Chronic Asthma

1. Diagnosis

1.1. Pulmonary Function Testing

1.2. Allergy Testing

1.3. HX of previous severity

1.4. Assessment of current signs and symptoms

2. Signs and Symptoms

2.1. Wheezing

2.2. Absence of wheezing in severe asthma (silent chest)

2.3. Cough

2.4. Shortness of Breath

2.5. Tachypnea

2.6. Accessory Muscle Use

2.7. Upright position

2.8. Increased Expiratory Phase

3. Treatment

3.1. Teach avoidance of triggers

3.2. Short acting beta agonists

3.3. Long acting beta agonists

3.4. Oral corticosteroids

3.5. Inhaled corticosteroids

4. Pathophysiology

4.1. Caused by exposure ot irritants and allergens

4.2. Cell mediated inflammatory response

4.3. Inflammation leads to shortness of breath

4.4. Airway remodeling as disease progresses due to poor control and chronic inflammation of airways

5. Epidemiology

5.1. Affects forty million Americans

5.2. Affects African Americans disproportionately

5.3. Usually affects boys predominantly more prior to puberty

5.4. Usually affects girls after puberty

6. ABG

6.1. Decreased PaO2

6.2. Normal PaCO2

6.3. Increasing PaCO2 impending sign of respiratory failure