Common Conditions > Asthma > Flashcards

Asthma Flashcards

(20 cards)

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1
Q

Pathophysiology of Asthma

A
  • Asthma is caused by inflammation of the bronchi, making them narrower
  • The muscle around the bronchi become irritated and contract, worsening the symptoms.
  • The inflammation can cause the mucus glands to produce excessive sputum, further blocking air passages
  • Ongoing inflammation can lead to scar tissue forming which thickens the airway walls
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2
Q

Signs and Symptoms

A
  • Wheeze
  • Coughing (can be worse at night or in the morning)
  • SOB
  • Chest tightness/pain
  • Other nonspecific symptoms in children might; hx of recurrent bronchitis, bronchiolitis, pneumonia, persistent cough with colds, recurrent croup
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3
Q

Causes of Asthma

A
  • Allergy related condition (or already irritated due to allergy eg hay fever)
  • Smoke, dust, fumes, mould, damp
  • Medicines (NSAIDS)
  • Stress
  • Sudden weather changes
  • Excersise
  • Adult onset
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4
Q

Pathophysiology of Recovery in Asthma

A
  • Smooth muscle returns to normal with salbutamol inhaler
  • Over time, the bronchial tree becomes less effective at recovering
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5
Q

Medical Risk Factors in Asthma

A
  • Previous hospital admissions
  • Anaphylaxis
  • High B2 agonist requirements, especially with little or no response
  • Brittle asthma
  • Multiple ED attendances in 12 months
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6
Q

Psychological/Behavioural Risk Factors in Asthma

A
  • Non compliance with treatment and medication
  • Failure to attend appointments/self-discharge
  • Psychosis, depression, other psychiatric illness or deliberate self harm
  • Alcohol or drug abuse
  • Smoking
  • Obesity
  • Severe stress, abuse, employment/income problems
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7
Q

Things you may see in your Primary Survey Asthma

A
  • Clearly abnormal resp rate
  • Tripoding
  • Exhaustion
  • Continual use of inhaler
  • Clammy/sweaty
  • Audible wheeze
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8
Q

History in Asthma

A
  • Patients requiring hospital usually have developed symptoms gradually over a number of hours (>6 hours)
  • There may be a hx of increasing wheeze/breathlessness which is often worse at night or early in the morning.
  • Respiratory infection, allergy, cold weather and physical excertion can also be triggers
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9
Q

Considerations in Asthma

A
  • Monitor oxygen and resps rate closely for signs of deteriorations
  • History taking must be thorough
  • Make sure to relisten to the chest
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10
Q

Life-Threatening Asthma Symptoms

A
  • Altered conscious lvl
  • Exhaustion
  • Cyanosis
  • Silent Chest
  • Poor respiratory effort
  • PEF <33% best or predicted
  • Arrhythmia
  • Hypotension
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11
Q

Sever Asthma Symptoms

A
  • PEF 33-50% best or predicted
  • SpO2 less than or equal to 92%
  • Inability to complete sentences in one breath
  • Tachycardia
  • Increased resps
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12
Q

Moderate Asthma Symptoms

A
  • Able to speak in sentences
  • Increasing symptoms
  • PEF >50-75% best or predicted
  • Tachycardia in children only
  • Increased resps in children only
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13
Q

Life-Threatening Asthma Management

A
  • Consider early and low threshold of enhanced care support
  • Prednisolone administration by PPs could be considered
  • IV Magnesium administration (CCP)
  • Adrenaline 1:1,000 IM
  • Assess for bilateral tensions
  • Time-critical transfer and ACHISE
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14
Q

Mild Asthma Symptoms

A
  • Below best lvl of functioning due to wheeze
  • PEF over 75%
  • No features of moderate or worse asthma
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15
Q

Asthma Algorithm

A
  1. Pt own inhaler, looking for improvement/deterioration
  2. Salbutamol nebuliser with oxygen attachment - reassessing (5mg with 5 min intervals)
  3. Ipratropium Bromide (nebulised 500mcg)
  4. Hydrocortisone/prednisolone (PP)
  5. IV Magnesium - CCP
  6. Adrenaline 1:1000 in life threatening asthma
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16
Q

Preventer Inhalers; what are they, what do they do?

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A
  • They are either steroidal inhalers, milder anti-inflammatories or long-acting beta agonists
  • These drugs act on the lung over a period of time to reduce the inflammatory reaction of asthma
  • Regular use can eradicate asthma symptoms
17
Q

Releiver Inhalers; what are they? how do they work in the body?

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A
  • If a patient uses them more than 3 times a week could suggest that there not managing their condition well
  • Short-acting beta agonist relievers work rapidly in the lungs to relax the smooth muscle spasm
  • Patients may sometimes have spacers that aid the administration
18
Q

Montelukast; why/when is it prescribed? how does it work in the body?

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A

Its a long term maintenance medication. May be prescribed if asthma is worsening despite using a preventer inhaler

The drug inhibits the action of leukotrienes, chemicals that contribute to inflammation and narrowing of the airways

Oral tablet

19
Q

Asthma Surgery

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A

Bronchial thermoplasty is a surgery offered to patients with sever asthma

The procedure uses heat on the muscles around the airway, preventing further narrowing of the airway to aid symptoms

20
Q

List of Asthma Differentials

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A
  • Smoke inhilations
  • Inhaled foreign body
  • Anaphalaxis
  • Cardiovascular causes
  • Anxiety attack
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