SOLUTIONS RATED A+
✔✔Allergic triad of symptoms - ✔✔allergies, eczema, and asthma
✔✔Samter's Triad - ✔✔Nasal polyps, asthma, and ASA allergy
✔✔Most common symptom of asthma - ✔✔wheezing
✔✔Common only symptom of asthma? - ✔✔Cough
-can often delay dx of asthma
AKA cough variant asthma
✔✔Best way to confirm asthma dx? - ✔✔bronchial provocation
✔✔Intermittent asthma - ✔✔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 - ✔✔step 1
✔✔Mild asthma - ✔✔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 - ✔✔normal FEV1 bt exacerbations
FEV1>80% predicted
FEV1/FVC normal
✔✔Mild asthma lung function - ✔✔FEV1>80% pred.
FEV1/FVC normal
✔✔Mild asthma tx - ✔✔Step 2
✔✔Moderate asthma - ✔✔Sx: daily
PM awakenings: >1x/week but not nightly
SABA use: daily
some limiation
✔✔mod. asthma lung function - ✔✔60<FEV1<80 predicted
FEV1/FVC reduced 5%
, ✔✔Mod. asthma tx - ✔✔step 3 and consider shot course of oral steroid
✔✔Severe asthma - ✔✔Sx: thruout day
pm awakenings: often 7x/week
extremely limited
✔✔severe asthma lung function - ✔✔FEV1<60% predicted
FEV1/FVC reduced >5%
✔✔severe asthma lung function tx - ✔✔step 4 or 5 and consider short course of
steroids
✔✔Asthma step 1 - ✔✔SABA prn
✔✔Asthma Step 2 - ✔✔low dose ICS
ALT- cromolyn, LTRA, nedocromil or theophylline
✔✔Asthma step 3 - ✔✔low dose ICS + LABA
or- medium dose ICS
✔✔Asthma step 4 - ✔✔medium dose ICS + LABA
✔✔Asthma step 5 - ✔✔high dose ICS + LABA
AND
consider omalizumab for patients with allergies
✔✔Asthma step 6 - ✔✔High dose ICS + LABA + oral corticosteroid
AND
consider omalizumab for pts with allergies
✔✔Asthma monitoring for acute episode - ✔✔f/u in 1-2 hours or next day until pt is
stable
then q3-5 days, then weekly until sx are controlled and peak flow consistently 80% of
predicted, then monthly until under control for at least 3 months
✔✔IDA - ✔✔MCH<23
MCV<80
Serum Iron dec
TIBC inc
RDW>15%
MICROCYTIC HYPOCHROMIC
✔✔Findings on blood test for IDA - ✔✔pencil cells on smear