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Chronic Asthma (Diagnosis (Lung function tests (Peak flow, Methacholine…
Chronic Asthma
Diagnosis
Medical history
Physical assessment
Lung function tests
Peak flow
Methacholine challenge
Exhaled nitric oxide test
Allergy testing
Chest xray
Sputum eosinophils
Epidemiology
According to CDC, 1 in 13 people have asthma
7.7% adults in US
8.4% children
Leading chronic disease in children
African-American children highest prevalence
More common in adult women
Pathophysiology
Airway inflammation
mast cells
eosinophils
macrophages
activated T lymphocytes
epithelial cells
Airflow obstruction
airway edema
mucous formation
Bronchial hyperrepnsiveness
stimuli
exogenous
endogenous
Triggers
Immune response
Adaptive
Innate
Treatment
Education
Stepwise approach
Medications
Long-Acting Beta Agonists
Leukotriene receptor antagonists
Low dose inhaled corticosteroid
Theophylline
Clinical Presentation
Acute asthma attack
Severity
Mild intermittent
Mild symptoms less than twice a week; few asthma attacks
Nighttime symptoms less than twice a month
Mild persistant
Symptoms 3 to 6 time a week; asthma attacks affect activities
Nighttime symptoms 3 to 4 times a month
Moderate persistant
Symptoms 3 to 6 times a week
Nighttime symptoms 3 to 4 times a month
Severe persistant
Ongoing symptoms during the day and night
Activities are limited
Coughing
Wheezing
Chest tightness/pain