PBL 3 (First session)

1. Clarify with the terms:

 Dyspnea- laboured or difficult breathing
- intense tightening in the chest and air hunger
- also called shortness of breath
 Cyanosed- Blueish discoloration of the skin or mucous membrane resulting
from inadequate amount of oxygen in the blood
 Coughing- a form of violent exhalation by which irritant particles in the
airways can be expel
 Nebulizer- drugs delivery device used to administer medication in form of
mist inhaled into the lungs commonly use for the treatment of asthma, cystic
fibrosis, COPD and other respiratory diseases or disorders
 Expiratory wheezes- an abnormal high pitch or low pitch sound heard either
by unaided human ear or through statoscopes during expiration
 Auscultation- the process of listening usually with the aids of a statoscope to
sound produce by movement of gas or liquid within the body.
-It is an aid to diagnosis of abnormality of the high lungs,
intestines and other organ according to the characteristic
changes in sound pattern cause by different disease
 Bilateral inspiratory-
• -Bilateral relating to or affecting both sides of the body or of a tissue or
organ or both pair of organs
 Inspiratory- the act of breathing air into the lungs through the mouth and
nose
 Moderate respiratory distress- severe difficulty in achieving adequate
oxygenation in spite of significant effort to breath
 Pediatrics- it is a branch of medicines dealing with the children and their
disease
 Arterial oxygen saturation- it is to measure hemoglobin oxygenation in the
arterial compartment of the circulatory systems
 Pulse oximetry- the test that measure your oxygen saturation level or the
oxygen level in your blood. It is to measure the function the heart and the
lungs
 Respiratory rate – number of breaths someone take every minutes
2. Identification of problems (Symptoms):
i. 6 years old boy with 20kg weight
ii. Heart rate higher – 130beats/min
iii. Audible expiratory wheezes
iv. SaO2 level is 90%
v. Complain with dyspnea, cyanosed and coughing that have aggressively
worsened during the past 2 days.
vi. Prolong expiratory phase
vii. High respiratory rate
viii. High temperature 38.8 C
ix. Occasional coughing
x. Anxious appearing in moderate respiratory distress
xi. Decrease breath sound

3. Brief Diagnosis:
- Asthma

4. Learning Outcomes:
1) Define and classify asthma (differentiate COPD and Asthma)
2) Discuss a pathophysiology of asthma
3) Explain generally the sign and symptoms of asthma
4) Describe causes and risk factors contributing to asthma severity
5) Explain lab test use to diagnose the disease
6) Discuss the pharmacological treatment (MOA and side effect) for asthma
- Guideline for treatment approach
- Beta 2 adrenergic agonist – LABA, SABA
- Inhaled or oral Corticosteroid
- Xanthine derivative
- leukotriene antagonist
- Long acting antimuscarinic-LAMA
- Immunomodulators
7) Explain the technique to use device (MDI, turbuhaler, dischaler, aerochamber)
and discuss non-pharmacological treatment for asthma