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FEV1<30%
Resp. Failure
Cor Pulmonale (elevation of JVP and pitting ankle edema)
QOL very impaired
Exacerbations may be life threatening
How does FEV1 decrease? - answer✔Inflammation
Narrowing of peripheral airways
Airway collapse in severe emphysema
COPD diagnosis? - answer✔SPIROMETRY is key
Primarily Inflammatory with superimposed bronchospasm - answer✔Asthma
Most common chronic respiratory disorder among all age groups - answer✔Asthma
Atophy - answer✔exaggerated IgE mediated immune response; all atophic disorders are type I
hypersensitivity disorders
Type I hypersensitivity reaction - answer✔Immediate hypersensitivity
IgE-mediated
Antigen binds to IgE that is bound to tissue mast cells and blood basophils, triggering release of
preformed mediators (histamine, proteases, chemotactic factors) and synthesis of other
mediators (prostaglandins, leukotrienes, platelet-activating factor, cytokines)
-causes vasodilation, increased cap. permeability, mucus hypersecretion
**atopic disorders (allergic asthma, rhinitis, conjunctivitis), anaphylaxis, some cases of
angioedema, urticarial, and latex and some food allergies
**Develop <1h after exposure to antigen
Allergic triad of symptoms - answer✔allergies, eczema, and asthma
Samter's Triad - answer✔Nasal polyps, asthma, and ASA allergy
Most common symptom of asthma - answer✔wheezing
Common only symptom of asthma? - answer✔Cough
-can often delay dx of asthma
Best way to confirm asthma dx? - answer✔bronchial provocation
Intermittent asthma - answer✔sx </2days/week
PM awakenings </2/month
SABA use </2 days/week
No interference with norm. activity
0-1 exacerbations requiring oral steroids / yr
Tx for intermittent asthma - answer✔step 1
Mild asthma - answer✔Sx >/2days/week but not daily
pm awakenings 3-4x/month
SABA use >2 days/week but not daily
minor limitation
Intermittent asthma lung function - answer✔normal FEV1 bt exacerbations
FEV1>80% predicted
FEV1/FVC normal
Mild asthma lung function - answer✔FEV1>80% pred.
FEV1/FVC normal
Mild asthma tx - answer✔Step 2
Moderate asthma - answer✔Sx: daily
PM awakenings: >1x/week but not nightly
SABA use: daily
some limiation
mod. asthma lung function - answer✔60<FEV1<80 predicted
FEV1/FVC reduced 5%
Mod. asthma tx - answer✔step 3 and consider shot course of oral steroid
Severe asthma - answer✔Sx: thruout day
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