Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine - Year 1 - Term 2 > W2 - Asthma Features and Management > Flashcards

W2 - Asthma Features and Management Flashcards

1
Q

Define asthma. Is it obstructive or constrictive?

A

Asthma: Inappropriate constriction of bronchiole smooth muscle, or inflammation of bronchioles. It’s an obstructive disorder from Greek (aazein) meaning “to gasp for breath”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In asthma, how are inspiration, expiration and ventilation affected?

A

Increased resistance means expiration phase is most affected. During inspiration the airway is pulled open by physical forces, so it’s easy to get air in

Reduced diameter of bronchioles impedes ventilation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In terms of pathophysiology, what 2 things make up asthma? They’re initiated by airway inflammation mediated by the immune system

A

Widespread narrowing of airways

Increased responsiveness of trachea and bronchi to stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How many people in the UK have asthma?

How many in the UK die per day from asthma? How many are preventable?

A

5.4 m have asthma

3 die per day - 2 are preventable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What % of kids and adults have asthma in the UK and in what gender is it more common

A

10-15% of kids
5-10% of adults

Kids: Male more common
Adults: Female more common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 6 risk factors of asthma?

A

Hereditary
Smoking
Occupation
Obesity
Diet
“Hygiene hypothesis”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Disease clustering of asthma in families suggests a genetic basis.

What inheritable trait is it caused by?

Asthma is more likely if this trait is inherited from whom?

Asthma is more likely if parents have any of which 4 diseases?

A

Inheritable trait: Atopy
Maternal atopy most influencial (3x father)
More likely if parents have: allergic rhinitis, asthma, hay fever or eczema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Maternal smoking during pregnancy does what to the lung and makes what 3 things more likely? What is the “grandmother effect”?

A

Reduces FEV1 in lung

Increases wheezy illness airway responsiveness and asthma in kids

Grandmother effect - likely epigenetic phenomena where smoke switches on genes which increase asthma in subsequent generations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What % of adult onset asthma is linked with occupation? Give 3 examples of jobs

A

10-15% linked with occupation

Bakers, painters, shellfish workers are some examples

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In the diet, what 3 vitamins, 1 mineral and 3 fats might be contributing to an increase in asthma prevalence?

A

Less vitamin C, D and E

Selenium

Poly unsaturated fats, oily fish, margarine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Name the 9 symptoms of asthma

A
  • Wheezing
    • Coughing
    • SOB (dyspnoea)
    • Difficulty in expiration
    • Chest tightness
    • Green or yellow sputum (occasional)
    • Symptoms worse at start/end of day
    • Weekly variation (occupation, better at weekends/holidays)
    • Annual variation (environmental allergens)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name the 9 asthma triggers
(Remember, triggers are different for each individual)

A
  • Exercise
    • Cold air
    • Cigarette smoke
    • Perfume/strong scent
    • URTIs
    • Pets
    • Tree or grass pollen
    • Food
      Drugs (aspirin/NSAIDS)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do we diagnose asthma? What 6 things can we look for?

A

Investigations can support - no single test to diagnose asthma

Look for:
-Recurrent episodes of symptoms
-Symptom variability
-Absence of symptoms of alternative diagnosis
- Recorded observation of wheeze
- Personal history of atopy
- Historical record of variable PEF or FEV1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What 3 past medical history can we look for if suspecting asthma?

A
  • Childhood asthma, bronchitis or wheeze in infancy
  • Eczema
  • Hayfever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

In a clinical history of asthma, which 3 things should you ask, relating to drugs?

A

Current inhalers (check technique), other asthma therapies, compliance

Beta blockers, aspirin, NSAIDS

Effects of previous drugs/inhalers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In a clinical history of asthma, what 4 things should you ask relating to social history?

A

Tobacco, recreational drugs, vaping

Pets

Occupation (past and present)

Psychological effects

17
Q

What 6 signs suggest it’s probably not asthma?

A

Finger clubbing
Cervical lymphadenopathy
Stridor
Asymmetrical expansion
Dull percussive note
Crepitations

18
Q

What is the first line objective testing for asthma, and why?

For whom is this test less reliable, and what does the test do?

A

Fractional exhaled nitric oxide (FeNo). It’s cheaper.

