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Chronic Asthma Exacerbation (Clinical presentation (Hypoxemia, Tachycardia…
Chronic Asthma Exacerbation
Pathophysiology
Bronchospams
Hyperinflation
Airway edema and obstruction
IgE produced
Interleukin-4 and 5 are influenced
Thick mucous production
Constriction of smooth muscle
Airway remodeling (smooth muscle hypertrophy)
Clinical presentation
Hypoxemia
Tachycardia
Chest tightness
Anxiety
Cough
Use of accessory muscles
Wheezing
Shortness of breath
Nasal flaring
Medication
Low dose inhaled corticosteroid
Expectorant
Theophylline
Short acting beta 2 agonist
Asthma inhalers
Leukotriene receptor antagonist
Oxygen
Long term maintenance: long acting beta2 agonist with inhaled corticosteroid and reviewing leukotriene receptor antagonist therapy
Treatment
Allergen and irritant avoidance
Oxygen therapy
Mechanical intubation
Diagnosis
Hypersensitive reaction to irritants
Arterial blood gas (Respiratory alkalosis)
Pulmonary function test
Chest x-ray
Labs to rule out infection
Pulse oximetry
Chronic asthma tends to have persistent and prolonged effects that aren’t responsive to medication
Physical Exam
Diminished or absent breath sounds
Decreased oxygen saturation
Wheezing
Difficulty breathing
Family history
Epidemiology
Genetics
Affects people of all ages
Family history
Most common in children
Risk factors
Occupation factors
Respiratory tract viral infections
Air pollutants
Sinus and nasal congestion
Exposure to secondhand tobacco smoke
Acid reflux
Obesity
Women
Causes
Infections
Common cold
Flu
Environmental allergies
Weather changes
Grass
Pollen
Mold
Dust mites
Trees
Indoor air pollutants
Food allergies
Fish
Peanuts
Eggs
Shellfish
Wheat