Year 3

• What is asthma?

  A chronic airway disorder causing wheezing
• What are the typical symptoms of asthma?

  Wheezing, breathlessness, chest tightness, coughing
• Are asthma symptoms reversible?

  Yes, typically reversible with treatment
• What causes asthma according to its aetiology?

  Genetic and environmental factors trigger immune responses
• What are some risk factors for asthma?

  Family history, allergens, smoke, obesity
• How does obesity relate to asthma risk?

  Higher risk, especially in women
• What is the purpose of spirometry in asthma investigations?

  Measures lung function
• What does peak flow measure?

  Monitors airflow
• What does FeNO measure?

  Measures airway inflammation
• What types of tests are allergy tests?

  Skin prick or blood tests
• What is the purpose of a chest X-ray in asthma investigations?

  Rules out other conditions
• Name a differential diagnosis for asthma.

  COPD
• What is the management approach for asthma based on NICE guidelines?

  Stepwise approach based on symptom control
• What are the steps in asthma management according to NICE guidelines?

  1. Step 1: SABA as needed
  2. Step 2: Low-dose ICS
  3. Step 3: Add LABA to ICS
  4. Step 4: Increase ICS or add LTRA/theophylline
  5. Step 5: Specialist care and biologics
  6. Additional management: Action plan and education
• What is a common complication of asthma?

  Exacerbations
• What does airway remodeling refer to in asthma?

  Permanent structural changes in airways
• What is a life-threatening exacerbation of asthma characterized by?

  Peak flow less than 33% and confusion
• What does a silent chest indicate in asthma?

  Severe bronchoconstriction with no air entry
• What are the features of moderate, severe, and life-threatening asthma exacerbations?

  • Moderate: Peak flow 50-75%, no severe symptoms
  • Severe: Peak flow 33-50%, respiratory rate >25, heart rate >110
  • Life-threatening: Peak flow <33%, oxygen saturation <92%, confusion, silent chest
• What is the treatment for mild exacerbations of asthma?

  Inhaled beta-2 agonists and steroids
• What additional treatments are considered for moderate exacerbations?

  Hospital admission and nebulized beta-2 agonists
• What treatments are used for severe exacerbations of asthma?

  Oxygen, nebulized ipratropium, IV magnesium
• What is the management for life-threatening exacerbations of asthma?

  Admission to HDU or ICU and intubation
• Why is serum potassium monitored during salbutamol treatment?

  Salbutamol causes hypokalaemia
• What are the long-term management steps after an acute asthma attack?

  Optimizing management and creating a self-management plan
• When should a patient be referred to a specialist after asthma attacks?

  After 2 attacks in 12 months