CMN 568 Exam 3 Asthma #1 Questions And Answers With Latest Updates

CMN 568 Exam 3 Asthma #1 Questions And Answers With Latest Updates
Definition of Asthma:
1. Chronic airway inflammatory disorder
2. Recurrent episodes of wheezing, chest tightness, shortness of breath, and
coughing at night or in the early morning
3. Reversible airway limitation
Diagnosis of Asthma[5]
1. History:: cough worse at night, recurrent wheezing/chest tightness
 recurrent difficult breathing
2. Symptoms occur or worsen at night, awakening the patient
3. Physical examination: wheezing, silent chest when severe asthma
4. Lung function test ( FEV1 and PEFR )
 - PEFR increases > 15% after inhalation of short-acting β2 –agonists 15~20
mins
 - PEFR varies > 20% from morning to 12 hours later
 - PEFR decreases > 15% after 6 mins of exercise
5. Risk factors:
 - Allergic IgE-mediated diseases, allergic rhinitis, atopic dermatitis, and
eczema
 - Familial members with asthma
 - exacerbation associated with weather change, foods, drugs…
Classification of Asthma Severity [5]
Classification
Clinical Features Before Treatment
Days Symptoms Night-time
Symptoms
Lung Function Test
STEP 1:
Intermittent
< 1 times/week < 2 times/month -FEV1 or PEF > = 80%
predicted
-PEF variability < 20%
STEP 2:
Mild persistent
> 1 times /week, but
< 1/day
> 2 /month -FEV1 or PEF > = 80%
predicted
-PEF variability 20-30%
STEP 3:
Moderate persistent
Daily symptoms > 1 /week -FEV1 or PEF in
60%~80% predicted
-PEF variability > 30%
STEP 4:
Severe persistent
Continual symptoms Frequent -FEV1 or PEF < 60%
predicted
-PEF variability > 30%
Stepwise Approach for Managing Asthma in Adult [5]
Quick Relief
All Patients - Short-acting bronchodilator with inhaled β2 -agonists as needed for
symptoms.
- Intensity of treatment will depend on severity of exacerbation.
- Use of bronchodilator > 1/week over a 3 months period in intermittent
asthma may indicate the need to “step-up” therapy
Classification Daily Control Medicines Other Treatment Options
STEP 1:
Intermittent
- No daily medication
STEP 2:
Mild persistent
- Anti-inflammatory: inhaled
corticosteroid (low doses)
- Sustained-release theophylline to
serum concentration of 5-15 

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