Notes in 06. Assessment of Asthma

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Status	Last Update	Fields
Published	06/26/2023	Four components of asthma management Use of {{c1::history, physical, and objective tests}} and pt reports to diagnose and assess the charact…
Published	06/26/2023	measures of asthma assessment and monitoring severity → the intrinsic intensity of the dz process. measured most easily and directly in pt who is…
Published	06/26/2023	measures of asthma → assessment and monitoring severity and control include current impairment and future risk impairment → {{c1::inten…
Published	06/26/2023	risk for exacerbations {{c1::severe}} airflow obstruction; as detected by spirometry persistent severe airflow obstruction {{c1::two}} …
Published	06/26/2023	risk for fatal asthma past hx of {{c1::sudden severe}} exacerbations prior {{c1::intubation}} or admission to ICU for asthma …
Published	06/26/2023	diagnosis of asthma methods for establishing diagnosis: detailed medical history physical exam {{c1::spirometry}} to demonstrate&n…
Published	06/26/2023	50-80% of asthmatics experience symptoms before age of {{c1::5 years}}
Published	06/26/2023	key indicators for considering a diagnosis of asthma {{c1::wheezing}} → high pitched whistling sounds when exhaling in children history of a…
Published	06/26/2023	medical history patterns of symptoms Perennial, seasonal, or both continual, episodic or both onset, duration, frequency {{c1…
Published	06/26/2023	medical history family history → asthma, allergies, sinusitis, rhinitis, eczema, or nasal polyps in close relatives social hx → social facto…
Published	06/26/2023	identification of triggers and co-morbid conditions {{c1::allergens}} → exposure of person who has asthma to inhalant allergens to which the pers…
Published	06/26/2023	identification of triggers and co-morbid conditions treatment of these conditions in a pt with asthma has shown imporvement in asthma control&nbs…
Published	06/26/2023	physical exam vital signs Respiratory rate SaO2 growth curve pulmonary exam {{c1::barrel}} chest retractions a…
Published	06/26/2023	differential diagnosis of asthmainfants and children upper airway disease allergic rhinitis and sinusitis obstructions involving large …
Published	06/26/2023	objectivce measures: spirometry objective assessments of pulmonary function important for the diagnosis of asthma because medical hx and PE …
Published	06/26/2023	objective measures → Spirometry (2) {{c1::gold standard}} for diagnosis measures how much volume and how fast you can move air into and out …
Published	06/26/2023	spirometry reliability spirometry is {{c1::effort dependent}} and requires coordination and cooperation of the pt w/ careful instruction and…
Published	06/26/2023	spirometry → key elements FVC → maximal volume of air forcible {{c1::exhaled}} from the point of maximal {{c1::inhalation}}FEV1 → forced exp…
Published	06/26/2023	characteristics of flow loops {{c1::classic}} flow volume loop has a rapid peak and expiratory flow rate w/ a gradual decline in flow back to zer…
Published	06/26/2023	criteria for acceptability lack of artifact → coughing, glottic closure, equipment problems satisfactory start w/o {{c1::hesitation}}sa…
Published	06/26/2023	acceptable efforts of spirometry
Published	06/26/2023	spirometry values obstructive pattern FEV1 {{c1::<80% predicted}}FEV1/FVC ratio → {{c1::Decreased}}FVC → {{c1::usually nor…
Published	06/26/2023	how often should spirometry be completed? at initial assessment after {{c1::treatment}} is initiated and symptoms and peak expiratory flows …
Published	06/26/2023	airway obstruction and reversibility FEV1 increases {{c1::>12%}} and at least {{c1::200mL}} short course of oral steroids may b…
Published	06/26/2023	PEF provides a simple, quantitative and reproducible measure of existence and severity of airflow obstruction PEF can be measured w/ spirome…
Published	06/26/2023	PEF continued accuracy of peak flow monitoring devices may {{c1::decrease}} over time; therefore measurements that are at odds w/ the clinic…
Published	06/26/2023	other diagnostic testing CXR may be normal in chronic asthma may note {{c1::hyperexpansion}}, peribronchial cuffing, perihilar haz…
Published	06/26/2023	normal CXR vs atelectasis
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Published	06/26/2023	goals of asthma therapy prevent chronic and troublesome symptoms maintain (near) "normal" pulm function maintain {{c1::normal acti…
Published	06/26/2023	"Rule of 2's" asthma control your asthma is well controlled if: daytime symptoms → {{c1::<2x/week}}nightime awakenings → {{c1::…
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