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13 Cards in this Set
- Front
- Back
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Pulmonary function test in asthma
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decreased FEV1
normal or decreased FVC decreased FEV1/FVC <75% |
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Reversibility in airway obstruction in asthma
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increase >12% and 200ml in FEV1 or <15% and 200ml in FVC after bronchodilation
absence of revesibility does not mean irreversibility |
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Stuff about PEF meter
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has diurinal variation
morning and afternoon after bronchodilation 20% change suggests inadequate controlled asthma <200 l/min suggests severe airflow obstruction |
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Bronchial provacation test
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use histamine or methacholine
high neg predictive value 95% positive test- decrease in FEV1 at least 20% at exposure to concentration of <16 mg/ml |
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Differential diagnosis of asthma
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upper airway- vocal cord problems, foreign body, airway edema
lower airway- COPD, bronchiectasis, cystic fibrosis, eosinophilic pneumonia, bronchiolitis obliterans churg strauss syndrome conversion disorder |
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Mild intermittent asthma
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symptoms <2 times a week
nighttime symptoms <2 times a month FEV1 or PEF > 80% PEF variability < 20% |
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Mild persistent asthma
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symptoms >2 times a week but less than once a day
nighttime symptoms >2 times a month FEV1 or PEF >80% PEF variability 20-30% |
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Moderate persistent asthma
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daily symptoms
daily use of B2 agonist nighttime symptoms >1 time a week FEV1 or PEF 60-80% PEF variability >30% |
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Severe persistent asthma
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continual symptoms
limited activity frequent nighttime symptoms FEV1 or PEF <60% PEF variability >30% |
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Action of theophylline
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bronchodilation
antiinflammatory mucociliary clearance diaphragmatic contraction |
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Action of anticholinergic
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reverse vagally mediated bronchospasm
decrease mucus gland hypersecretion good for beta blocker induced bronchospasm |
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Dose of steroid in asthma exacerbation
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mild- 0.5-1 mg/kg/day (40-60mg) for 3-10 days
severe- 1 mg/kg of prednisone equivalent every 6-12 hours for 48 hours or until FEV1 (PEFR) returns to 50% and then reduced to 60-80 mg/day until PEF reaches 70% |
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Criteria to discharge to home
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PEF or FEV1 has returned to >70
minimal symptoms |
