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Asthma
Immunology
23
Medical
Professional
07/06/2012

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Cards

Term
What is a hallmark of fatal asthma?
Definition
Neutrophilic accumulation
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?
Definition
Alternaria
Dustmites
Term
What genes are associated with asthma?
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
Term
What is the criteria to consider starting controller medication in a child <4 years old?
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
Term
What percentage of asthmatics have GERD?
What percentages of adult asthmatics have episodes triggered by NSAIDS?
Definition
45-65%
5-10%
Term
What is the diagnosis of exercise induced asthma?
Definition
FEV1 decrease >15% after exercise challenge or history and an appropriate bronchodilator response
Term
In pregnant women what percentage improve, stay the same and worsen?
Definition
1/3, 1/3, 1/3
Term
What is the classification of asthma in child 0-4 year old?
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
Term
What is the classification of asthma for child 5-11?
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%
Term
What is the classification of asthma >12 years of age?
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%
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?
Definition
HMW- animals, plants, food
LMW- platinum, penicillin, epoxy, isocyanate, acid anhydride, plicatic acid
HMW
HMW
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?
Definition
Plicatic acid
Diisocyanates
Platinum
Term
What are the characteristics of reactive airway disease syndrome (RADS)?
Definition
nonallergic occupational asthma, single/high dose exposure, no latency, onset within 24 hours, persists <3 months
Term
What percentage of MDI albuterol reaches the lungs?
Definition
12-14%
Term
What receptor is higher in aspirin-sensitive asthmatics?
Definition
cys-LTs (leukotriene receptors)
Term
What gene is increased in asthmatics?
Definition
Mucin gene (MUC5AC)
Term
What is the major outdoor pollutant involved in asthma exacerbations?
Definition
Ozone (O3)
Term
What % of patient with asthma have ABPA?
What % with CF have ABPA?
Definition
-1-2%
-1-15%
Term
What is the diagnostic criteria for ABPA in asthma patients?
Definition
+ skin test to A fumigatus
tIgE>1000
IgG or IgE to A fumigatus
Central bronchiectasis
Eosinophilia >1000
Term
What is the diagnostic criteria for ABPA in asthma patients?
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)
Term
What are the stages of ABPA?
Definition
I: meets ABPA criteria undergoing tx
II: remission after tx
III: recurrence of exacerbation
IV: corticosteroid-dependent asthma
V: Pulmonary Fibrosis
Term
What is the tx of ABPA?
Definition
daily prednisone (0.5-1mg/kg) and taper to every other day after CXR improves
itraconazole can be steroid sparring
Term
What is indicative of an ABPA flare?
Definition
rising IgE (double from baseline)
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