Flashcards in Obstructive Lung Disease Deck (97)
Which two conditions can be complicated by allergic bronchopulmonary Aspergillosis?
Asthma and CF
Allergic bronchopulmonary Aspergillosis is diagnosed by detected very high levels of what in the blood?
If someone aspirates a foreign body, which bronchus is it most likely to get stuck in?
Right inferior lobe bronchus
What is a clinical sign that is very specific to large airway obstruction, and should always be thoroughly investigated?
Stridor (inspiratory wheeze)
What are some investigations which may be performed in someone with a suspected large airway obstruction? Which is the most sensitive test?
Imaging (x-ray/CT) of the chest and neck, spirometry and bronchoscopy (the most sensitive test)
What medical therapy should be prescribed for a patient with newly diagnosed asthma (aged 17+) who has an infrequent, short-lived wheeze and normal lung function?
After starting/stopping a medication for asthma, how long should the new treatment regime be followed before considering making changes?
What medical therapy should be prescribed for a patient with newly diagnosed asthma (aged 17+) who has symptoms which indicate the need for maintenance therapy at presentation?
SABA + low-dose ICS
What medical therapy should be prescribed for an adult whose asthma remains uncontrolled following 4-8 weeks of treatment with a SABA alone?
If an adult's asthma remains uncontrolled following 4-8 weeks of treatment with a low-dose ICS and SABA, what treatment regimen should be tried next?
SABA + low-dose ICS + LTRA
You can consider decreasing maintenance therapy for asthma when symptoms have been controlled with current maintenance therapy for how long?
At least 3 months
If an adult's asthma remains uncontrolled following 4-8 weeks of treatment with a SABA, low-dose ICS and LTRA, what treatment regime can be tried next?
SABA + low-dose ICS + LABA +/- LRTA
In COPD, what combination of drugs is superior to any drug alone at increasing FEV1?
LABA + LAMA
Which vaccinations should be offered to all COPD patients?
Pneumococcal and influenza
If inhaled therapies are required for COPD, which medications can be offered first line to use as required?
SABA or SAMA
What medical therapy should be offered to patients with COPD who are limited by symptoms or have exacerbations despite treatment with a SABA or SAMA, and have no asthmatic features suggestive of steroid responsiveness?
LABA + LAMA (in addition to SABA or SAMA)
What medical therapy should be offered to patients with COPD who are limited by symptoms or have exacerbations despite treatment with a SABA or SAMA, and have asthmatic features, or features suggesting steroid responsiveness?
LABA + low-dose ICS (in addition to SABA or SAMA)
Give 5 examples of anti-inflammatory medications which can be used in the treatment of asthma and COPD?
Corticosteroids, cromones, LTRAs, methylxanthines, anti-IgE monoclonal antibodies
How can steroids be given in the treatment of asthma and COPD? Give an example of each type?
Inhaled (beclomethasone), oral (prednisolone), IV (hydrocortisone)
Name some side effects of inhaled corticosteroids?
Hoarse voice, oral candidiasis, increased risk of pneumonia (only in COPD)
Which medications should be given via a nebuliser in acute severe asthma?
Salbutamol (5mg) + ipratropium bromide (500mcg)
Which medications can be given IV in acute severe asthma?
Hydrocortisone (200mg) and magnesium sulphate (2g)
COPD is characterised by largely irreversible airway obstruction. This is an umbrella term for which conditions?
Chronic bronchitis and emphysema
What is the most effective way to prevent COPD?
Which 3 inflammatory cells are most involved in the pathophysiology of COPD?
CD8+ lymphocytes, neutrophils and macrophages
What are the 3 main pathological features of COPD?
Hypersecretion of mucus, small airway obstruction and alveolar destruction
When would cromones be used?
Prophylaxis of allergic asthma in children
Give an example of a monoclonal IgE antibody?
How are monoclonal IgE antibodies given?
As an IV injection every 2-4 weeks