Term
| What is the primary pathological complication with asthma? |
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Definition
| Inflammation (then bronchospasms) |
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Term
| Asthma exacerbations are ______ and classified in what three categories? |
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Definition
| Episodic, mild, moderate and severe where mild asthma can have severe exacerbation. |
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Term
| Airway inflammation is ____ whether or not sx are present. |
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Definition
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Term
| ____ is crucial to preventing problems w/ asthma |
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Definition
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Term
| What are objective data collected during asthma assessment? |
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Definition
| Peak flow meters (Airflow obstruction), spirometry and exhaled nitric oxide, allergy testing |
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Term
| What are the rescue meds? |
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Definition
| Short acting Beta 2's [relx smooth muscles in broncho airways], anticholinergics [PSNS induce bronchodilation], oral steroids [30'-1hr] |
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Term
| what are the asthma controller meds? |
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Definition
| inhaled corticosteroids, anti leukotrienes, long acting beta 2's, MDI, Dry powder inhalers |
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Term
| What is the first sx of an asthma attack? |
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Definition
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Term
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Definition
| Helps with diagnosis and ongoing treatment; Measures OBSTRUCTION to airflow in airways for children |
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Term
| how often do kids with mild asthma need to be seen? Mod-severe? |
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Definition
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Term
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Definition
| Objective, a measure of eosinophillic inflammation, serial measurement reflects AIRWAY INFLAMMATION, 5-15ppb normal value |
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Term
| What are some triggers that are also allergens? |
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Definition
| Cold air, strong emotions, exercise, odors, SMOKE, windy/dusty days, foods |
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Term
| Acute asthma exacerbations occur in what two phases? |
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Definition
| Early phase (minutes of exposure)--bronchospasm and inflammation [b2a-->immedeate bronchodilator]; Late Phase 6-9 hrs later, leads to broncial hyperresponsiveness [mast cell degranulation sx get worse over time] that can become chronic and requires anti-inflammator meds AND bronchodilators. |
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Term
| What is the biggest trigger of all? |
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Definition
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Term
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Definition
| COLD SYMPTOMS (cough, chest tight, SOB, throat clearing, less active)--Low PCO2 and Tachypnea (trying to blow off CO2), EXPIRATORY wheeze |
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Term
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Definition
| Coughing/Vomiting, Inspiratory WHEEZING (a late sign of inflammation), Stop to breath when talking OMINOUS, trouble walking normal distances, anxiety, accessory muscles, insp&expir wheezing, head bobbing |
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Term
| What are the goals of the asthma guidelines? |
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Definition
| How severe is their disease and how well controlled it is before determining treatment. |
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Term
| How is severity assessed? |
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Definition
| Before tx or if already diagnosed it is inferred by what meds are needed to achieve control |
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Term
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Definition
| By how symptomatic the child is ON THEIR MEDS and how at risk they are for exacerbation |
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Term
| What are the four Rules of Two? IF YOU ANSWER YES TO ANY OF THE RULES OF 2, what does that mean? |
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Definition
| Does your child: need albuterol more than 2xweek, asthma sx at night more than 2xmonth (KEY!!), Refill rescue meds more than 2xyr, Measure a peak flow at less than 2x10 or 20% from personal best blow?--Asthma is NOT under control, requires a controller med, child has reached PERSISTANT asthma level |
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Term
| Asthma is a ____ inflammatory disease but we notice ____ sx. |
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Definition
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Term
| What is the progression of asthma over time? |
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Definition
| Inflammatory cells present in airways-->Results in HYPERREACTIVE/HYPERsensitized airways which when triggered become further inflammed-->inflammation leads to congestion and bronchiol constriction |
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Term
| After an acute asthma attack, which airways take months to normalize? |
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Definition
| the small airways (MMEFR)--max mid expiratory flow rate |
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Term
| What are the asthma mortality risk factors? |
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Definition
| Past Hx of sudden attacks, prior intubation/ICU admission, >= 2 hospitalizations in last 12 mos or 3 ER visits in last 12 mos, >= 2 cannisters SABA/mo [also oral steroid use, poor preciever sx, outdoor MOLD ALLERGY, mental health, drugs, poor/urban] |
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