Allergic Rhinitis, Asthma, COPD Flashcards
1
Q
Exaggerated response to antigen
A
Hypersensitivity
2
Q
Type of antigen that enters the body
A
Exogenous
3
Q
Any substance that induces the immune system to produce antibodies against it
A
Antigen
4
Q
Blood group antigen
A
Endogenous
5
Q
Normal proteins or complexes that are recognised by the immune system of someone with an autoimmune condition
A
Auto-antigen
6
Q
A type of antigen that produces abnormally vigorous immune response
A
Allergen
7
Q
IgE mediated release of histamine, mast cells, and basophils
A
Type 1: Allergic reaction (immediate hypersensitivity)
8
Q
Reaction within 1 hour
A
Type 1: Allergic reaction (immediate hypersensitivity)
9
Q
Ex: Bee sting, latex allergy, medications (penicillin), urticaria, anaphylaxis, atopy
A
Type 1: Allergic reaction (immediate hypersensitivity)
10
Q
Treatment for Anaphylaxis
A
Epinephrine
11
Q
Genetic tendency to develop allergic diseases such as allergic rhinitis, asthma, and atopic dermatitis
A
Atopy
12
Q
Allergic disease in atopy
A
Allergic rhinitis, asthma, atopic dermatitis
13
Q
Involves IgG and IgM bound cell surface antigens
A
Type 2: Cytotoxic reaction
14
Q
Hours to days rxn
A
Type 2: Cytotoxic reaction
15
Q
Ex: Hemolytic reactions (bursting or destruction of RBC) with medications (ex. Sulfa drugs such as cotrimoxazole cause hemolytic anemia), graft rejections
A
Type 2: Cytotoxic reaction
16
Q
Involves circulating IgG and IgM immune complex that deposits in post capillary venules
A
Type 3: Immune complex reaction
17
Q
1-3 weeks rxn
A
Type 3: Immune complex reaction
18
Q
Example: SLE, Serum sickness
A
Type 3: Immune complex reaction
19
Q
Cell mediated immunity
A
Type 4: Delayed hypersensitivity
20
Q
Mediated by T-cells rather than antibodies
A
Type 4: Delayed hypersensitivity
21
Q
Example: Mantoux test
A
Type 4: Delayed hypersensitivity
22
Q
Ex: nickel (cancerous) allergy, SJS, poison ivy
A
Type 4: Delayed hypersensitivity
23
Q
Poison ivy due to Urushiol, can cause
A
Contact dermatitis
24
Q
Involves inflammation of nasal mucous membranes in sensitized individuals when inhaled allergenic particles contact mucous membranes and elicit a response mediated by immunoglobulin E (IgE).
A
ALLERGIC RHINITIS
25
Mediators of immediate hypersensitivity
Histamine, leukotrienes, prostaglandin, tryptase, kinins
26
_________ produces rhinorrhea, itching, sneezing, and nasal obstruction
Histamine
27
Allergic rhinitis:
Response lasting <4 days/ week or <4 weeks per year
Intermittent
28
Allergic rhinitis:
Response lasting >4 days/week or >4 weeks/ year
Persistent
29
Allergic rhinitis:
Symptoms that do not interfere with quality of life
Mild
30
Allergic rhinitis:
Symptoms that interfere with quality of life such as sleep disturbance and work performance
Moderate to severe
31
Occurs in response to specific antigens present at predictable times of the year
Seasonal (hay fever) allergic rhinitis
32
Occurs year-round in response to nonseasonal allergens and usually causes more subtle, chronic symptoms.
Persistent allergic rhinitis
33
dark circles under the eyes
allergic shiners
34
safer and more generally accepted than
intradermal testing
Percutaneous testing
35
can detect IgE antibodies in the blood that are specific for a given antigen, but it is less sensitive than percutaneous tests
radioallergosorbent test (RAST)
36
effective in preventing the histamine response but not in reversing its effects after they have occurred
H1-receptor antagonists
37
more effective when taken 1 to 2 hours before anticipated exposure to the offending allergen
Antihistamines
38
sympathomimetic agents that act on adrenergic
receptors in nasal mucosa
Decongestants
39
may occur with prolonged use of topical agents (>3–5 days)
Rhinitis medicamentosa
40
has replaced pseudoephedrine in many nonprescription antihistamine–decongestant
Phenylephrine
41
relieve sneezing, rhinorrhea, pruritus, and nasal congestion with minimal side effects
Intranasal corticosteroids
42
They reduce inflammation by blocking mediator release, suppressing neutrophil chemotaxis, causing mild vasoconstriction, and inhibiting mast cell–mediated, late-phase reactions.
