Home Lung emergency What is Asthma?(shortness of breath) Pathogenesis | treatment

What is Asthma?(shortness of breath) Pathogenesis | treatment

 Asthma

Content:

  •  Definition
  • Phenotypes
  • Pathogenesis
  • Sign / symptoms
  • Classification
  • Diagnosis
  • Medical Management

Definition:

       Defined by the history of respiratory symptoms such as wheeze, shortness of breath, chest tightness & cough that vary over time & in intensity, together with variable expiratory flow limitation.
      Variation is triggered by-exercise, allergen, irritant exposure, change in weather, viral respiratory infections.

Phenotypes:

  • Recognizable clusters of demographic, clinical & / pathophysiological characteristics.
  • Allergic asthma
  • Non allergic asthma
  • Late onset asthma
  • Asthma with fixed airflow limitation
  • Asthma with obesityobesity

Pathogenesis:

Asthma Pathogenesis

Pathogenesis of asthma



Asthma

Airway inflammation

Symptoms:

  • Wheeze , cough , shortness of breath , chest tightness.
  • Symptoms occur variably over time ,vary in intensity.
  • Worsen at night / on walking.
  • Triggered by coldness, allergens , exercises.
  • Appears /worsens with viral infections.
  • Fever. 
  • Sputum production.
  • H/o allergic rhinitis /atopic dermatitis.
  • Family history 

Sign:

  • Tachypnoea , tachycardia.
  • Use of accessory muscles.
  • Wheeze – expiratory, audible.
  • Silent chest.
  • Percussion : hyper resonance. 
  • Altered mentation.
  • Pulsus paradoxus 


Asthma classification
Life threatening:

Diagnosis:

  • History and examination
  • PEER
  • Pulmonary function test: FEV1/FVC ratio
Normal >0.75 – 0.80 in healthy adults, >0.90 in children.
Excessive bronchodilator reversibility : FEV1 >12% .
  • ABG- CO2 retention. 
  • Chest xray.
  • CBC.
  • Sputum examination.
  • FENO – fraction of exhaled nitric oxide.
  •      predictor for exacerbation in allergic patients.
  • Allergen testing.

Treatment:

  • Oxygen – Sao2>90%
  • SABA – inhaled/systemic.
  • Costicosteroids  - inhaled/systemic.
  • Anticholinergics – ipratropium bromide.

  • STATUS ASTHMATICUS

  • Magnesium sulfate- 1-2 gm iv over 30 mins.
  • Ketamine:0.2 mg/kg bolus.
  • Methylxanthines.
  • Ephinephrine
  • LABA Leukotriene modifiers – montelukast , zaferlukast , zileuton.
  • Mast cell modifiers – cromolyn , nedocromil.
  • Immunomodulators : mepolizumab : IL5. omalizumab : block Ig E. Heliox

About

This website for medical students who struggle to study over the books this for yours we are given as a consiced format more...

Next
« Prev Post
Previous
Next Post »

No comments:

Post a Comment

Subscribe to: Post Comments (Atom)