Asthma Flashcards
What is the definition of asthma?
chronic (1) inflammatory disorder of the airways that is characterized by (2) episodic reversible bronchospasm resulting from an exaggerated response to a stimulus
What cells play major roles in asthma?
mast cells, eosinophills, and T cells
What is the long term consequence of chronic inflammation (this is what leads to the obstruction)?
remodeling of the airway
T or F: Asthma is curable
F: very manageable
Describe the epidemiology of asthma
- -2-7% of the pop has it
- -overall female > male but in childhood male > female
- -blacks > risk of asthma death
- -30-50% of kids will “outgrow” asthma
- -20-30% of adult onset asthma will experience remission
How is asthma classified?
intermittent = 1-2 episodes/year
persistent = > 1-2 episodes/year
-mild, moderate, severe
How is mild persistent asthma treated?
inhaled steroids
How is moderate persistent asthma treated?
inhaled steroids and long acting beta agonists (LABAs)
How is severe persistent asthma treated?
inhaled steroids, long acting beta agonists (LABAs), and leukotreine modifiers
*leukotreines cause constriction
What type of asthma treatment is assc with an increased in mortality?
LABA
What is the rescue medication for an acute asthma attack?
LABA
What is the most common type of asthma? What age group is it most common in?
extrinsic and kids
What is the pathophys of extrinsic asthma?
type I HS reaction: IgE response to environmental allergens
Triggering of response:
Ag recognized by Th2 cell which makes IL-5 and IL-5 and IL-13.
–IL-4 activates B cells to make IgE against Ag. IgE binds FcR and coats Mast cells. Mast cells degranulate and make IL-5 when exposed to Ag
–IL-13 promotes mucous production.
–Mast cell and Th2 cell IL-5 recruit and activate eosinophils.
Early/immediate response: minutes
-mast cell and eosinophil granule contents either directly or through neuronal reflexes… induce bronchospasm, increase vascular permeability and mucus production, and recruit additional mediator-releasing cells from the blood
Late phase: hours
the arrival of recruited neutrophils, eosinophils, basophils, lymphocytes, and monocytes are active and release more inflam mediates that cause more inflammation, mucous prduction, bronchoconstriction, and damage to epithelium in airways
What are common environmental allergens that cause extrinsic asthma?
house dust mites
cockroaches
pets (cell debris in their saliva)
mold
How is extrinsic asthma diagnosed?
wheal-and-flare reaction
T or F: infections can trigger extrinsic asthma
T
What triggers intrinsic asthma?
respiratory infection (rhinovirus, parainfluenze) and inhaled air pollutants (sulfur dioxide, ozone, nitrogen dioxide)
what is the epidemiology of intrinsic asthma
adult onset
Are skin tests + or - in intrinsic asthma?
negative
What is the pathophys of intrinsic asthma?
not sure but know that eosinophils are involved bc it is treated the same as extrinsic asthma
How can intrinsic and extrinsic asthma be differentiated?
IgE levels are only elevated in extrinsic also intrinsic is not allergen mediated so a skin test will be negative
What drugs can induce asthma
aspirin
NSAIDS