global initiative for asthma
What does GINA stand for?
national asthma education and prevention panel
What does NAEPP stand for?
b
Which one is updated annually?
a) NAEPP
b) GINA
b
Which one is based ONLY off symptoms?
a) NAEPP
b) GINA
b
Which is for symptom relief, or before exercise/known allergen exposure?
a) maintenance and reliever (MART)
b) Reliever
c) Controller
d) Maintenance
e) anti-inflammatory reliever (AIR)
c
Which targets symptoms & future risk?
a) maintenance and reliever (MART)
b) Reliever
c) Controller
d) Maintenance
e) anti-inflammatory reliever (AIR)
d
Which is used regularly?
a) maintenance and reliever (MART)
b) Reliever
c) Controller
d) Maintenance
e) anti-inflammatory reliever (AIR)
e
Which provide rapid relief + controller therapy?
a) maintenance and reliever (MART)
b) Reliever
c) Controller
d) Maintenance
e) anti-inflammatory reliever (AIR)
a
Which is for maintenance treatment + symptom relief?
a) maintenance and reliever (MART)
b) Reliever
c) Controller
d) Maintenance
e) anti-inflammatory reliever (AIR)
atopy, school age onset, presence of bronchial hyper-responsiveness (BHR)
What are predictors of adult asthma? (3)
atopic dermatitis, asthma, allergic rhinitis
Which conditions are a part of the allergic triad?
genetic predisposition + environmental interaction
Etiology of Asthma =
>= 6 months
Annual flu vaccine is recommended in all patients ______ of age.
infections, allergic rhinitis, GERD, obesity, OSA, mental illness
Comorbid conditions of Asthma? (6)
f; no single diagnostic test
Asthma diagnosis only requires one test. T/F?
obstruction; reversible
Diagnosis of asthma requires expiratory airflow _____ that is at least partially _______.
c
Measures nitric oxide in exhaled breath; used to indicate level of airway
inflammation.
a) FVC
b) FEV1
c) FeNO
d) PEFR
d
Used in initial diagnosis to test for variability in expiratory airway flow
limitation.
a) FVC
b) FEV1
c) FeNO
d) PEFR
FeNO; PEFR
_______ & _______ should be measured at baseline and after use of SABA to
test for reversibility.
Spirometery, PFTs
Asthma diagnosis is confirmed by what tests? (2)
>=5 yo
At what age can patients be assessed with a FVC test?
a
Total volume of air that can be exhaled after deep inhalation.
a) FVC
b) FEV1
c) FeNO
d) PEFR
b
Volume of air that can be exhaled in the first second of FVC.
a) FVC
b) FEV1
c) FeNO
d) PEFR
> 80%
What is a normal FVC reading?
percentage of total air capacity that can be exhaled in one second
What does FEV1/FVC ratio tell us?
initial assessment, after therapy initiation/ PEF have normalized, every year at follow up
How often do we conduct FEV1/FVC tests? (3)
increase in FEV1 of > 200 ml; >= 12% from baseline after inhalation of SABA
How can we test reversibility? (2)
methacoline; >=20%
________ should cause a ________ decrease in FEV1 and can be used to
identify airway hyper-responsiveness
c
Respond well to ICS.
a) asthma w/ peristent airflow limitation
b) adult-onset asthma
c) allergic asthma
d) non-allergic asthma
b
Require higher doses of ICS.
a) asthma w/ peristent airflow limitation
b) adult-onset asthma
c) allergic asthma
d) non-allergic asthma
a
Asthma caused by long periods of standing.
a) asthma w/ peristent airflow limitation
b) adult-onset asthma
c) allergic asthma
d) non-allergic asthma
b
This form of asthma is usually in women.
a) asthma w/ peristent airflow limitation
b) adult-onset asthma
c) allergic asthma
d) non-allergic asthma
use of FeNO in diagnosis/management, indoor allergen mitigation, use of intermittent ICS, use of LAMA, use of SQ/SL immunotherapy, bronchial thermoplasty
What are the 6 priority topics of NAEPP guidelines?
ICS + formoterol; reduces exacerbations/ED visits; adds simplicity to doses
What is the track 1 recommended medication?
Why?
controller replaced with maintenance, ICS + SABA not for MART; can be used in steps 2-5, no SABA monotherapy
What were the 3 key changes to GINA 2023?
ICS + form ; ICS + SABA
What medications are involved in AIR (anti-inflammatory reliever) ?
Low dose ICS + formoterol; for patient maintenance & prn for relief
What medications are involved in MART (maintenance and reliever therapy)?