Resp. exam 2 Flashcards
(98 cards)
What does Asthma look like on Chest X ray?
May be normal
Hyperinflation
Flattening of diaphragm
Mucus plugging
Atelactasis
Pathophysiology of Asthma? (what is happening in the lungs?)
increased resistance to airflow due to AIRWAY NARROWING (normal physiology between the attacks)
6 triggering factors to cause asthma?
Airway irritants, environmental pollutants (including occupational exposure)
Exercise, cold air , dry air
Upper and lower resp. tract infection
Aspirin (COX inhibition leading to overproduction of leukotriens)
Beta blockers
Gastro esophageal reflux
Clinical Features of Asthma?
SOB Cough , chest tightness Wheezing Dyspnea Worst at night
Physical findings of asthma in between attacks?
In between attacks a patients exam will be normal, this is a reversable disease.
Physical findings of asthma during an attack?
Tachypnea
Insp. and exp. wheezing
Use of accessory muscles
Pulsus paradoxus
Paradoxical movement of abdomen
Diagnosis of Asthma: what happens to the peak flow expiratory rate?
decreased
Diagnosis of Asthma: what happens to the FVC, FEV1, FEV1/FVC?
decreased
Diagnosis of Asthma: does Residual volume increase or decrease and why?
Increase bc of air trapping
Diagnosis of Asthma: What is the patients diffusion capacity?
Normal
**In a patient with Asthma, how can you improve their flow rate?
bronchodilators
In Asthma, they have Bronchial hyper-responsiveness to what?
histamine
People with Asthma have a high count of what blood component?
Eosinophils creating Eosinophilia
What should the CO2 status and O2 status of an asthmatic be?
Should be Hypocapnia (low CO2)
mild hypoxemia.
Two medications that can trigger asthma?
Aspirin (cox inhibition leading to overproduction of leukotrienes)
Beta blockers
When is asthma the worst?
at night
Treatment of asthma? (5 drug types)
Anti-inflammatory drugs
Bronchodilators
Anti-leukotrienes-Zileuton
Montelukast (singulair) and Zafirlukast
Anti-IgE monoclonal therapy
Name anti-inflammatory drug types for asthma?
inhaled steroids
systemic steroids
Cromolyn
How does the anit-inflammatory drug Cromolyn work?
prevents mast cell degranulation, useful in PROPHYLAXIS not for an acute attack of asthma. Also used to prevent exercise induced asthma.
What is a common medication used as part of the therapy for Asthma to try and prevent an attack from reflux?
Prilosec (PPI)
How come ASA is a trigger for Asthma?
Cox inhibition leads to an overproduction of leukotrienes.
Is asthma considered a reversible or non reversible dz?
Reversible bc between attacks they are “normal” or have no symptoms even though their PFTs will not be “normal”
What is paradoxical movement of the abdomen that you sometimes see in patients who are having an asthma attack?
opposite movement of the abdominal wall during inspiration and expiration. During inspiration the diaphragm will pull upward which is opposite from normal inspiration when the diaphragm pulls downward.
What kind of lung dz is asthma considered?
obstructive