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Clinical 4th Year > Chapter 6- COPD/ASTHMA > Flashcards

Chapter 6- COPD/ASTHMA Flashcards

1
Q

What’s the aim of asthma management

A 
No daytime symptoms 
No nighttime awakening
No rescue medication 
No asthma attacks 
No limitations on activity 
Normal lung function (FEV1 and/or PEF>80%)
Minimal side effects
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2
Q

Should you use a spacer for MDI ?

A

Yes

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3
Q

What does the acronym SIMPLE stand for in asthma management

A 
S=stop smoking 
I= inhaler technique 
M=monitoring (PEF)
P=pharmacotherapy 
L=lifestyle 
E=education
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4
Q

What vaccines should you recommend to asthmatics

A

Pneumococcal vaccination and annual flu vaccination

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5
Q

Symptoms of asthma

A

SoB
Wheeze
Chest tightness
Dry irritating cough

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6
Q

Pathology of asthma

A

Airflow obstruction
Bronchohyperresponsiveness
Inflammation

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7
Q

Eosinophils high in asthma?

A

Yeh

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8
Q

What medication is good for airway inflammation

A

Inhaled corticosteroid

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9
Q

What medication is good for smooth muscle dysfunction

A

long acting beta agonist (formoterol, salmeterol)

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10
Q

Smoking history is most like to be asthma or COPD?

A

COPD

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11
Q

The asthma control test refers to the past how many weeks?

A

4 weeks

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12
Q

A score of <20 on the asthma control test indicates what?

A

Further recommendations regarding management of asthma

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13
Q

Life threatening asthma attack has a PEF of what?

A

<33%

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14
Q

Person have an acute severe asthma attack has a PEF of what

A

33-50%

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15
Q

Person Having a moderate asthma attack has a PEF of what?

A

50-75%

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16
Q

What’s target oxygen sats in asthma

A

94-98%

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17
Q

In acute asthma attack due you use driven by oxygen or air?

A

Oxygen

18
Q

What is bronchiectasis

A

Abnormal widening of airways, fluid fills gap making prone to infection

19
Q

What is omalizumab

A

Anti-immunoglobulin E for treating severe persistent allergic asthma in people aged 6 and over

20
Q

Are asthma symptoms often bad at night

A

Yeh

21
Q

List effects of long term oral corticosteroids

A 
Adrenal suppression 
Glucose intolerance 
Decreased bone mineral density 
Cataracts and glaucoma 
Growth failure
22
Q

How does omalizumab work

A

Monoclonal antibody that binds to IgE

23
Q

Omalizumab should only be considered for what patients

A

Patients with convincing IgE mediated asthma

24
Q

Anti-IgE (omalizumab) licensing criteria

A 
Step4/5 asthma 
FEV1<80% 
>2 severe exacerbation
\+ve skin prick test or +ve RAST to common aeroallergen
IgE>50 and <700lu/ml
25
Q

What can the dose of omalizumab be from? What dose it depend on?

A

75-375mg

Depends on patients body weight and baseline serum IgE concentration

26
Q

Name four drugs that can be used for (steroid sparring effects) in difficult to treat asthma

A

Cyclosporin
MTX
Gold
Terbutaline

27
Q

T-cell profiling can classify asthma patients into two groups

A

Th2 high

Th2 low

28
Q

Patients with Th2 high asthma have airway eosinophilia which is promoted by what?

A

IL-5

29
Q

What is mepolizumab

A

Monoclonal antibody against IL-5 licensed as add on treatment for use in severe refractory eosinophilic asthma

30
Q

Mepolizumab is approved for patients who have an eosinophil count of at least what?

A

150 cells per microlitre

31
Q

What is reslizumab

A

Monoclonal antibody for treating eosinophilic asthma inadequately controlled by ICS

32
Q

How long are immunosuppressants given for initially in difficult to treat asthma

A

Three month trial

33
Q

Name three cardinal symptoms of COPD

A

Dyspnea
Chronic cough
Sputum production

34
Q

List risk factors for COPD

A 
Smoking 
Air pollution 
Low birth weight 
Recurrent lung infection 
Cannabis smoking 
Low socioeconomic status 
Alpha-1 antitrypsin deficiency
35
Q

Key features of blue bloaters ‘chronic bronchitis’

A

Inflammation change= mucocillary dysfunction

And increase goblet cell secretions (excess mucous)

36
Q

What’s the FEV1 values for each of the stages of COPD

A 
1= FEV1 >80%
2= FEV1 50-80%
3= FEV1 30-50%
4= FEV1 <30 or <50+ chronic respiratory failure
37
Q

How is staging/assessment of severity in COPD determined?

A

Severity of symptoms
Spirometry
Risk of exacerbation

38
Q

List the treatments for COPD

A 
Smoking cessation 
Vaccination 
Bronchodilators 
Corticosteroids 
Pulmonary rehab 
Oxygen therapy 
Surgical interventions 
Carbocysteine
39
Q

Less that what value is pO2 life threatening

A

<8kPa

40
Q

What is magnesium?

A

Smooth muscle relaxant can be put in saline or glucose

41
Q

What’s the oxygen target in COPD

A

88-92% (don’t want too much oxygen as won’t get rid of CO2)

Clinical 4th Year (9 decks)

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