| 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 |
