1️⃣ Overview of Asthma & Clinical Manifestations

What is airway hyperresponsiveness?

Exaggerated bronchoconstrictive response to stimuli.

What does bronchoconstriction mean?

Narrowing of the airways of the lungs.

What are leukotrienes?

Proinflammatory mediators that cause bronchoconstriction, mucus production, and mucosal edema.

What is status asthmaticus?

Acute, severe asthma unresponsive to usual bronchodilators; life-threatening.

What is a trigger in asthma?

Any factor that initiates asthma symptoms (e.g., allergens, infections, exercise).

What is work-exacerbated asthma (WEA)?

Asthma worsened by work-related exposures.

What are common clinical manifestations of asthma?

Dyspnea, wheezing, cough, chest tightness.

What is PEFR?

Peak expiratory flow rate; measures airway obstruction.

What PEFR value is considered severe asthma?

< 50% of personal best.

Why is it important to have an asthma action plan?

Guides treatment during exacerbations; improves outcomes.

Is wheezing always present in asthma?

No, absence of wheezing can occur in severe obstruction.

What is the hallmark of chronic bronchitis?

Cough with sputum for at least 3 months/year for 2 consecutive years.

What structural lung change occurs in emphysema?

Destruction of alveoli → ↓ gas exchange surface area.

Name 3 non-pharmacologic approaches to asthma.

Allergen avoidance, smoking cessation, breathing exercises.

List one occupational exposure that may worsen asthma.

Dust, chemicals, fumes.

How does GERD relate to asthma?

Can trigger reflex bronchoconstriction.

Why avoid sulfites in asthma?

May trigger life-threatening asthma in sensitive individuals.

What is airway remodeling?

Permanent structural changes from chronic inflammation.

What is the goal of asthma therapy?

Control symptoms, prevent exacerbations, maintain lung function.

How often should asthma treatment be reviewed?

Every 1 to 6 months.

What should patients monitor at home?

PEFR trends.

What do the GINA guidelines focus on?

Symptom control & risk reduction.

What is preferred controller therapy in adults?

Low-dose ICS + SABA as needed.

What should you do if a patient overuses SABA?

Reassess controller therapy; step up if needed.

Name one CAM therapy sometimes used in asthma.

Breathing exercises (e.g., Buteyko).

Is CAM therapy recommended in guidelines?

No; insufficient evidence.

Why are bronchodilators used?

Relieve bronchospasm.

Why are anti-inflammatory agents used?

Reduce airway inflammation.

What is the preferred route for most asthma meds?

Inhalation.

What is the first-line rescue drug?

Short-acting beta2 agonist (albuterol).

When is systemic corticosteroid used?

For severe exacerbation or poor control.

Why is tolerance to SABA concerning?

Diminished bronchodilation with overuse.

What is a non-drug trigger to always assess?

Environmental allergens.

What is the main cause of asthma morbidity?

Poor control and undertreatment.

Why teach spacer device use?

Improves medication delivery to lungs.

When should montelukast be taken?

Evening.

What is a potential psychiatric side effect of montelukast?

Suicidal ideation.

What is a monoclonal antibody used in asthma?

Omalizumab.

Why must omalizumab be given in healthcare setting?

Risk of anaphylaxis.

What type of asthma qualifies for omalizumab?

Severe allergic asthma.

What are eosinophilic phenotype monoclonal antibodies used for?

Severe eosinophilic asthma.

What is the role of leukotriene modifiers?

Maintenance therapy.

What is the black box warning for montelukast?

Neuropsychiatric events.

Why monitor kids on ICS?

Possible growth suppression.

Why rinse mouth after ICS?

Prevent oropharyngeal candidiasis.

What is the role of combination inhalers?

Simplify regimen, improve adherence.

What is stepwise asthma therapy?

Adjusting treatment based on control.

What causes late-phase asthma reaction?

Continued inflammatory mediator release.

When should emergency help be sought in asthma?

If symptoms worsen despite SABA use.

What allergy must be warned about for seafood-related asthma?

Potential cross-reaction with contrast dye.