| 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 |
