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Teaching Curriculum: Asthma
Priorities:
Pediatrics 1, Internal Medicine 1,
Family Practice 1, Student 1
OBJECTIVES
Upon completion of this rotation, the allergy rotator should be able to:
- Define asthma
- Define the meanings of the terms:
- wheezing
- rhonchus
- crackles (rales)
- stridor
- List the three major pathologic factors responsible for airway obstruction in asthma and differentiate asthma from emphysema
- Explain the pathophysiology of asthma regarding the:
- IgE mechanisms
- airway remodeling
- genetics
- 5. Discuss precipitating factors including:
- infection
- irritants
- exercise
- allergens
- medications
- intrinsic factors including gastroesophageal reflux disease
- Describe the clinical findings typical of asthma
- Create a differential diagnosis of asthma
- Discuss the role of spirometry in the diagnosis and management of asthma. Describe the different spirometric tests of lung function and the changes produced in these tests by asthma.
- Describe the typical spirometric and flow volume loop findings in patients with asthma, COPD, and laryngeal obstruction
- Discuss etiologic evaluation of asthma by:
- history
- skin testing
- Explain environmental control measures.
- Discuss classifying asthma severity in patients based on day and night time symptoms & lung function-mild intermittent, mild persistent, moderate persistent, severe persistent.
- Discuss the different classes of drugs used in the medical management of asthma and their side effects and their use in step therapy based on asthma severity:
- epinephrine
- beta2 agonists
- theophylline (methylxanthenes)
- cromolyn and nedocromil
- steroids, inhaled and systemic
- atropine, ipratropium bromide
- leukotriene modifiers
- antihistamines
- Demonstrate proficiency in the proper use of the meter dosed inhaler, spacer devices, dry power inhalers and how to instruct patients in their use.
- Explain goals and precautions of immunotherapy in patients with asthma
- Discuss use of peak flow meters in the clinical management of asthma and develop an asthma action plan based on levels of peak flow measurements
- Describe a basic program of outpatient management for:
- an adolescent or young adult female who has asthma with a febrile viral respiratory tract infection
- an adolescent or young adult male with seasonal asthma each August and September
- a 15-year-old adolescent with exercise-induced bronchospasm
- Define and explain the management of status asthmaticus
- Discuss quality of life issues regarding patients with chronic asthma
- Recognize emotional/behavioral aspects of caring for patients with asthma
- List indications for referral to an allergy/immunologist
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