Nasal Corticosteroids
43
mast cell stabilizer, is available as a nonprescription nasal spray for symptomatic prevention and treatment of allergic rhinitis
Cromolyn Sodium
44
It prevents antigen-triggered mast cell degranulation and release of mediators, including histamine
Cromolyn Sodium
45
The most common side effect of Cromolyn Sodium
local irritation
46
anticholinergic agent that may be useful in persistent allergic rhinitis
Ipratropium bromide
47
It exhibits antisecretory properties when applied locally and provides symptomatic relief of rhinorrhea.
Ipratropium bromide
48
leukotriene receptor antagonist approved for treatment of persistent allergic rhinitis in children as young as 6 months
Montelukast
49
considered third-line therapy after those agents
Montelukast
50
Adr of decongestants
Anorexant
51
process of administering doses of antigens
responsible for eliciting allergic symptoms into a
patient
Immunotherapy
52
A chronic allergic disorder characterized by episodes of severe breathing difficulty, coughing, and wheezing using the air passage to narrow and cause shortness of breath
Asthma
53
The inflammation is due to bronchi hyper
responsiveness to a variety of stimuli
Asthma
54
Induces a thickened, engorged, edematous airway wall and narrowing of the air lumen.
Plasma protein leakage
55
Migrates to the airways and release inflammatory mediators
Eosinophils
56
Release cytokines from type 2 T-helper cells that mediate allergic inflammation
T- lymphocytes
57
produces IL-2 and interferon gamma that are essential for cellular defense mechanism
Type 1- T- helper
58
Release of histamine, eosinophil, and neutrophil
chemotactic factors, leukotriene C4, D4 and E4,
prostaglandin and platelet activating factors.
Mast Cell degranulation
59
release a number of inflammatory mediators
including PAF and leukotrienes B4, C4, and D4
Alveolar macrophages
60
Releases eicosanoids, peptidases, matrix proteins, cytokines, and nitric oxide.
Bronchial epithelial cells
61
Expectorated mucus from patients with
asthma are _____________
highly viscous
62
Characterized by episodic dyspnea with wheezing
Chronic asthma
63
Progression to Acute state:
☐ Inflammation
☐ Airway edema
☐ Excessive mucus accumulation
☐ Severe bronchospasm
Severe acute asthma
64
Skin paleness
Pallor
65
Peak Expiratory flow and FEV1 are less than 50% of normal predicted values.
Acute severe asthma
66
a condition in which stomach acids back up into your throat
GERD
67
defined as a drop in FEV1 of greater than 15% of baseline (preexercise value)
EXERCISE-INDUCED BRONCHOSPASM
68
may be worse when the air is cold and dry
Exercise-induced asthma
69
triggered by workplace irritants such as chemical fumes, gases, or dust
Occupational asthma
70
triggered by particular allergens, such as pet dander, cockroaches, or pollen
Allergy-induced asthma
71
the volume of air that can forcibly be blown out after full inspiration, measured in liters
Forced vital capacity (FVC)
72
most basic maneuver in spirometry tests
FVC
73
Normal FEV1 value
80-120%
74
volume of air that can forcibly be blown out in one second, after full inspiration
Forced expiratory volume in 1 second/ FEV1
75
relieve reversible bronchospasm by relaxing the smooth muscles of the bronchi
Beta2 agonists
76
Act as bronchodilators and are used to treat
bronchospasm in acute asthmatic episodes and to prevent bronchospasm associated with exercise-induced asthma or nocturnal asthma.
Beta2 agonists
77
Choice in the tx of acute symptoms in younger children
Pirbuterol
78
Effective in smaller doses & fewer adverse effects
Levalbuterol
79
With little effect on cardiac muscle contractility
Ipratropium and albuterol
80
administered to replace deficient endogenous hormones
Corticosteroids
81
Corticosteroid that is used for both acute and chronic asthma
Prednisolone
82
preventive treatment of nocturnal asthma or exercise-induced asthmatic symptoms
LONG-ACTING BETA2 AGONISTS
83
LONG-ACTING BETA2 AGONISTS: Increased intracellular cyclic AMP levels
Arformoterol
84
5-lipoxygenase inhibitor that act on leukotrienes
Zileuton
85
These agents are used for long-term control and prevention of symptoms, especially nocturnal symptoms.
