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Respiratory System > Clinical features of Astma in childhood and treatment > Flashcards

Clinical features of Astma in childhood and treatment Flashcards

1
Q

what part of the airway responds to stimuli in astma

A

bronchi and tranchea

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2
Q

what are the general symptons of astma

A

wheezing, coughing, shortness of breath, chest tightening

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3
Q

When are asthma symptoms worse

A

start or end of the day

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4
Q

what percent of children and adults have astma

A

children 10-15
adults 5-10

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5
Q

what is the most common gender to have asthma in children and adults

A

children - male
adults - female

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6
Q

what is the total cost of astma in the UK

A

around 2.5 billion annualy ( this includes lost productivity and benefits)(

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7
Q

what happens to the airway during an asthma attach

A

the smooth musles tirghnes, there is air trapped in the aveoli

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8
Q

atropy

A

the bodys predistription to develop allerigic diseases such as asthma , alleric rhinitis and atopic dermitis
it is the predistion to produce ige in response to a change in the external environment

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9
Q

what heridetry factor increases risk of astma

A

if aperivous family member has had astma or a atopic disease

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10
Q

what facgorsdoes maternal smoking in pregnacy have

A

fev1, wheezing illness, airway responsivness, asthma

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11
Q

epigenetic

A

study of how disease and enviroment can cause changes to how you genes work

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12
Q

can you grandmother smoking effect you

A

yes, it can turn on certain genes which can be passed to the mother

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13
Q

what occupations can make you more likley to have asthma, which substances do theyinvolvle

A

crab/proawns, amalzye/ subtilisin, antibions/ salbutamol, grains, rat urine protines, welding solder flux, twin pack paint

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14
Q

what are personal risk factor for astma

A

obesity, vitamen e, c and d defincies, hygenie hypothiesins

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15
Q

what sort of variations do you see in asthma
daily
weekly
annualy

A

daily, nocturnal/ early morning
weekly - better at weekends and holiday
manually - envirometna allergens

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16
Q

what can trigger an astma attachk

A

exercise, cold air , cigarette smoke, perfumes, utis, pets, tree and grass pollen , food , drugs

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17
Q

what is pmh for astma

A

chilhood astma, borochis or wehhes, eczema or hayfever
perinatal medical history

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18
Q

what is inclued in drug history

A

current inhalerous, complinace
b blockers, aspirin, ns aids
effect of prevous drus/ inhaliors

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19
Q

what is included in family history

A

asthma ns other atopic diseases

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20
Q

what is inclueded in social history

A

tobacco, recriota drus, vaping
pets
occupation
psycological astma

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21
Q

what are signs that someone may not have astma

A

finger clubing, cervial lymphadenopathy
stridor
asymmetical epanisino, dull percussion note - collapsed lung
crepiations - brochiates

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22
Q

what can cause generalised airflow obstuction

A

copd -
bronchioaties,
cycstic fibrosis

23
Q

what can causes strider

A

tumour
foreing bodys

24
Q

main way to test for astma

A

spirometry with it less than being 40% fev/fvc

25
Q

how do co levels differ for people with asthma and copd

A

higher in people with copd due to them less able to bind it to there blood cells due to destruced alveoi

26
Q

how to teste response to broncidliation

A

test baseline 15 before salubamol and 15 after salbulatom, see 12% increase in baseline at least

27
Q

how to test response to steriods

A

do it after two weeks
do baseline before starting
this sepaerts copid
use corticosteroids

28
Q

what pattern are you looking for in airflow overtime with peak flow

A

sawtooth pattern due to dips in moring and evenings

29
Q

what differene is sinee in exhaled nitic oxicd for astmatic

A

significatly hgiher

30
Q

how do histamine and methachoine testo for atmat

A

they can reduce fev/fvc and thus indicate astma as induce astma attack

31
Q

what blood test can be done to dected astma

A

total and specifc ige
full blod cout including eosionphilia

32
Q

what may be seen in a chest xray

A

hyperinflation, hyperlucent

33
Q

what are teh main symotes of moderate astma attach

A

able to spea full senacts
heart rate less tah 110
rr less than 25
higher fev/fvc of around 50-75%
sa02 greater than 92%
pa02 greater than 8kpa (60mmhg

34
Q

main symptones of moderate astma attack

A

Able to speak, complete sentences
HR < 110
RR < 25
PEF 50 - 75% predicted or best
SaO2 ≥ 92% (no need for ABG)
PaO2 ≥ 8kPa

35
Q

main symptons of severe astma

A

Inability to complete sentences in one breath
HR ≥110
RR ≥25
PEF 33 - 50% predicted or best
SaO2 ≥ 92%
PaO2 ≥ 8kPa

36
Q

main symptons of life threathing astma

A

Grunting
Impaired consciousness, confusion, exhaustion
Bradycardia/ arrhythmia/ hypotension
PEF < 33% predicted or best
Cyanosis
Silent chest
Poor respiratory effort

SaO2 < 92% (definitely needs blood gas!)
PaO2 < 8kPa
PaCO2 normal (4.6 - 6.0kPa)
`

37
Q

main symptons of near fatal astma

A

Raised PaCO2
Need for mechanical ventilation

38
Q

what are the aims of treatment for astma

A

no daytime symptons, no nighttime symptoms, no astma attacks, no limitatins on activity and exercise and a normal lung function
mimical side effects of medication

39
Q

best ways to control astma theraputily

A

exercise, weight managment, stoping smoking

40
Q

astma action plan

A

a document which all people with astma should carry, describes normal peak flow, which is there preventer oand deliver inhalier, who to call in an emergency and emercenty steps

41
Q

What is a pmdi

A

a metered inhalier - normal inhaleir - gives certin dose

42
Q

what is the puprose of a space

A

it diffuses the medcaiton into a tube for those who can have medication normally due to not being able to coordinate breath sounds

43
Q

what are dpi

A

dry powerderd inhaliors - need a certian level of inspiration for these to work

44
Q

what form of inhalior can salbutamol work in and what is its function

A

mdi and dpi, function as a reliver

45
Q

what form can terbutaline work in and what is its purpose

A

a dpi, reliver

46
Q

what are oral ways to reduce astma

A

leukotriene receptor antagoinsit
theophylline
prednisolone

47
Q

what are specialist options to reduce astma

A

omalizumab (anti ige)
mepolizumab (anti interleukin 5)
bronchial thermoplasty

48
Q

what are some hospialt resatmens for severe astma attach

A

iv steriods, iv magnesium, iv amiophylline

49
Q

what are some of the effects of iv magnesium

A

feeling of incontentice,

50
Q

what is a severe conditoin which you risk developing if you have asthma attack

A

pneumothorax

51
Q

what type of steriods are used daily for asthma as preventos

A

corticol

52
Q

what is the order of treatment for astma

A

cortical steriods, then laba, thne increase ibs, or add ltra or stop laba if non functional then refer for specialised

53
Q
A

Respiratory System (28 decks)

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