Asthma
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13 questions
| 🇬🇧 | 🇬🇧 |
| What are some characteristics of chronic Asthma | Airway inflammation Reversible airflow obstruction Increase in airway responsiveness Airway remodelling |
| What is the main difference between extrinsic and intrinsic asthma | Extrinsic has FH atopy where there is IgE produced on contact with normally a harmless environment, and also has a early onset compared to Intrinsic which is adult onset and is often associated with bronchitis or cold or can be exercise induced |
| What cell drives the process of inflammation | Th2 cells which release cytokines which attract inflammatory cells including MAST cells and eosinophils |
| What are the three phases of extrinsic asthma | Early ( 15 minutes ) --> cross linkages of two IgE on mast cells causing degranulation Late ( 4 hours ) --> After recovery from mediators from mast cells, then activation of macrophages and chemotaxis and eosinophils into the lining of the bronchi Prolonged hypersenstivity ( days ) --> Exaggerated response of airway after exposure , inflammatory cells in the bronchial walls continue giving loss of epithelial cells |
| What are some differences between a normal lung and a asthmatic lung | Airway remodelling Hypertrophy and hyperplasia of smooth muscle Hypertrophy of mucus glands Thickening of the basement membrane |
| On a spirometer, what would asthma look like? | Obstructive pattern Reduced FEV1/FVC ratio Obstructive flow volume loop |
| For diagnosis of asthma, what recurrent symptoms do you need to find | Wheeze Breathlessness Chest tightness Cough Variable airflow obstruction |
| What is some investigations that can be used for asthma | Spiromtery Allergy testing --> Skin prick or blood IgE levels Exhaled Nitricoxide Chests X-rays --> generally normal in chronic |
| What are some management plans for asthma | Drugs Primary prevention Education Manage life threatening asthma |
| What are some drugs that can be used to treat asthma | Airway relaxants : - Beta2 agonists (short & long acting) - Muscarinic antagonists (ipratropium b - Theophylline/aminophylline Anti-inflammatory agents (‘preventers’) - Corticosteroids - Leukotriene receptor antagonist |
| What is Status Asthmaticus | Medical emergency Where the acute severe asthma causing the airway obstruction is unresponsive to drug therapy |
| What causes the narrowing of the airways | Mucosal swelling Thickening of bronchial walls due to infiltration of by inflammatory cells Mucus overproduction; the mucus is also abnormal- it is thick, tenacious & slow moving --> mucus plugs Smooth muscle contraction The epithelium is shed and is incorporated into the thick mucus. The inflammation also causes hyper responsiveness of airways to nonspecific stimuli |
| What is the classification for severe asthma | Pulse > 110 beats per minute Respiratory rate > 25 Cannot complete sentences in a single breath PEFR - 33%-50% |