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21 Cards in this Set
- Front
- Back
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Define Asthma |
Chronic inflammation of airways leading to airway obstruction Reversible with bronchodilators |
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Risk factors of Asthma |
Allergies FHx Occupational triggers |
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Sxs of Asthma |
Sob Chest tightness Dry cough Wheeze Worse at night / cold |
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Key examination finding of asthma |
Widespread polyphonic expiratory wheeze |
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What pharmacologics can worsen asthma? |
Non selective beta blockers NSAIDs |
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Investigations of asthma |
Spirometry - <70% suggests obstructive pathology Reversibility testing of >12% in FEV1 Peak flow Diary -20% variability |
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What is FeNO and what can it be used for? |
Measured nitric oxide exhaled Marker of inflammation Above 40ppb - positive Smoking can make it unreliable |
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Long term Mx for asthma |
SABA e.g. salbutamol as required ICS regularly LABA Increasing ICS or add Leukotrine receptor antagonists e.g. montelukast |
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Supportive Mx of Asthma |
Annual flu jab Annual asthma review Regular exercise Smoking cessation (inc passive) |
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Sxs of acute exacerbation of asthma |
Progressive SOB Use of accessory muscles Raised RR Symmetrical wheezing ‘Tight’ on auscultation with reduced air entry |
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Moderate asthma exacerbation features |
Peak flow 50-70% best or predicted |
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Severe asthma exacerbation features |
Peak flow 33-50% best or predicted RR above 25 HR above 110 Unable to complete sentences |
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Life threatening asthma exacerbation features |
Peak flow less than 33% O2 sats less than 92% PaO2 less than 8kpa Becoming tired Confusion No wheeze or silent chest |
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Mx of mild asthma exacerbation |
Inhaled beta 2 agonists via spacer 4x of ICS for 2 weeks Oral steroids if ICS inadequate Antibiotics if bac infection Follow up in 48 hrs |
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Mx of moderate asthma exacerbations |
Consider hosp admission Nebulised beta 2 agonists Steroids |
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Mx of severe asthma exacerbation |
Hosp admission O2 to maintain sats at 94-98% Nebulised ipratropium bromide IV mag sulphate IV Salbutamol IV aminophylline |
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Define COPD |
Long term irreversible airway obstruction Involving emphysema and bronchitis |
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Sxs of COPD |
SOB Cough Sputum production Wheeze Recurrent infections |
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Investigations of COPD |
Spirometer - +ve of <70% (no reversibility testing) Chest X-ray to rule out other pathology FBC ECG/Echo |
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Long term Mx of COPD |
Smoking cessation Annual pneumococcal and flu vaccine Pulmonary rehab |
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Long term Mx of COPD |
Smoking cessation Annual pneumococcal and flu vaccine Pulmonary rehab Long term O2 for severe with chronic hypoxia |