Methylxanthines
86
Directly relaxes smooth muscles of respiratory tract
Theophylline
87
stabilize the mast cell membrane, and inhibit the activation and release of mediators from eosinophils and epithelial cells
Mast cell stabilizer
88
indicated for moderate-to-severe persistent asthma in patients who react to perennial allergens
Monoclonal antibody
89
Recombinant humanized monoclonal antibody; selectively binds to IgE and inhibits binding to IgE receptors
Omalizumab
90
most potent anti-inflammatory agents
Steroids
91
An aerosol inhaled corticosteroid indicated for maintenance tx of asthma as prophylactic therapy
Ciclesonide
92
Selective competitive inhibitor of LTD4 and LTE4 receptors
Zafirlukast
93
Block binding of leukotriene D4 to its receptor
Montelukast
94
these healthy oils may reduce the inflammation that leads to asthma symptoms
Omega-3 fatty acids
95
Airflow limitation that is NOT FULLY reversible with bronchodilators
COPD
96
associated with neutrophilic rather than eosinophilic inflammation
COPD
97
Poorly responsive even to high dose inhaled
corticosteroids and is associated with progressive,
inexorable loss of pulmonary function over time,
especially with continuous smoking
COPD
98
Enzyme that disrupts the lining of the alveoli
Protease
99
associated with chronic or recurrent excessive mucus secretion into the bronchial tree
Chronic bronchitis
100
Blue bloaters
Chronic bronchitis
101
Pink puffers
Emphysema
102
Pulmonary HTN
Cor pulmunale
103
Cor pulmunale is also known as
Right-sided HF
104
Emphysema is located in
Alveoli
105
emphysema associated with smoking and typically most severe in the upper lobe
Centriancinar
106
Most severe in the lower lungs. No smoking
Panacinar
107
What deficiency is associated with no smoking but has emphysema
Alpha 1 antitrypsin deficiency
108
least common; involves the distal airway structure, ducts, and sacs
Distalacinar
109
The stimulus for activation of inflammatory
cells and mediators is an exposure to noxious particles and gas through ___________
Inhalation
110
most common etiologic factor in acquiring COPD
tobacco smoke
111
dilated airspace in the lung parenchyma
Bullae
112
a major component of alveolar walls
Elastin
113
Breaks down elastin
Elastase
114
MOST SIGNIFICANT SYMPTOM OF COPD
Breathlessness
115
may occur particularly during exertion and
airflow obstruction exacerbation
Wheezing
116
Nonpharmacologic therapy for those with Chronic Hypoxemia
Long-Term Oxygen Therapy
117
Normal FEV1
Stage 0
118
FEV1: Greater than or equal to 80%
Stage 1: Mild COPD
119
FEV1: 50-79%
Stage 2: Moderate COPD
120
FEV1: 30-49%
Stage 3:Severe COPD
121
FEV1: <30%
Stage 4: Very Severe COPD
122
With anti oxidant and mucokinetic property
Oral N acetyl cysteine
123
May elicit bronchospasm: if so:
Inhalant therapy of NAC + Bronchodilator
124
via midline sternotomy or video assisted thoracoscopy
Bullectomy
125
A drug used as an antidepressant.
Bupropion
126
Can markedly reduce nicotine cravings.
Bupropion
127
associated with an increased risk for seizures
Bupropion
128
a new agent became available to assist in tobacco cessation attempts
Varenicline
129
a nicotine acetylcholine receptor partial agonist that has shown benefit in tobacco cessation.
Varenicline
130
relieves physical withdrawal symptoms and
reduces the rewarding properties of nicotine
Varenicline
131
Lungs w/ ribs w/ diaphragm
Thorax
132
Chronic bronchitis is located in
Bronchioles
133
Increases in markers (e.g _________ & ____________) of oxidants are seen in the epithelial lining fluid of COPD patients.
Hydrogen peroxide & nitric oxide
134
Little or no dyspnea
Stage 1: Mild COPD
135
Dyspnea on moderate exertion
Stage 2: Moderate COPD
136
Dyspnea on mild exertion
Stage 3:Severe COPD
137
Dyspnea even at rest
Stage 4: Very Severe COPD
138
Neozep
Paracetamol + Chlorpheniramine + Phenylephrine
139
rebound vasodilation with congestion
Rhinitis medicamentosa
140
Found in fish, flaxseed and other foods
Omega-3 fatty acids
