COPD exacerbation
vocal cord dysfunction
heat
16
Q

how to tell is wheeze is a vocal cord dysfunction?

A

expiratory wheeze concentrated in the larynx

17
Q

why would you have inhaled corticosteroids to treat someone’s moderate asthma?

A

prevent airway remodelling and mucous secretion rather than just treating symptoms

18
Q

medications in asthma should follow which principles?

A

lowest dose to achieve suitable asthma control and minimal side effects

19
Q

what not to forget when treating asthma in adults to be patient focused?

A

psychosocial factors and education

20
Q

how NOT to give Beta 2 Agonist?

A

don’t give LABA alone

21
Q

when use combo inhalers?

A

if corticosteroids alone doesn’t work LABA/ICS

22
Q

when use leukotriene receptor antagonists?

A

children, with tablets, not really great for adults

23
Q

side effects of beta agonists and ICS?

A

palpatations for SABA/LABA

oral thrush for ICS

24
Q

what is ciclesonide used for?

A

ICS that’s less harsh on vocal cord, used for singers with asthma

25
Q

how to ask for adherence?

A

how often do you renew your script?

26
Q

how to treat severe life threatening asthma attack? 5 things

A
admit to ICU
oxygen
oral or IV prednisolone
SABA nebulized
supportive breathing
IV magnesium