08.18 - Asthma (Muthiah) - Questions Flashcards
T/F: All airway remodeling in Asthma is permanent
False, some is reversible
Treatment of Mild Persistent Asthma
Inhaled steroids
Tx of Moderate Persistent Asthma
Inhaled steroids and LABA’s
Tx of Severe Persistent Asthma
Inhaled steroids, LABA’s, Leukotriene Modifiers
Most common type of asthma
Extrinsic
IgE in Intrinsic Asthma
Non-allergic: Serum IgE not elevated (as much)
Skin antigen test in Intrinsic Asthma
Usually negative
Family Hx in Extrinsic vs Intrinsic
Positive in extrinsic usually, Non-contributory in intrinsic
Samter’s Syndrome
Asthma, Aspirin Sensitivity, Nasal Polyps
When does exercise-induced bronchospasm occur
5-10 minutes after exercise
Pathophys of Exercise-Induced
Cooling and mucosal drying of airways triggers mast cell release of histamine
Pre-treatment of Exercise-induced
Beta-agonist or Cromolyn
What is Cromolyn
Mast cell membrane-stabilizing agent (can’t degranulate)
Why is nocturnal asthma common between midnight and 8am
Decline of circulating catecholamines and cortisol
Type of response/reaction in ABPA
IgE-mediated reaction; Type 3 IgE-mediated response
Distinguishing features of ABPA
Very elevated eosinophilia; Very high IgE; Fleeting chest infiltrates
Mainstay tx of ABPA
Prednison (Anti-fungals don’t improve mortality)
Origin of Major Basic Protein
Eosinophils
Where does fibrosis occur in remodeling
Subepithelial
Relevant Interleukins in Asthma vs COPD
IL-5 in Asthma; IL-8 in COPD
Asthma vs COPD: Neutrophilic vs Eosinophilic during exacerbation
Asthma is Neutrophilic; COPD is Eosinophilic (contrary to primary inflammatory cell)
3 signs of life threatening asthma
Accessory muscle use; Hypoxemia; Hypercapnea
Death from asthma is usually related to
Diffuse mucous plugging of airways
What is considered diagnostic on Peak Flow Meter
Diurnal varation of PEFR >20%
DLCO in Asthma
Normal (occassionally elevated)
Why should we use LABA’s cautiously
Associated with increased mortality
