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Asthma
Clinical Medicine
Question | Answer |
---|---|
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 |