Asthma_Adults

Question 1

Bronchodilator Response on LFT’s are indicated by:

Answer 1

Increase of FEV1 or FVC by 12% or greater and an absolute increase in FEV1 or FVC by 200mL.

In Children increase FEV1 or FVC by 12%

Question 2

What’s a patient asthma control test?

Answer 2

https://www.asthmaaustralia.org.au/sa/about-asthma/resources/asthma-control-test

Question 3

What are the signs of good, partial and poor control of asthma?

(Ref: Respiratory Check)

Answer 3

Criteria: 
Daytime sx < or equal to 2 days
Use of SABA < or equal to 2 days 
Any limitation of activity
Any night time sx

Good: daytime sx and SABA use < or equal to 2 days, nil limitation of activity, nil night time sx
Partial: 1-2 of above
Poor: 3 or more of above

Question 4

When would you consider ICS?

Answer 4

For patients who report

• asthma sx x2 or > times past month or
• waking due to asthma sx x1 or > more during the past month.

r/v the dose in 6-8 weeks

(Resp Check)

Question 5

1. When would you commence a medium to high dose of ICS?

2. If stepping down treatment, by how much would you decrease the dose of ICS?

Answer 5

1. Frequent night waking
   Poor lung function
2. reduceICSdose (25 to 50% dose reduction every 2 to 3 months)

(Ref: etg)

Question 6

During review of patient’s with asthma what are the main treatment issues to check?

Answer 6

Inhaler technique 
adherence 
reviewing current meds-need to step up or down 
asthma action plan (yearly)
Discuss comorbidities  

(Ref: etg)

Question 7

What is occupational asthma?

Answer 7

Asthma caused by exposure to agents encountered in the work environment without pre-existing asthma

(Ref: etg)

Question 8

What may constitute uncontrolled asthma?

Answer 8

1. ‘Uncontrolled’ asthma is defined as at least one of:
   poor symptom control
2. Asthma Control Questionnaire score consistently above 1.5[Note 7]
3. Asthma Control Test score consistently 15 or below[Note 8]
4. frequent flare-ups—2 or more flare-ups requiring courses of oral corticosteroids (each course lasting 3 days or more) in the last 12 months
5. severe or life-threatening flare-up(s)—at least one flare-up requiring hospitalisation, intensive care unit admission or mechanical ventilation in the last 12 months
6. airflow limitation—post-bronchodilator forced expiratory volume in 1 second (FEV1) less than 80% predicted post-bronchodilator; consider coexisting chronic obstructive pulmonary disease in these patients (seeoverlap of asthma and COPD).

(Ref: etg)