FeNo is an eosinophilic inflammatory marker in lungs and nose.

The test is less reliable in smokers

19
Q

What will spirometry results look like for someone asthmatic?

A

Less than 70% FEV1 if symptomatic
Normal spirometry if asymptomatic

20
Q

If a spirometry test shows less than 70% FEV1, what other 3 tests can be done and what illnesses can they exclude?

A

Full pulmonary function test - exclude COPD/emphysema

Carbon monoxide gas transfer test - exclude COPD if reduced

Reversibility test - exclude COPD if no change

21
Q

What does a carbon monoxide gas transfer test do?

A

Measures gas transfer of CO to Hb across alveoli

22
Q

What does a reversibility test entail?

A

User B2 agonist (or oral steroid). After 15 mins for agonist, or 2 weeks for steroids, check FEV1

23
Q

If a spirometry test returns a normal value but you still suspect asthma, what other 6 tests can you do?

A

Peak flow monitoring

Airway responsiveness

Exhaled nitric oxide

Chest x-ray

Skin prick test

Total and specific IgE

24
Q

Name the 4 “types” of asthma

A

Moderate
Severe
Life Threatening
Near Fatal

25
Q

What does ability to speak, heart rate, resp rate and peak flow look like for: Moderate asthma, severe asthma and life threatening asthma?

A

Ability to speak
Moderate: Complete sentences
Severe: Unable to speak sentences in one breath
Severe: Grunting, confusion

Heart rate:
Mod: <110
Sev: >110
LT: Bradycardia/arrhythmia

Resp rate:
Mod: <25
Sev: >25
LT: Cyanosis/silent chest

Peak flow:
Mod: 50-75%
Sev: 33-50%
LT: <33%

26
Q

What do oxygen saturation and arterial blood gas/PaCO2 look like for moderate, severe, life threatening and near-fatal asthma?

A

Moderate
>92%
No need for ABG
PaCO2 reduced

Severe
>92%
PaCO2 reduced

Life threatening
SaO2 <92%
PaCO2 normal

Near fatal
PaCO2 raised
Need for mechanical ventilation

27
Q

Name 5 non-pharmacological management for acute asthma

A

Exercise
Weight loss
Patient education and self-management plans
Smoking cessation
Flu/pneumococcal vaccination

28
Q

What are the 6 aims of treatment for asthma?

A
  • No daytime symptoms
    • No night-time wakening
    • No need for rescue medication
    • No asthma attacks
    • No limitations on activity including exercise and normal lung function
      Minimal side effects from medication
29
Q

Outline the stepwise approach to managing asthma

A
  1. Monitor with low-dose ICS
  2. Regular preventer - Low dose ICS
  3. Low dose ICS + inhaled LABA
  4. Increase ICS. If LABA works keep it otherwise stop. Consider LTRA, S R theophylline, LAMA
  5. Increase ICS. Add forth drug, e.g. LTRA, SR theophylline, beta agonist tablet, LAMA. Refer to specialist
30
Q

What indicates that you may need to escalate an asthma patient’s medication?

A

If they’re using 3+ doses of short acting B2 agonists a week

31
Q

Name the 3 broad categories of pharmacological management of asthma

A

Inhaled therapy
Oral therapy
Specialist treatments

32
Q

Name 3 types of oral therapy

A

Leukotrine receptor antagonist
Theophylline
Prednisolone

33
Q

Name 3 types of specialist treatment

A

Omalizumab
Mepolizumab
Bronchial thermoplasty

34
Q

Name 4 types of inhaler

A

pMDI (Metered Dose Inhaler)
pMDI with spacer
Dry Powder Inhaler (DPI)
Short-Acting B2 Agonists (SABA) Relievers

SABA used for flare ups and exposure to triggers

35
Q

What 5 ways should you treat a mild/moderate asthma attack?

A

Increase inhaler use
Oral steroid
Treat trigger
Early follow up
Back up plan

36
Q

What 4 drugs can you give in hospital for moderate/severe asthma attack

A

Nebulisers - salbutamol/ipratropium

Oral/IV steroid

Magnesium

Aminophylline

Medicine - Year 1 - Term 2 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions