B4-032 Asthma

Question 1

the profound healthcare costs of asthma stem from

Answer 1

acute management with urgent cares and ERs

Question 2

coughing in asthma is typically at what times of day?

Answer 2

early morning or night

Question 3

what type of cell is predominate during acute exacerbation of asthma?

Answer 3

neutrophils

mast cells and eosinophils also present

Question 4

associated with […] that is often reversible with/without treatment

Answer 4

variable airflow obstruction

Question 5

association of molecular mechanisms to certain phenotypes

Answer 5

endotypes

Question 6

treatment targeted at a patient’s specific endotype

Answer 6

precision medicine

Question 7

T2- High Phenotypes

3

Answer 7

• early onset allergic asthma
• late onset eosinophilic asthma
• aspirin exacerbated respiratory disease

Question 8

• onsets before age 12
• strong allergic and family hx
• positive allergen skin tests and IgE

Answer 8

early onset allergic asthma

Question 9

• adult onset
• steroid resistant
• comorbid chronic rhinosinusitis and nasal polyposis
• blood/sputum eosinophilia
• high IL5, IL13, IgE, and exhaled NO

Answer 9

late onset eosinophilic asthma

Question 10

• asthma
• chronic rhinosinusitis with nasal polyposis
• acute respiratory tract reactions to ASA or COX-1 NSAIDs

Answer 10

AERD

Question 11

expiratory wheeze

Answer 11

asthma

Question 12

stridor is associated with

Answer 12

vocal cord dysfunction

Question 13

what test diagnosis asthma?

Answer 13

no single test

Question 14

severity of asthma is determined by

2 things

Answer 14

impairment
risk

Question 15

chronic therapies for asthma

5

Answer 15

• trigger avoidance
• inhaled corticosteroids
• leukotriene inhibitors
• biologics
• allergy shots

Question 16

single steps to reduce exposure are generally

Answer 16

uneffective

Question 17

standard of care for treatment of asthma

Answer 17

inhaled corticosteroids

Question 18

once the symptoms are well controlled

Answer 18

deescalatate steroids

Question 19

rule of 1/3s

Answer 19

pertains to symptoms during pregnancy
1/3 no symptoms
1/3 get worse
1/3 get better

Question 20

risk associated with poorly controlled asthma in pregnancy

4

Answer 20

• increased perinatal mortality
• low birth weight
• preeclampsia
• preterm birth

Question 21

the move to precision based medicine puts what treatment at the forefront for severe asthma?

Answer 21

biologics

Question 22

does wheezing have to be present for a diagnosis of asthma?

Answer 22

no

Question 23

symptoms of asthma

Answer 23

• wheezing
• coughing
• recurrent bronchitis
• shortness of breath

Question 24

common triggers

Answer 24

• exposure to irritants
• infection
• weather changes
• anxiety
• reflux disease

Question 25

identifying and recognizing [...] is a key component of well controlled asthma

Answer 25

triggers

Question 26

can acid reflux contribute to asthma symptoms?

Answer 26

yes if poorly controlled

Question 27

are bronchodilators meant for daily use?

Answer 27

no

Question 28

help control the airway inflammation associated with asthma and prevent symptoms

Answer 28

long term controller medications

Question 29

open airways quickly so that more air can flow though

Answer 29

quick relief bronchodilators

Question 30

airway remodeling is caused by

Answer 30

permanent scarring due to long term inflammation

Question 31

for best results, the optimal patient for pulmonary function testing is

Answer 31

cooperative and able to understand instructions and give forceful respiratory effort

Question 32

benefits of inhaled corticosteroids

Answer 32

* improved lung function * reduced risk of asthma attacks * decrease airway hyperresponsiveness * improve symptoms

Question 33

key elements of self-management of asthma

Answer 33

* recognizing presence and severity of an attack * knowing when to get help * instensifying therapy

Question 34

step 5 therapy recommends

Answer 34

increasing to high dose inhaled steroid

Question 35

step 4-6 therapy recommends considering

Answer 35

allergy immunotherapy or Omalizumab (IgE inhibitor)

Question 36

samter's triad

Answer 36

asthma, nasal polyps, aspirin sensitivity

Question 37

mainstay of asthma treatment

Answer 37

inhaled corticosteroids

Question 38

beclomethasone is an

Answer 38

inhaled corticosteroid

Question 39

comolyn sodium is a

Answer 39

mast cell stabilizer

Question 40

can be useful in addition to inhaled corticosteroids | ecspecially extrinisic allergic asthma

Answer 40

leukotriene inhibitor

Question 41

in patients with difficult to control asthma already on inhaled corticosteroids and luekotriene inhibitos, consider

Answer 41

ipratropium bromide

Question 42

IL-5 inhibitors are used to treat

Answer 42

severe persistent asthma

Question 43

top three causes of cough

Answer 43

* asthma * GERD * postnasal drip

Question 44

preferred treatment for patients with moderate persistent asthma

Answer 44

ICS/formoterol for daily and rescue therapy

Question 45

allergen mitigation is not recommended unless

Answer 45

patient has historical or allergen testing of indoor allergens

Question 46

individuals with asthma of any severity should be assessed for

Answer 46

allergens at home/work, symptoms on exposure, and allergy testing | if none identified, no need for allergen mitigation