Asthma

Question 1

What condition is characterised by reversible airflow obstruction?

Answer 1

Asthma

Question 2

What percentage of children have asthma?

Answer 2

5-10%

Question 3

what percentage of adults have asthma?

Answer 3

2-5%

Question 4

Which is a normal asthmatic likely to have more issues with, inspiration or expiration and why?

Answer 4

Expiration.
Because breathing out is a passive process compared to the powerful muscles which are able to suck in air on inspiration and overcome asthma obstruction.

Question 5

which antibody triggers a B-cell/T-cell interaction causing degranulation of mast cells?

Answer 5

IgE

Question 6

what is the consequence of degranulation of mast cells in the airway?

Answer 6

Narrowing of airway, oedema and excess mucous secretion

Question 7

What are the three features of asthma (triad) which cause airway narrowing?

Answer 7

1. Bronchial Smooth muscle constriction
2. Mucosal oedema
3. Excessive mucous secretion

Question 8

What drug is an anti-IgE drug, which prevents its production, causing mast cells to degranulate?

Answer 8

Omalizumab

Question 9

What are the three most common symptoms of asthma?

Answer 9

1. Cough
2. Wheeze
3. Shortness of breath

Question 10

What is meant by diurnal variation in regards to asthma symptoms?

Answer 10

Asthma symptoms that worsen overnight and in the early morning

Question 11

What would you expect to happen to someone’s PEFR measurement if they have difficulties breathing out and their lungs fill with air?

Answer 11

PEFR would decrease

Question 12

What are the five main triggers for asthma?

Answer 12

1. Unknown
2. Infections
3. Environmental stimuli (dust, smoke, etc.)
4. Cold air
5. Atopy

Question 13

Define, the genetic tendency to develop allergic disease

Answer 13

Atopy

Question 14

What test can be used to see what allergens individuals have?

Answer 14

Skin prick test

Question 15

what is meant by asthma biphasic response?

Answer 15

This is a two phase anaphylactic event. After someone has an asthma attack and recovers, they tend to have a response some hours later

Question 16

what are the two core drugs used to treat mild/moderate asthma?

Answer 16

1. Intermittent short-acting beta-adrenergic agonist
2. Low dose inhaled corticosteroid

Question 17

Which drug helps to relieve symptoms of asthma?

Answer 17

Short-acting beta-2 adrenergic antagonist

Question 18

Which drug helps to prevent further asthma attacks?

Answer 18

Inhaled corticosteroid

Question 19

If asthma become moderate/ more severe, what drugs would be used in treatment?

Answer 19

1. High dose inhaled corticosteroid
2. Regular long-acting beta-adrenergic agonist

Question 20

Give three examples of adjuvant therapy for severe asthma

Answer 20

1. Regular montelucast
2. Pulsed oral steroid (prednisolone)
3. Biologic therapy

Question 21

What does “nebulised” mean?

Answer 21

To turn a liquid drug into a very fine spray, so it can be breathed in by a patient

Question 22

Which muscle type is relaxed by beta-adrenergic agonists?

Answer 22

Bronchial smooth muscle

Question 23

By relaxing bronchial smooth muscle, what does this reduce?

Answer 23

1. Bronchoconstriction
2. Resting bronchial tone

Question 24

Which type of beta-adrenergic agonist MUST be used alongside a steroid inhaler?

Answer 24

Long lasting

Question 25

When should low dose corticosteroids be introduced into treatment in someone with mild/moderate asthma?

Answer 25

Use if short acting beta-2 adrenergic agonist has to be used >3 times each week

Question 26

what is the main risks when taking any steroid?

Answer 26

Adrenal suppression and osteoporosis

Question 27

what is a “spacer”?

Answer 27

A spacer is a device used to increase the ease of administering aerosolised medication from a enter-dosed inhaler.

Question 28

When is a spacer recommend for use in adults with asthma?

Answer 28

If their daily dose exceeds 800 micrograms

Question 29

If an adult has an acute asthma attack in the dental chair, how should you manage this patient?

Answer 29

Use a short-acting beta-2 adrenergic antagonist via a large-volume spacer. Give four puffs initially, followed by 2 puffs every 2 minutes. Max 10 puffs.

Question 30

If a child has an acute asthma attack in the dental chair, how should you manage this patient?

Answer 30

Use a short-acting beta-2 adrenergic antagonist via a large-volume spacer. Give a puff every 30-60 seconds. 10 puffs max.