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Clinical Medicine

Differential of cough and wheezing in children? CRADLE (Cystic Fibrosis, Respiratory tract infection, Aspiration, Dyskinetic cilia, Lung and airway malformations, Edema)
REVERSIBLE obstruction of airflow due to bronchial hyperreactivity, and inflammation of airway? asthma
Risk factors for exacerbation: #1 ATOPY, URI, exercise induced, GERD, drugs (ASA), weather changes? asthma
Symptoms: wheeze, prolonged expiration, dyspnea, cough? asthma
Asthma Severity Classifications? 12 or older Symptoms day <2/wk, night <2/month; FEV1 > 80% predicted mild intermittent
Asthma Severity Classifications? 12 or older Symptoms day >2/wk but NOT daily, night >2/month; FEV1 > 80% predicted mild persistent
Asthma Severity Classifications? 12 or older Daily symptoms, night > 1/month; FEV1 60-80% predicted moderate persistent
Asthma Severity Classifications? 12 or older Cont. daily symptoms w/ limited activity, night frequent, FEV1 < 60% severe persistent
Ddx of? COPD, CHF, PE, Mechanical obstruction (tumor), Pulmonary infiltrate w/ eosinophilia, ACEI cough, vocal cord dysfunction asthma
Pathophysiolgy inculdes? smooth muscle dysfunction airway inflammation airway remodeling asthma
Triggers? exercise, URI, smoke, pollen, weather, animal fur or feathers, GERD asthma
Management of acute mild exacerbation: asthma? SABA
Management of acute moderate exacerbation: asthma? SABA (q 60 min for 1-3 hours) Oral steroids
Management of acute severe exacerbation: asthma? SABA (high dose q 20 min) Ipatropium (q 60 min) Systemic steroids (po or IV)
Acute ____ exacerbation? dyspnea only with activity; PEF ≥ 70% pred or best mild
Acute _____ exacerbation? dyspnea interferes with normal activity; FEV1 or PEF 40 - 69% pred/personal best moderate
Acute _____ exacerbation? dyspnea at rest, interferes with conversation; FEV1 or PEF < 40% pred/personal best severe
Complications of acute asthma exacerbation? respiratory failure pneumothorax death
Long term goals of asthma therapy? reduce impairment reduce risk
4 components of asthma care? Assessment and monitoring Control (environmental factors and comorbid conditions) Medications Education
Asthma *Control* Classification? symptoms <2 day/wk, <2night/month, FEV1 >80%, Rescue meds < 2days/wk well controlled
Asthma *Control* Classification? symptoms >2 day/wk, >2night/wk, but not nightly, FEV1 >60 - <80%, Rescue meds >2days/wk not well controlled
Asthma *Control* Classification? symptoms throughout the day, >4night/week, FEV1 <60%, Rescue meds several times per day very poorly controlled
Created by: duanea00