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Clinical health midterm2 > Allergy and asthma > Flashcards

Allergy and asthma Flashcards

1
Q

Race differences + asthma

A

4.6/10.000 black woman died of asthma compared to 2.7/10.000 white woman.

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2
Q

incidence rate ratio (IRR) + asthma

A

IRR were increased among woman who reported childhood abuse.

IRR for woman who felt in danger in the home in addition to being abused as children were higher than those for woman who were abused but did not feel in danger.

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3
Q

Physical abuse + asthma

A

Exposure to physical abuse during childhood was associated with an increased incidence for adult-onset asthma of greater than 20%. The risk was higher among women who also felt in danger in the home as a child.

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4
Q

IRR + sexual abuse

A

IRR were weaker for sexual abuse during childhood, and there was little evidence that abuse during adolescence increased asthma incidence.

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5
Q

Allergies

A

An immune-mediated hypersensitivity reaction

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6
Q

Different types of allergies

A 
Asthma bronchial: 2-10%
Exzema: 10-20%
Pollen
Food: 1-2%
Drug: 5-20%
Anaphylaxis <1%
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7
Q

Allergies + personality (early studies)

A

Neurotic trait = higher probability to get allergy as behavioral inhibition, introversion, social anxiety.

Alexithymia, passive, avoidance coping, high depndence

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8
Q

Allergies and personality (later studies)

A

higher hostility, high perfectionism, high need for being loved and need for approval, high rates of emotional coping, less satisfaction with family life, better financial situation (they are still less satisfies)

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9
Q

psychophysiological approaches to allergies

A

Dysfunction in the HPA axis
Dominance of the right hemisphere (alteration of laterality)
Bidirectional connection between the CNS and immune system components

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10
Q

Psychodynamic approach to allergies

A

Communication through the allergic symptom

Symptom as symbol of a psychological problem

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11
Q

Allergies + psychopathologies

A

There is a high correlation between allergic symptoms and anxiety, depression, exhaustion.

More than 50% of patient hd mild, medium or severe depression. (the direction can also go the other way around, because 40% of those who is depressed also get allergic symptoms)

Most frequent:

  • panic disorder
  • anxiety disorder
  • phobias
  • somatization problems
  • sleep problems
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12
Q

Two types of pediatric asthma

A

Extrinsic and intrinsic

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13
Q

Extrinsic asthma

A

Atopic - associated with evidence of allergen sensitization.

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14
Q

Intrinsic asthma

A

Nonatopic - is brought by exercise or other triggers but does not have an obvious extrinsic trigger.

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15
Q

Symptoms of asthma

A 
Shortness of breath
Cough
Wheezing
Chest tightness
Agitation
HEart rate
Respiratory rate
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16
Q

Prevalence of asthma

A

0-17 y: boys have higher rate

> 18 y: woman have higher rate

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17
Q

Psychosocial factor of asthma

A
  • anxiety and fear of having an attack
  • Uncertainty, because it is unpredictable and uncontrollable (learned helplessness)
  • Unreleated emotional reactions and problems lead to more frequent visits to emergencies.
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18
Q

Environmental risk factors of asthma

A

house dust, cat and dog allergens, as well as exposure to environmental tobacco smoke in children over 6 years.

In children younger than 6 years, exposure to pet had a protective effect.

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19
Q

psychosocial risk factors of asthma

A
  • preterm birth and eight gain predict childhood asthma
  • Childhood physical and sexual abuse
  • intimate partner violence exposure of the other (at 7month of age)
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20
Q

Psychosomatic risk factors of asthma

A
  • ambivalence toward the mother

- asthma can be a sign of suppressed crying for the mother

21
Q

Asthma and stress

A

Asthma people tend to have greater bronchoconstriction compared to healthy people in response to stress.

HPA xix have a reduced responsiveness to psychosocial stress

22
Q

Rosenberg et al. (asthma)

A

Stress is likely to affect the onset and course of asthma by directly acting on pathogenic mechanisms in the airways

23
Q

Asthma and panic

A

Its overrepresented among asthma patients.

Bidirectional interactions:

  • Panic may elicit asthma symptoms
  • Mild and severe asthma symptoms might trigger panic
24
Q

Asthma and depression

A

People with depression is 3-17 times more likely to have a comorbidity of asthma compared with that of counterparts without depression.

people with asthma is 1.52 times more likely to have a comorbid depression compared with those without asthma.

