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24 Cards in this Set
- Front
- Back
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define asthma
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CHRONIC inflammatory condition of the lung airways
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highest mortality rate is found in what group with asthma?
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African American
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kid has Intermittent dry cough and expiratory wheeze most common, worse at night, and chest pain...what do they likely have
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asthma
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if you see chest pain in kids what should you think is the cause?
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lungs or GI
heart not normally affected in kids |
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mom brings in the kid and she says he just has decreased physical activity. You ask if he has Difficulty keeping up with peers in physical activity, she says yes, and that he is generally fatigued. What does the kid have?
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asthma
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cold or dry air can precipitate what?
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asthma
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there are many, but what are 3 things that can have wheezing that are NOT asthma?
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Allergic rhinitis*
Chronic sinusitis* Gastroesophageal reflux (GER)* |
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Improvement > ___ of FEV1 in response to albuterol is consistent with asthma
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>12%
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what are the problems with spirometry in diagnosing asthma in kids? 3
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Patient must be compliant
Generally not reliable until >6 YO Results must be reproducible |
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what is the 3 strikes rule?
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Patient needs controller therapy if child has:
Asthma symptoms or requires quick-relief medicine >3 times per week Awakens at night due to asthma >3 times per month Requires a refill for a quick relief inhaler >3 times per year |
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what is the “Step-up, Step-down” Approach?
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used in asthma
Initiate higher-level controller therapy in the beginning Step-down once good asthma control achieved |
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what are the 3 quick relief meds for asthma?
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Short-acting beta-agonists (albuterol):
“Rescue” medications Prevent exercised-induced bronchospasm Anticholinergic agents (ipratropium bromide): Less potent than beta-agonists Use in combination with above Systemic glucocorticoid therapy: Use in combination with above two |
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if a pt has mild intermittent asthma, what medications do you have them on?
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NO LONG TERM MED
only the rescue inhaler (if higher rating, then they are on long term med) |
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what should you use to educate parents on how to effectively use their drug management?
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Refer back to the stop-light system
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Allergies, severe lower resp tract infections and male gender are all early childhood risk factors for what?
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Persistent Asthma
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Ask about previous bronchodilator and steroid use!
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some parents will tell you they already treat with aunt millie's albuterol
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what are xrays for kids with asthma like?
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appear normal or only have subtle changes
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if a child is diagnosed with asthma, how often will he/she have to visit the doc?
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Regular clinic visits every 2-4 weeks until good asthma control is achieved
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besides drug therapy, what is an important treatment for asthma?
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Eliminate or Reduce Environmental Triggers!!!
Pet dander Mattress and pillow covers Annual influenza immunizations Dust and dust mites |
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What are some subtle CXR changes that indicate asthma? (2)
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Hyperinflation
Flattened Diaphragms |
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Diagnosis of Asthma relies primarily on ________
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History!
Not like to show up on PE unless they are having an exacerbation |
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A child presents with prolonged expiratory breathing,ronchi/crackles, and an expiratory wheeze. What's going on?
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Exacerbation of Asthma
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What are some early childhood risk factors for persistent asthma? (4)
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– Wheezing apart from colds
– Male gender – Low birth weight – Environmental tobacco smoke exposure |
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Asthma in children is more common in __________ locales.
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Metropolitan
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