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21 Cards in this Set
- Front
- Back
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What is the triad of asthma characteristics?
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1) Inflammation of the airways
2) Airway hyperresponsiveness 3) Reversible airflow obstruction |
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What is the most common type of asthma? What is the pathophysiology behind it?
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Extrinsic asthma; we produce IgE to environmental antigens
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What are common triggers of asthma?
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Pollens, house dust, molds, cockroaches, animal dander, cold air, tobacco smoke, medications and exercise
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How will a patient with asthma present?
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Shortness of breath, wheezing, chest tightness, and cough
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What is the most common asthma finding on physical exam?
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Wheezing during inspiration and expiration
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What time of the day are asthma symptoms the worst?
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Night time
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What is the most common cause of wheezing?
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Asthma
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Besides asthma, what else can cause wheezing?
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CHF, COPD, lung cancer, cardiomyopathies
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What test is used to definitively diagnose asthma? What are the findings?
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Pulmonary function tests; decreased FEV1/FVC ratio (<.75)
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How can one prove reversible airway obstruction?
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Spirometry before and after bronchodilators, if bronchidilator results in FEV1/FVC ratio by at least 12%
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What does a peak flow meter measure?
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Peak expiratory flow rate, measures airway obstruction
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What are normal peak flow values?
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450-650 for men, 350-500 for women, mild > 300, moderate 100-300, severe < 100
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What is the bronchoprovocation test?
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Useful when asthma is suspected but PFTs are normal, measures airway narrowing in response to a stimuli (metacholine); hyperresponsive airways develop obstruction at low doses
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Is a chest x-ray any useful in diagnosing asthma?
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CXR is normal in mild asthma, but severe asthma reveals hyperinflation
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When is it necessary to obtain arterial blood gases?
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When the patient is in significant respiratory distress, patient should have low PaCO2; if PaCO2 is normal or increased then respiratory failure may ensue
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Why do patients with severe asthma attacks have low PaCO2?
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They have increased respiratory rate which should cause PaCO2 to decrease
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When patients with severe asthma attacks have normal or high PaCO2, what does that indicate? What should you do with these patients?
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Respiratory muscle fatigue or severe airway obstruction; patient should be hospitalized and mechanical ventilation considered
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What are the available treatment modalities for asthma?
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1) short-acting and long-acting beta2 agonists
2) inhaled or oral corticosteroids 3) Leukotriene modifiers 4) Cromolyn for prophylaxis |
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How should you treat a patient that has been admitted to the hospital for severe asthmatic attack?
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1) Inhaled beta2-agonist via nebulizer or metered dose inhaler (MDI); assess patient response to bronchodilators
2) Corticosteroids IV (or oral), taper off once clinical improvement is seen 3) Supplemental oxygen, keep O2 sat above 90% 4) Intubutation for patients in respiratory failure |
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When should one consider a patient to have aspirin-sensitive asthma?
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Consider this in patients with asthma, nasal polyps and a history of aspirin/NSAID use
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How is asthma classified?
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*Mild intermittent: symptoms 2 days/week and 2 nights/month
*Mild persistent: symptoms more than twice a week *Moderate persistent: symptoms once a day and more than 1 night a week *Severe persistent: symptoms throughout the day on most days and frequently at night |