25
Q

Ortega

A

Asthma is associated with anxiety disorder, but not affective disorder

26
Q

Asthma + behavioral problems

A

Asthma is associated with higher rate of behavioral problems

  • low maternal education
  • smoke in home
  • parental asthma
  • minor psychiatric disorder in mother
  • mother drinks alcohol
27
Q

Mechanisms of behavioral problems in asthma

A

Living with behavioral problems in childhood may affect the management of asthma symptoms and worsen it.

Bidirectional relationship between asthma and behavioral problems

Third variables: Low SES, maternal psychiatric problems

28
Q

Asthma symptoms perception

A

Its important with symptom perception training, since you can either be overperceivers (take more medications than nneccesary) or underestimates (less medications).

29
Q

Interventions focusing on environmental risk factors

A
  • breastfeeding
  • Food avoidance
  • Maternal dietary allergen avoidance during pregnancy
  • house dust mite avoidance
30
Q

Breastfeeding (intervention)

A

Protective effect against asthma and allergic disease.

Infants fed with formulas of intact cow milk or soy protein compared with breast milk have a higher incidence of atopic dermatitis and wheezing illnesses in early childhood

31
Q

Food avoidance

A
  • avoidance of cow milk has been suggest for high-risk infants
32
Q

House dust mite avoidacne

A

Show some benefit

33
Q

Eczema (atopic dermatitis, AD) symptoms

A
  • Rash that appear suddenly
  • makes the skin dray, itchy
  • form on the scalp and face
  • causes itches that comes on go
  • skin infections
  • with time: thicken skin

adults: have more severe symptoms

34
Q

eczema + epidemiology

A

10-20% children

1-3% adults

35
Q

eczema + outcome

A

For some children, the condition completely disappears by age 2

About half of the children who get AD will have it as adults

36
Q

Cause of atopic dermatitis

A

Children are more likely to develop AD if one of the parents has AD, asthma or hay fever.

37
Q

Risk factor of AD

A
  • family member who have AD
  • where the child lives (e.g. city with high pollution)
  • gender: females are more likely than males
  • mothers age when child is born: the older the mother > more likely for the child to get AD
  • social class: more common in higher social classes
38
Q

Treatment of AD

A

Cant cure AD, but can control it.

Treatment can:

  • prevent for getting worse
  • calm the skin
  • relieving pain and itch
  • reduce emotional tress
  • prevent infections
  • stop skin from thickening
  • control itching
39
Q

Psychodetermatology

A

Interaction between skin, mind and body

40
Q

Goal of psychodermatology treatment

A

not only to improve conditions of the skin, but also teach patient/carers how to cope with the disease

41
Q

AD is psychophysiology disorder?

A

because it is not caused by stress, but appears to be precipitated by stress in some patients, and emotional factors can determine the natural course of the disease.

However chronic stress flares up pre-existing dermatosis.

42
Q

Catecholamines

A

adrenaline + noradrenaline have effect on the immune system. increased allergic inflammatory response

43
Q

Cortisol + AD

A

Cortisol act as a negative feedback mediator in the hypothalamus and inhibit the furter release of corticotrophin.

44
Q

psychodermatological aspect of itch

A

emotional factors can cause, and frequently heighten the itching and scratching behavior, which can lead to serious impairment in QoL.

45
Q

culture + eczema

A

in culture that values smooth, perfect skin, disfigured skin can cause stigmatization, social withdrawal, anxiety and depression

46
Q

Eczema + QoL (children)

A

the impact of AD on QoL is high.

Infant with AD: significant dependents or clinginess, fearfulness, and behavioral problems compared to control population.

Ad causes irritability, sleep disturbance, anxiety and depression in children.

47
Q

Eczema + QoL (adults)

A

frequently observed in people with AD are: self-image issues, hostile personality characteristics, dysthymic states and neurotic symptoms.

Can affect interpersonal relationships, decrease sexual desire, reduce work productivity and affect social/leisure activities. They are more restless in their sleep, more wake, spend less time asleep.

Has an affect on psychological well-being, comorbidity with anxiety, depression and sucicideal ideation

48
Q

Treatment

A

Psychological intervention:

  • Education !!!
  • Brief dynamic psychotherapy
  • biofeedback
  • CBT
  • relaxation techniques and hypnosis

Clinical health midterm2 (8 decks)

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