08.18 - Asthma (Muthiah) - Questions

Question 1

T/F: All airway remodeling in Asthma is permanent

Answer 1

False, some is reversible

Question 2

Treatment of Mild Persistent Asthma

Answer 2

Inhaled steroids

Question 3

Tx of Moderate Persistent Asthma

Answer 3

Inhaled steroids and LABA’s

Question 4

Tx of Severe Persistent Asthma

Answer 4

Inhaled steroids, LABA’s, Leukotriene Modifiers

Question 5

Most common type of asthma

Answer 5

Extrinsic

Question 6

IgE in Intrinsic Asthma

Answer 6

Non-allergic: Serum IgE not elevated (as much)

Question 7

Skin antigen test in Intrinsic Asthma

Answer 7

Usually negative

Question 8

Family Hx in Extrinsic vs Intrinsic

Answer 8

Positive in extrinsic usually, Non-contributory in intrinsic

Question 9

Samter’s Syndrome

Answer 9

Asthma, Aspirin Sensitivity, Nasal Polyps

Question 10

When does exercise-induced bronchospasm occur

Answer 10

5-10 minutes after exercise

Question 11

Pathophys of Exercise-Induced

Answer 11

Cooling and mucosal drying of airways triggers mast cell release of histamine

Question 12

Pre-treatment of Exercise-induced

Answer 12

Beta-agonist or Cromolyn

Question 13

What is Cromolyn

Answer 13

Mast cell membrane-stabilizing agent (can’t degranulate)

Question 14

Why is nocturnal asthma common between midnight and 8am

Answer 14

Decline of circulating catecholamines and cortisol

Question 15

Type of response/reaction in ABPA

Answer 15

IgE-mediated reaction; Type 3 IgE-mediated response

Question 16

Distinguishing features of ABPA

Answer 16

Very elevated eosinophilia; Very high IgE; Fleeting chest infiltrates

Question 17

Mainstay tx of ABPA

Answer 17

Prednison (Anti-fungals don’t improve mortality)

Question 18

Origin of Major Basic Protein

Answer 18

Eosinophils

Question 19

Where does fibrosis occur in remodeling

Answer 19

Subepithelial

Question 20

Relevant Interleukins in Asthma vs COPD

Answer 20

IL-5 in Asthma; IL-8 in COPD

Question 21

Asthma vs COPD: Neutrophilic vs Eosinophilic during exacerbation

Answer 21

Asthma is Neutrophilic; COPD is Eosinophilic (contrary to primary inflammatory cell)

Question 22

3 signs of life threatening asthma

Answer 22

Accessory muscle use; Hypoxemia; Hypercapnea

Question 23

Death from asthma is usually related to

Answer 23

Diffuse mucous plugging of airways

Question 24

What is considered diagnostic on Peak Flow Meter

Answer 24

Diurnal varation of PEFR >20%

Question 25

DLCO in Asthma

Answer 25

Normal (occassionally elevated)

Question 26

Why should we use LABA’s cautiously

Answer 26

Associated with increased mortality