Flashcards in Respiratory: Asthma Deck (14):
1
What is asthma?
A chronic inflammatory disorder of the airways resulting in reversible airway obstruction - inflammation, bronchoconstriction and mucus
2
What is the consequence of repetitive episodes of asthma?
The airway undergoes remodelling, there is damaged epithelium and increased smooth muscle thickness
3
What are some allergens that can trigger asthma?
Indoor allergens: pets, dust mites, mould
Outdoor allergens: pollens, tobacco smoke, pollutants
Others: Cold air, exercise, medications such as NSAIDs and beta blockers
4
What are some of the signs and symptoms of asthma?
Recurrent wheeze, breathlessness, chest tightness
Cough - dry, worse at night, exercise induced
Variable airflow obstruction
5
What is a wheeze?
A high pitched, expiratory musical sound from narrowed airways (compression or obstruction)
6
How can you assess difficulty in breathing?
In adults - measure RR and look for accessory muscle use
In children - recession of the IC muscles, nasal flaring, tracheal tug (because in children the skin and tissues are more pliable)
7
What is atopy?
A genetic tendency to develop allergies eg eczema, hayfever, allergies and asthma all grouped together
So look for these in PMH
8
What is the gold standard of diagnosis of asthma?
Spirometry however due to long waiting lists, it is more practical to give a months trial of bronchodilators and measure peak flows. If they help then continue to treat as asthma
9
How can you help pts to prevent asthma exacerbations?
Change bedding, pillows etc every few years
Get fresh air
Stop smoking
10
What is a short acting beta agonist?
Salbutamol inhaler (use with a spacer in children)
If used more than 3x a week or there are nocturnal symptoms eg coughing or wheezing more than once a week need a preventer inhaler
11
What does the brown preventer inhaler do?
Contains a steroid to inhibit inflammatory cells and mediators.
Aims to prevent attacks rather than treat attacks
12
What is a long acting beta agonist?
Salmeterol inhaler
Has a slower onset of action so not used for acute asthma attacks
13
How would you treat a severe asthma attack?
- give oxygen
- give salbutamol and atrovent nebulisers back to back
- get IV access in case you need to give IV salbutamol
- be prepared to intubate and admit to ITU
14