Asthma (13) Flashcards
True/False: Asthma tends to have a normal or decreased DLCO
True
Asthma is described as a lung disorder characterized by what?
- Reversible bronchial smooth muscle(bronchospasm)
- Airway inflammations
- Increase airway responsiveness to an assortment of stimuli (mucus production)
With time patients with asthma smooth muscle layers what?
Hypertrophy- increase in thickness 3x the normal thickness.
True/False: Airway becomes infiltrated with inflammatory cell (histamine) and eosinophils.
True
What’s the best mucolytic for asthma?
Water.
What does mucus for asthmatics look like?
Thick, whitish, tenacious mucus
Major pathologic anatomic alterations during asthma attack are…
- Smooth muscle construction
- Excessive production of thick, whitish, bronchial mucus
- Mucus plugging
- Hyperinflation of alveoli (air trapping)
- Potential atelectasis caused by mucous
- Bronchial wall inflammation
What is remodeling?
Permanent structural changes to the airway from chronic inflammation that leads to less responsiveness airway to treatment.
The pathologic alterations of the lung during an asthma exacerbation are completely absent/present between episodes.
Absent.
Asthma in kids and adults.
Twice as prevalent in boys than girls. But more common in women than men in adults.
About how many die per day from asthma in the US?
9
Risk factors in Asthma…
Host factor - genetic or intrinsic factors
Environmental factors - triggers or extrinsic factor
Host factors are
Genetics
Obesity
Sex and gender
Environmental factors are
Allergens
Infections
Occupational tobacco smoke
Diet
Other risk factors
Drugs Food additives Exercise induced bronchospam Gastroesophageal reflex Sleep Emotional stress
Diagnosis of Asthma
Table 13-4 on 217
Signs and symptoms of asthma
Wheezing History of recurrent cough Dyspnea Chest tightness Worsening symptoms at night or seasonal Family history Worsen of extrinsic or intrinsic triggers Cold that takes 10days to clear
Intermittent asthma
•Symptoms: cough, wheezing, chest tightness or difficulty breathing less twice a week
- Flare-ups are brief but intensity may vary
- nighttime symptoms less than twice a month
- no symptoms between flare-ups
- Lung function test FEV1 is 80% or more above normal
- peak flow has less than 20% variability am to am or am to pm. Day to day.
Mild persistent asthma
•Symptoms: cough, wheezing, chest tightness or difficulty breathing 3-6times a week
- Flare-ups May effect activity level
- nighttime symptoms 3-4times a month
- Lung function test FEV1 is 80% or more above normal
- peak flow has less than 20-30%variability
Moderate persistent asthma
•Symptoms: cough, wheezing, chest tightness or difficulty breathing daily
- Flare-ups May effect activity level
- nighttime symptoms 5 or more times a month
- Lung function test FEV1 is 60% but less than 80% normal values
- peak flow has more than 30%variability
Severe persistent asthma
•Symptoms: cough, wheezing, chest tightness or difficulty breathing are continual
- frequent nighttime symptoms
- Lung function test FEV1 is 60% or less than normal values
- peak flow has more than 30%variability
Tests for asthma
•Spirometry
-FEV1 Normal
- FVE1/FVC normal
• Peak expiratory flow rates
•Methacholine challenge
-to determine mild or exercise induced asthma
• RAST
- skin or serum testing for sensitive allergens
- big in asthmatics with extrinsic factors
•Fractional exhaled nitric oxide sensitive to presence of airway inflammation
