PTHASMODERATEPERSISTENTASTHMA

ABFMKSAASTHMA

PTHASMODERATEPERSISTENTASTHMA

WAKESUPWITHNIGHTTIMESX

WEEKLY

WHATMEDSSHOULDSHEBEON-ANSMODERATEPERSISTENTASTHMA

=

STAGE3

= 3MEDS =

ALBUTEROL

ICS + LABA

PTSUSPECTEDOFHAVING

EXERCISEINDUCEDASTHMA

BaselinepulmonaryfunctiontryingoutexhibitsanFEV1= ofthree.1L

IFPFTISDONEAFTEREXERCISE

= WHATmeasurementsOFFEV1afterexercisingmighthelpaprognosisofexercise-brought onbronchospasm?-ANSFEV1<2.5 15%decreaseinFEV1 afterexerciseisCOMPATIBLEWITHDIAGNOSISOF

EXERCISEINDUCEASTHMA

AirflowobstructionisdefinedasanFEV1 /FVCratio

LESSTHAN

70%.AirwayREVERSIBILITYisdefinedas anincreaseinFEV1orFVC =

BYHOWMUCH-ANS12%

WHICHASTHMAMEDSAREASSOCIATEDWITHBONELOSS-ANSBOTHINHALED

AND ORAL

CORTICOSTEROIDS

WHATIS

mostcommonacid/baseabnormalityintheearlystages ofanasthmaexacerbation?-ANSRESPIRATORYALKALOSIS

HYPERVENTILATION

=

LOWCO2=HIGHPH-ALKALOSIS

WHICHASTHMAMEDICATION

= mosteffectiveasthmaagent forpreventingexacerbations,-ANSICS

WHATISTXOFCHOICEFOR

aspirin-inducedasthma-ANSLEUKOTRIENCEINHIBITORS = Montelukast

PTWITHASTHMALIKESX

+

RHINITIS

+

NASALPOLYPS

TOW-ANSASPIRININDUCEDASTHMA

WHICHNSAIDCANBEUSEDINSTEADOFASPIRIN

INPTWITH

ASPIRININDUCEDASTHMA-ANSSALSALATE

CANALSO

USE

TYLENOL

PTADMITTEDFORASTHMAEXACERBATION

AccordingtoNationalAsthmaEducationandPreventionProgramguidelines,hospital dischargecanbeconsideredinthispatient = oncethepeakflowraterisesaboveathreshold of-ANS>420 Inpatientswithinadequatelymanagedallergies,

OPTIMALMANAGEMENTOFWHATOTHER

COMORBIDITIES

CANHELPGETBETTERCONTROLOFASTHMA-ANSGERD

ALLERGICRHINITIS

OSA ALLERGICbronchopulmonaryaspergillosis

AREUSEOF

ICS

SAFEFORPREGNANTPTSWITHASTHMA-ANSYES

Long-actinginhaledβ-agonistsare lessinalllikelihoodtobepowerfulwhereinoneofthefollowing ethnicagencies?-ANSAFRICANAMERICANS USEOFLABAINHALERS(salmeterolandmanyothers) HAVEHIGHRISKOFWHAT-ANSsevereasthmaexacerbations

NEVERPRESCRIBE

MONOTHERAPYOFLABAINHALERS

SHOULDALWAYSBEUSEDWITHOTHERINHALERSLIKEICS

Chroniclow-tomedium-doseinhaledcorticosteroiduseinchildrenisassociatedwith-

ANSNOLONGTERMADVERSEAFFECT

WRONGANS=

B)asignificantreductioninbonemineraldensity Symptomssuggestingthatrespiratory arrestmaybecomingnearnearinpatientswithaextremeallergiesexacerbatioNINCLUDE

-ANSLACKOFWHEEZING

BRADYCARDIA

LOSSOFpulsusparadoxusbecauseofrespirationmusclefatigue.

PTHAS

STAGE1=MILDINTERMITTENTASTHMA

NONIGHTTIMESX

USESALBUTEROL1X/WEEKONLY

BUTHASHISTORYOF

ASTHMAEXACERBATIONSOVERPASTYRTHATWERETXATURGENTCARE

WHATINHALERSSHOULDTHISPTBEON-ANSALTHOUGHPTHAS

STAGE1=MILDINTERMITTENTASTHMA

--WHICHUSUALLYISJUSTSABAFORTX

BUTDUETOMULTIPLEEXACERBATIONSOFASTHMA,

TXTHISAS

STAGE2-slightpersistentallergies = SABA + ICS WHATSHOULDbetakenintoconsiderationinpatientswith severeallergies = refractorytotreatment-ANSallergicbronchopulmonaryaspergillosis Diagnosticstandards= serumIgGtoAspergillus associatedwithcrucialbronchiectasisonexcessive-resolutionchestCT Omalizumab=antibodydirectedtowardscirculatingIgE.ISUSEDTOTXWHAT-ANSIgE-mediatedhypersensitivereaction =

TRIGGERFORASTHMA

PTWITHCOPDORASTHMA

WHICHCARDIACSTRESSTESTSHOULDBEAVOIDEDINTHESEPTS-ANSAdenosine ORDipyridamole=cancauseintensebronchospasm

STRESSTEST

WRONGANS

=

DOBUTAMINEECHO,EXERCISESTRESSTEST

maximumnotunusualfacetimpactof β2 -agonistsIHALERS-ANSTREMORS

OTHERS.E.:

TACHYCARDIA

WHICHELECTROLYTEABNORMALITYCANBECAUSEBY

B2AGONISTINHALERS-ANSHYPO-K-ALEMIA-pushesKintocells