1

Question 1

What is airway remodeling?

Answer 1

Permanent alterations in airway structure

Question 2

Describe the acute phase in Inflammatory cascade

Answer 2

peaks within 15 min of exposure, resolves in 1 hour ; release of inflammatory mediators when exposed to allergens

Question 3

Describe the late phase in inflammation phases

Answer 3

peaks 4-6 hours after exposure; WBC are recruited and resident cells are activated. Can result in in airway obstruction and injury. may result in 75% reduction in FEV1

Question 4

Describe the Chronic phase in inflammation

Answer 4

Persistent levels of inflammation can lead to cell damage, and changes in structure known as remodeling.

Question 5

What mechanisms contribute to airway hyperresponsiveness?

Answer 5

inflammation, dysfunctional neuroregulation, and structural changes

Question 6

Describe airway obstruction

Answer 6

narrowing in airways may be reversible spontaneously or with meds. In some cases it isn’t reversible

Question 7

What are the 4 steps to Sensitization?

Answer 7

1. Specialized immune system cells recognize and process the antigen into products of its component proteins
2. Antigen presenting cells present the antigenic protein-peptide-to specialized immune cells, T-lymphocytes
3. T lymphocytes communicate with B lymphocytes resulting in production of IgE antibodies specific to the allegen
4. IgE antibodies bind to the surface of mast cells, where they are primed to recognize the particular allergen on subsequent exposure

Question 8

What is the reaction during the acute-phase reaction?

Answer 8

Orchestrated by mast cells- 1. At re-exposure to sensitized allergen, mast cell bound IgE antibodies recognize the allergen and 2. Trigger the release of inflammatory mediators from mast cells

Question 9

What is the late phase reaction?

Answer 9

Orchestrated by eosinophils and T cells 1. inflamm cell recruitment, infiltration, and activation continue 2. airway constitutive cells continue to release inflam mediators 3. Mediators form eosinophils promote damage to the airway epithelium. Sloughing of the damaged epith. leasds to a loss of barrier and secretory function and exposure to nerve endings. Airway tissues swell, blood vessels dialate, increased mucus secretion 4. Mediators released from activated T cells stimulate B cell production of IgE antibodies and amplify recruitment and activation of eosinophils and mast cells 5. mediators from all sources induce a delayed or 2nd wave of inflamm response

Question 10

What is the chronic phase reaction?

Answer 10

persistent cell damage, permanent structural changes. Causes airway remodeling

Question 11

What are the consequences of airway remodeling?

Answer 11

Airway wall thickening; persistent and incompletely reversible airway narrowing and formation of mucus plugs

Question 12

What are results of airflow limitation from bronchoconstriction?

Answer 12

vascular congestion, edema, thick sticky secretions

Question 13

What changes in pulm function occur from airflow limitation?

Answer 13

increase in airflow resisitance;decrease in exhalations, decrease in the rate that air can be exhaled, hyperinflation of the lungs and thorax, increase in work of breathing, changes in resp muscle function, decrease in blood O2 concentration

Question 14

What is the early phase reaction? Time wise

Answer 14

immediate hypersensitivity reactions occur in minutes. Bronchoconstriction occurs in most patients

Question 15

What is the late phase reaction? Time wise

Answer 15

2-4 hours after exposure can persist 24 hours max intensity 6-9 hours after onset. late or second wave bronchoconstriction is apparent with 30-50% of patients

Question 16

What is the chronic phase reaction? Time wise?

Answer 16

pul function fluctuates and slowly deteriorates with effects that can persist for days

Question 17

Early allergic reaction begins with an initial exposure to give allergens. What process occurs at that time?

Answer 17

Sensitization

Question 18

During an acute-phase reaction, mast cell bound IgE antibodies recognize the allergen and trigger mast cell degranulation. Mast cell release which of the following?

Answer 18

Inflammatory mediators

Question 19

Histologic changes result in which of the following?

Answer 19

Airway remodeling

Question 20

What factors are assoc with inflammation?

Answer 20

Multiple cell types and mediators

Question 21

What are consequences of inflammatory mediators?

Answer 21

Acute bronchoconstriction, congestion and leakage of blood vessels, tissue edema, increased mucus production, stimulation of sensory nerves