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27 Cards in this Set
- Front
- Back
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what is the characteristic triad of asthma?
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airway inflammation
airway hyperresponsiveness reversible airflow obstruction |
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extrinsic vs intrinsic asthma?
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extrinsic:
- atopic pts (incr IgE) - assd with eczema/hay fever - begins at young age intrinsic: - not related to atopy or envirnomental triggers |
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what (2) medications are associated with triggering asthma?
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beta-blockers
aspirin |
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what is the definition of pulsus paradoxis?
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decr systolic BP (>12 mmHg) on inspiration
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what are 3 common causes of pulsus paradoxis?
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cardiac tamponade
tension pneumothorax asthma |
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what is required for the diagnosis of asthma?
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spirometry:
- decr FEV1 - decr FEV1/FVC (<0.75) |
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when is airflow obstruction considered reversible?
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incr in FEV1 or FVC (>12%) following bronchodilator inhalation
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what are the ranges of peak flow rates in adults?
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normal:
- 450-650 L/min (men) - 350-500 L/min (women) mild: >300 L/min moderate: 100-300 L/min severe: <100 L/min |
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what is a sign that an asthmatic may be decompensating (respiratory failure)?
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if PaCO2 is nl/increased, be worried
- asthmatics should have incr RRs -> decr PaCO2 - if fatigued, PaCO2 levels will rise - hospitalize or ventilate mechanically |
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what is salmeterol (advair)?
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long acting beta2-agonist
(good for nightitme/exercise induced asthma) |
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what is the onset/duration of albuterol?
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onset: 2-5 minutes
duration: 4-6 hours |
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when do you give an asthmatic systemic (IV/oral) corticosteroids?
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for acute severe exacerbations
(PFM <60%) (intiate taper w/ inhaled corticosteroids!) |
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what should you think when you see nasal polyps?
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cystic fibrosis
aspirin-sensitive asthma |
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what are the characteristics of mild intermittent asthma?
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sxs 2+ times/week
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what are the characteristics of moderate persistant asthma?
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daily sxs
frequent exacerbations |
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what are the characteristics of severe persistant asthma?
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continual sxs
frequent exacerbations limited physical activity |
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what are the long-term control meds used for mild intermittent asthma?
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none
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what are the long-term control meds used for moderate persistant asthma?
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daily inhaled (low-dose) corticosteroid
or cromolyn/nedocromil (mast-cell stabilizers) or methylxanthine (theophylline) or antileukotriene (monteleukast) |
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what are the long-term control meds used for severe persistant asthma?
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daily inhaled (high-dose) corticosteroid
+ long acting inhaled B2-agonist or methylxanthine + systemic corticosteroids |
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what are the characteristics of bronchiectasis?
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permanent, abnl dilation/destruction of bronchial walls
damaged cilia (onset usually childhood) |
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half of all cases of bronchiectasis are due to ____.
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cystic fibrosis
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what are (4) clinical features of bronchiectasis?
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chronic cough (lots of stinky sputum)
dyspnea hemoptysis (can be fatal) persistant pneumonias |
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what is the diagnostic study of choice for bronchiectasis?
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high-resolution CT
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what is the defect in cystic fibrosis?
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defect in chloride channel protein (CFTR) -> impaired chloride and water transport -> thick secretions
(chromosome 7) |
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what (5) systems are affected by CF?
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respiratory tract
exocrine pancreas sweat glands intestines genitourinary tract |
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what is the most frequent pulmonary infection seen in CF?
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pseudomonas
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what are (5) important treatments in CF?
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pancreatic enzyme replacement
fat-soluble vitamin supplements *chest PT annual influenza vaccine antibiotics for infections |
