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Asthma
| Question | Answer |
|---|---|
| Most common disease among | children |
| Prevalence is increasing in | Industrialized countries, people with low income, blacks |
| Ethnicities affected (high to low) | Blacks>Whites>Hispanics |
| Age of diagnosis | 50% at age 2 , most by age 5 |
| Factors that increase rate of decline of lung function | Smokers/ emphysema> Asmathics> Non Asmathics |
| Are all asmathics Atopic | No |
| Significant risk factor for asthma | Genetic predisposition to atopy |
| Environmental risk factors | Low income, Small family size, Exposure to second hand tobacco, Allergen exposure, Urbanization, RSV infection, Decreased exposure to common childhood infectious agents |
| Risk factors for early , reccurrent wheezing with viral infections | Low birth weight, Male gender, Parental smoking |
| Asthma Triggers | Respiratory infections, Allergens, Environment, Emotions, Exercise, Drugs, Occupation |
| Respiratory infections that can trigger asthma | RSV, Rhinovirus, Influenza, Parainfluenza, Mycobacterium pneumonia, Chlamydia |
| Allergens that can trigger asthma | Airborne pollens, Dust mites, Animal dender, Cockroaches, Fungal Spores |
| Emotions that can trigger asthma | Anxiety, Stress, Laughter |
| Exercise that can trigger asthma | Exercise in cold, dry climate |
| Drugs that can trigger asthma | ASA, NSAIDs, Sulfites, Benzalkonium chloride, Nonselective Beta blockers |
| Occupations that can trigger asthma | Bakers, Farmers, Spice workers, Printers, Chemical workers, Plastic/ Rubber/ Wood workers |
| What is single most significant trigger of asthma in children | Respiratory infections |
| Environment that can trigger asthma | Col air, fog, ozone, sulfur dioxide, nitrogen dioxide, tobacco smoke, wood smoke |
| Most important precipitant of severe asthma exacerbation | Environment |
| What is an issue in patients with atopy/ nasal polyps | ASA/ NSAIDs |
| Signs of asthma | Expiratory or wheezing on auscultation, dry hacking cough, Sings of atopy (AR/ eczema), Reduced o2 saturation) |
| Symptoms of asthma | Episodic dyspnea, Chest tightness, Coughing (night), Wheezing/ Whistling when breathing, |
| Does patient always have signs and symptoms of sthma at the time of exam | NO |
| IS there a single diagnostic test | NO |
| Diagnosis | Patient history, Reversible Airway obstruction with SABA, Bronchoconstriction/ exercise challenge to determine if BHR exists, Spirometry |
| What does SABA stand for | Short acting Beta agonist |
| What does reversible airway obstruction with SABA provide? | Confirmation of asthma but not diagnosis |
| Are positive exercise challenges diagnostic | NO |
| What is Spirometry | Forced Expiratory Volume in one second - decrease of 15% or more following 6 minutes of near maximal exercise |
| When is severity most easily measured | When patient is not receiving treatment |
| Asthma Step 1 treatment | SABA PRN |
| Asthma Step 2 treatment | Low dose ICS or Cromolyn, LTRA, Nodocromil, Theophyline |
| Asthma Step 3 treatment | Low dose ICS +LABA, Medium dose ICS, or LOW dose ICS+LTRA, Theophyline or Zileuton |
| Asthma Step 4 treatment | Medium dose ICS + LABA, or Medium dose ICS +LTRA, Theophyline or Zileuton |
| Asthma Step 5 treatment | High dose ICS + LABA AND Consider Omalizumab for patient with allergies |
| Asthma Step 6 treatment | High dose ICS + LABA+ Oral Corticosteroid AND Consider Omalizumab for patient with allergies |
| Exercise induced bronchospasm sign | Drop in FEV1 of 15% or more from baseline |
| Exercise induced bronchospasm treatment | Pre treatment with SABA |
Created by:
pola