Term
| What is a hallmark of fatal asthma? |
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Definition
| Neutrophilic accumulation |
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Term
What allergen at 6 years of age is associated with persistent asthma by 11 years of age?
What allergen is correlated with wheezing and airway hyperresponsiveness? |
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Definition
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Term
| What genes are associated with asthma? |
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Definition
| IL-4 gene cluster (5q31-33), B2-adrenoreceptor gene polymorphisms(decreased response to beta2 agonist), disintegrin and metalloproteinase (ADAM 33) gene, chitinase-like proteins (CHIT 1) and YKL-40 |
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Term
| What is the criteria to consider starting controller medication in a child <4 years old? |
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Definition
| 1) at least 4 episodes of wheezing in the past year that lasted >1 day and affected sleep with positive asthma predictive index, 2) symptomatic treatment >2 days per week for >4 weeks, 3) oral steroids >2 in 6 months, 4) during periods or seasons of previously documented risk |
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Term
What percentage of asthmatics have GERD?
What percentages of adult asthmatics have episodes triggered by NSAIDS? |
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Definition
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Term
| What is the diagnosis of exercise induced asthma? |
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Definition
| FEV1 decrease >15% after exercise challenge or history and an appropriate bronchodilator response |
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Term
| In pregnant women what percentage improve, stay the same and worsen? |
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Definition
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Term
| What is the classification of asthma in child 0-4 year old? |
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Definition
Intermittent- symptoms/SABA use <2d/wk, 0 nighttime symptoms, no interference with activity, 0-1 oral steroids per year
Mild persistent- symptoms/SABA use >2d/wk, 1-2 nighttime symptoms per month, minor interference with activity, >2 oral steroids per year
Moderate persistent- symptoms/SABA use daily, 3-4 nighttime symptoms per month, some interference with activity, >2 oral steroids per year
Severe persistent- symptoms/SABA use throughout the day, >1 nighttime symptoms per week, extreme interference with activity, >2 oral steroids per year |
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Term
| What is the classification of asthma for child 5-11? |
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Definition
Intermittent- symptoms/SABA use <2d/wk, <2 nighttime symptoms per month, no interference with activity, 0-1 oral steroids per year, FEV1>80%, FEV1/FVC >85%
Mild persistent- symptoms/SABA use >2d/wk, 3-4 nighttime symptoms per month, minor interference with activity, >2 oral steroids per year, FEV1 >80%, FEV1/FVC >80%
Moderate persistent- symptoms/SABA use daily, >1 nighttime symptoms per week, some interference with activity, >2 oral steroids per year, FEV1 60-80%, FEV1/FVC 75-80%
Severe persistent- symptoms/SABA use throughout the day, often nightly symptoms per week, extreme interference with activity, >2 oral steroids per year, FEV1 <60, FEV1/FVC <75% |
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Term
| What is the classification of asthma >12 years of age? |
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Definition
Intermittent- symptoms/SABA use <2d/wk, <2 nighttime symptoms per month, no interference with activity, 0-1 oral steroids per year, FEV1>80%, FEV1/FVC normal
Mild persistent- symptoms/SABA use >2d/wk, 3-4 nighttime symptoms per month, minor interference with activity, >2 oral steroids per year, FEV1 >80%, FEV1/FVC normal
Moderate persistent- symptoms/SABA use daily, >1 nighttime symptoms per week, some interference with activity, >2 oral steroids per year, FEV1 60-80%, FEV1/FVC reduced 5%
Severe persistent- symptoms/SABA use throughout the day, often nightly symptoms per week, extreme interference with activity, >2 oral steroids per year, FEV1 <60, FEV1/FVC reduced >5% |
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Term
Give examples of high molecular weight and low molecular weight agents that cause occupational asthma?
Is atopy a risk factor for sensitization to HMW or LMW agents?
AR precedes occuation asthma in HMW or LMW agents? |
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Definition
HMW- animals, plants, food
LMW- platinum, penicillin, epoxy, isocyanate, acid anhydride, plicatic acid
HMW
HMW |
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Term
In occupational asthma what agent activates complement?
What agent induces both immunologic and nonimmunologic reactions?
What agent has smoking as a risk factor for sensitization? |
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Definition
Plicatic acid
Diisocyanates
Platinum |
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Term
| What are the characteristics of reactive airway disease syndrome (RADS)? |
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Definition
| nonallergic occupational asthma, single/high dose exposure, no latency, onset within 24 hours, persists <3 months |
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Term
| What percentage of MDI albuterol reaches the lungs? |
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Definition
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Term
| What receptor is higher in aspirin-sensitive asthmatics? |
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Definition
| cys-LTs (leukotriene receptors) |
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Term
| What gene is increased in asthmatics? |
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Definition
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Term
| What is the major outdoor pollutant involved in asthma exacerbations? |
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Definition
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Term
What % of patient with asthma have ABPA?
What % with CF have ABPA? |
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Definition
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Term
| What is the diagnostic criteria for ABPA in asthma patients? |
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Definition
+ skin test to A fumigatus
tIgE>1000
IgG or IgE to A fumigatus
Central bronchiectasis
Eosinophilia >1000 |
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Term
| What is the diagnostic criteria for ABPA in asthma patients? |
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Definition
clinical deteriotation with no other cause
tIgE>1200
+ skin test to A. fumigatus
IgE or IgG to A fumigatus
fixed CXR abnormality (infiltrate, mucous plugging) |
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Term
| What are the stages of ABPA? |
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Definition
I: meets ABPA criteria undergoing tx
II: remission after tx
III: recurrence of exacerbation
IV: corticosteroid-dependent asthma
V: Pulmonary Fibrosis |
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Term
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Definition
daily prednisone (0.5-1mg/kg) and taper to every other day after CXR improves
itraconazole can be steroid sparring |
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Term
| What is indicative of an ABPA flare? |
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Definition
| rising IgE (double from baseline) |
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