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Resp Disease
Asthma
Question | Answer |
---|---|
What is the definition of Asthma | Hyperreactivity of the airways |
What does hyperreactivity of the airways lead to | Bronchoconstriction & Bronchospasm Mucosal Swelling Increased production of thick tenacious mucus |
What two types of asthmas are there? | Extrinsic Intrinsic |
What kind of asthma is extrinsic | it is considered type one -allergenic |
what things can onset extrinsic asthma | pollen, mold, dander, foods Usually heredity Appears in children and adults younger than 30 excessive IgE antibody Early, late, biphasic dual reactions |
What kind of asthma is intrinsic | non allergenic Type II |
What things can onset intrinsic asthma | Air Pollutants exercise emotions usually no family history first seen after 30 |
What is the pathophysiology in asthma | Increase IgE- especially on mast cell Inhaled allergen or intrinsic Allergen reacts to IgE Mast cell degranulates and realeases chemicals Histamine-Leukotrienes |
What are signs, symptoms, and observations of asthma | Increased RR, WOB, HR, CO, BP Prolonged (forceful) expiration Decreased PEFR |
What are the breath sounds of asthma | Wheezing- will always hear on expiration If heard on inspiration more serious Crackles/Rhonchi |
What does it mean when you don't hear wheezes when listening to a distress asthma pt | no air movement- could be life threatening |
What are the ABG results associated with asthma | Increased pH decreased PaCO2- hyperventilation decreased PaO2 increased HCO3 |
What happens when mediators are released in asthma | bronchoconstriction bronchospasm pulmonary vasodilation airway inflammation increase mucus production |
If the PaCO2 rises dramically and suddenly during an asthma attack, what does that mean | No air movement-very dangerous the pt is wearing out |
What will an xray show with a pt with asthma | no significant change may be slightly darked and increased capacity due to air trapping |
What happens to the systolic BOP during an asthma attack | decrease during inspiration by 10-20 mmHg |
Which WBC increases during an asthma attack | eosinophils and sputum -usually around 1-3% but in asthma 10% |
What is the way to distinguish bronchitis/brocholitis from asthma | WBC eosinophils |
What will a PFT test show on an asthmatic | Decreased Airflow Low peak flow Increased RV, FRC Diffusion normal PFT normal during between exacerbation |
What is the the first treatment when it comes to asthma | prevention |
What are some medical treatments with pt that have asthma | asthma action plan immunotherapy |
What is immunotherapy | antigen extract to desensitize pt |
What is the 1st line of defense in asthma | maintenance- long acting beta 2- serevent Inhaled steroids- flovent |
What is the 2nd line of defense in asthma | Rescue Beta 2 (albuterol, xopenex) anticholinergic-ipratropium |
What is the 3rd line of defense in asthma | Emergency Oral and IV steroids |
What is the 4th in asthma | Xanthines-aminophyline (side effects) Magnesium Sulfate (IV) Heliox |
What are the special meds used in asthma | luekotriene antagonist (LTRA) - Montelukast Sodium (Singulair) |
What are the prophylatic names used in asthma | Cromolyn (intal) and nedocromil (tilade) |
When would you use xolair (omalizumab) | 12 yrs of age and above have a moderate to severe persistent asthma have asthma triggered by year-round allergens in the air continue to have asthma symptoms even though they are taking inhaled steroids |
What is the prognosis in asthma pts | asthma action plan- control of asthma monitoring peak flow |
What are other considerations in asthma treatments | heliox back to back-contiuous SABA |
True or False: A methocholine challenge can be used in the diagnoses of asthma | True |