Clinical features of Astma in childhood and treatment

Question 1

what part of the airway responds to stimuli in astma

Answer 1

bronchi and tranchea

Question 2

what are the general symptons of astma

Answer 2

wheezing, coughing, shortness of breath, chest tightening

Question 3

When are asthma symptoms worse

Answer 3

start or end of the day

Question 4

what percent of children and adults have astma

Answer 4

children 10-15
adults 5-10

Question 5

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

Answer 5

children - male
adults - female

Question 6

what is the total cost of astma in the UK

Answer 6

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

Question 7

what happens to the airway during an asthma attach

Answer 7

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

Question 8

atropy

Answer 8

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

Question 9

what heridetry factor increases risk of astma

Answer 9

if aperivous family member has had astma or a atopic disease

Question 10

what facgorsdoes maternal smoking in pregnacy have

Answer 10

fev1, wheezing illness, airway responsivness, asthma

Question 11

epigenetic

Answer 11

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

Question 12

can you grandmother smoking effect you

Answer 12

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

Question 13

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

Answer 13

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

Question 14

what are personal risk factor for astma

Answer 14

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

Question 15

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

Answer 15

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

Question 16

what can trigger an astma attachk

Answer 16

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

Question 17

what is pmh for astma

Answer 17

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

Question 18

what is inclued in drug history

Answer 18

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

Question 19

what is included in family history

Answer 19

asthma ns other atopic diseases

Question 20

what is inclueded in social history

Answer 20

tobacco, recriota drus, vaping
pets
occupation
psycological astma

Question 21

what are signs that someone may not have astma

Answer 21

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

Question 22

what can cause generalised airflow obstuction

Answer 22

copd -
bronchioaties,
cycstic fibrosis

Question 23

what can causes strider

Answer 23

tumour
foreing bodys

Question 24

main way to test for astma

Answer 24

spirometry with it less than being 40% fev/fvc

Question 25

how do co levels differ for people with asthma and copd

Answer 25

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

Question 26

how to teste response to broncidliation

Answer 26

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

Question 27

how to test response to steriods

Answer 27

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

Question 28

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

Answer 28

sawtooth pattern due to dips in moring and evenings

Question 29

what differene is sinee in exhaled nitic oxicd for astmatic

Answer 29

significatly hgiher

Question 30

how do histamine and methachoine testo for atmat

Answer 30

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

Question 31

what blood test can be done to dected astma

Answer 31

total and specifc ige full blod cout including eosionphilia

Question 32

what may be seen in a chest xray

Answer 32

hyperinflation, hyperlucent

Question 33

what are teh main symotes of moderate astma attach

Answer 33

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

Question 34

main symptones of moderate astma attack

Answer 34

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

Question 35

main symptons of severe astma

Answer 35

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

Question 36

main symptons of life threathing astma

Answer 36

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) `

Question 37

main symptons of near fatal astma

Answer 37

Raised PaCO2 Need for mechanical ventilation

Question 38

what are the aims of treatment for astma

Answer 38

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

Question 39

best ways to control astma theraputily

Answer 39

exercise, weight managment, stoping smoking

Question 40

astma action plan

Answer 40

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

Question 41

What is a pmdi

Answer 41

a metered inhalier - normal inhaleir - gives certin dose

Question 42

what is the puprose of a space

Answer 42

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

Question 43

what are dpi

Answer 43

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

Question 44

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

Answer 44

mdi and dpi, function as a reliver

Question 45

what form can terbutaline work in and what is its purpose

Answer 45

a dpi, reliver

Question 46

what are oral ways to reduce astma

Answer 46

leukotriene receptor antagoinsit theophylline prednisolone

Question 47

what are specialist options to reduce astma

Answer 47

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

Question 48

what are some hospialt resatmens for severe astma attach

Answer 48

iv steriods, iv magnesium, iv amiophylline

Question 49

what are some of the effects of iv magnesium

Answer 49

feeling of incontentice,

Question 50

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

Answer 50

pneumothorax

Question 51

what type of steriods are used daily for asthma as preventos

Answer 51

corticol

Question 52

what is the order of treatment for astma

Answer 52

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