asthma_brainscape_cards_comprehensive

Question 1

How many people worldwide are affected by asthma?

Answer 1

~300 million

Question 2

What percentage of the U.S. population had asthma as of 2012?

Answer 2

8% (~20 million people)

Question 3

What is the global prevalence range of asthma?

Answer 3

5-16%

Question 4

At what age can asthma occur?

Answer 4

Any age (childhood > adulthood)

Question 5

How much does the U.S. spend annually on adult asthma?

Answer 5

$18 billion

Question 6

How many physician office visits are related to asthma annually in the U.S.?

Answer 6

~10.5 million

Question 7

How many ER visits are related to asthma annually in the U.S.?

Answer 7

~2 million

Question 8

How many asthma-related deaths occur annually in the U.S.?

Answer 8

4000 deaths

Question 9

What characterizes asthma’s pathophysiology?

Answer 9

Chronic and recurrent bronchial hyperresponsiveness and obstruction

Question 10

What cells and mediators are involved in asthma inflammation?

Answer 10

CD4+ T cells, eosinophils, IgE, T-helper cells (TH2)

Question 11

What is the role of IgE in asthma?

Answer 11

Regulates mast cell degranulation, leading to bronchospasm after antigen exposure

Question 12

Is asthma inflammation reversible?

Answer 12

Yes, inflammation and bronchial constriction are reversible

Question 13

What happens with recurrent airway inflammation in asthma?

Answer 13

Can lead to airway remodeling with permanent lung changes (mucosal cell hyperplasia, endothelial cell injury, subepithelial fibrosis)

Question 14

What occupational exposures are risk factors for asthma?

Answer 14

Smoke, dust, fumes, dust-mites, pollen, dander, cold exposure, metals

Question 15

What is the impact of obesity on asthma risk?

Answer 15

BMI > 30 kg/m2 increases incidence of asthma by 2-3x

Question 16

What are the main risk factors for asthma?

Answer 16

Occupational exposure, smoking, obesity, allergic rhinitis, family history

Question 17

What are common signs and symptoms of asthma?

Answer 17

Shortness of breath, cough (worse at night), wheezing, chest tightness

Question 18

When does asthma-related wheezing most commonly occur?

Answer 18

More commonly during expiration

Question 19

Does the absence of wheezing exclude asthma?

Answer 19

No, it does not exclude the diagnosis

Question 20

What are severe symptoms indicating respiratory failure in asthma?

Answer 20

Prolonged expirations, increased work of breathing, retractions, lack of air movement, decreased breath sounds

Question 21

What historical points are important for hospitalized asthma patients?

Answer 21

Acute vs chronic symptoms, medication compliance, previous hospitalizations, intubation history, triggers

Question 22

What are risk factors for asthma-related death?

Answer 22

Previous severe exacerbation, multiple hospitalizations, high SABA usage, comorbidities, low socioeconomic status, psychosocial problems, psychiatric disease, illicit drug use

Question 23

What conditions are in the differential diagnosis of asthma in infants and children?

Answer 23

Allergic rhinitis, sinusitis, foreign body, viral bronchiolitis, cystic fibrosis, heart disease

Question 24

What conditions are in the differential diagnosis of asthma in adults?

Answer 24

COPD, CHF, pulmonary embolism, tumors, medication-induced (ACE inhibitors), vocal cord dysfunction

Question 25

What is the gold standard diagnostic test for asthma?

Answer 25

Spirometry demonstrating reversibility of airflow obstruction with bronchodilator

Question 26

What spirometry result indicates bronchodilator reversibility in asthma?

Answer 26

Improvement of ≥ 12% & 200 mL in FEV1 after treatment

Question 27

What does a positive methacholine test indicate in asthma?

Answer 27

A decrease in FEV1 by 20% with ≤ 8 mg/dl of methacholine

Question 28

What is the indication for using fractional exhaled nitric oxide (FeNO) in asthma?

Answer 28

To assist in diagnosis and monitor eosinophilic inflammation, especially in allergic asthma

Question 29

What findings on chest X-ray might you see during an asthma exacerbation?

Answer 29

Typically normal, but can show hyperinflation, bronchial wall thickening, hilar prominence

Question 30

What is the initial treatment for a mild to moderate asthma exacerbation?

Answer 30

Oxygen if needed (SaO2 ≥ 90%), albuterol (up to 3 doses in the first hour), corticosteroids if no immediate response to SABA

Question 31

What is the goal SaO2 during severe asthma exacerbation treatment?

Answer 31

SaO2 ≥ 90%

Question 32

What are the treatment options for severe asthma exacerbation?

Answer 32

Oxygen, albuterol, corticosteroids, consider adjunctive treatments (ipratropium, magnesium, heliox, non-invasive ventilation)

Question 33

What is the first-line treatment for intermittent asthma?

Answer 33

PRN SABA or ICS-Formoterol

Question 34

What is the preferred treatment for severe persistent asthma (Step 6)?

Answer 34

High Dose ICS + LABA + oral steroid (prednisone)

Question 35

What is the treatment approach for exercise-induced asthma?

Answer 35

Albuterol 15-30 min prior to exercise, montelukast (second-line), cromolyn sodium (alternative)

Question 36

What is the mechanism of omalizumab in asthma treatment?

Answer 36

Monoclonal antibody that prevents binding of IgE to receptors on basophils and mast cells

Question 37

What is the benefit of mepolizumab in asthma treatment?

Answer 37

Reduces ER visits and hospitalizations, particularly in patients with high blood eosinophil counts

Question 38

What is the mechanism of dupilumab in asthma treatment?

Answer 38

Anti-IL-4 receptor alpha-subunit monoclonal antibody that blocks IL-4 and IL-13 signaling in Th2 inflammation

Question 39

What percentage of asthma patients also have GERD?

Answer 39

20-80%

Question 40

What is the impact of pregnancy on asthma?

Answer 40

Symptoms worsen in 1/3 of patients, especially between 13-24 weeks

Question 41

What are the risks of poorly controlled asthma during pregnancy?

Answer 41

Preeclampsia, prematurity, decreased growth of child, cesarean delivery

Question 42

What percentage of patients with asthma experience exercise-induced asthma?

Answer 42

>90%

Question 43

What are the diagnostic criteria for allergic bronchopulmonary aspergillosis (ABPA)?

Answer 43

(+) aspergillus skin test, increased IgE and/or IgG to Aspergillus, central bronchiectasis

Question 44

What is occupational asthma?

Answer 44

Asthma induced by workplace exposure in a patient without preexisting asthma