Asthma (13)

Question 1

True/False: Asthma tends to have a normal or decreased DLCO

Answer 1

True

Question 2

Asthma is described as a lung disorder characterized by what?

Answer 2

1. Reversible bronchial smooth muscle(bronchospasm)
2. Airway inflammations
3. Increase airway responsiveness to an assortment of stimuli (mucus production)

Question 3

With time patients with asthma smooth muscle layers what?

Answer 3

Hypertrophy- increase in thickness 3x the normal thickness.

Question 4

True/False: Airway becomes infiltrated with inflammatory cell (histamine) and eosinophils.

Answer 4

True

Question 5

What’s the best mucolytic for asthma?

Answer 5

Water.

Question 6

What does mucus for asthmatics look like?

Answer 6

Thick, whitish, tenacious mucus

Question 7

Major pathologic anatomic alterations during asthma attack are…

Answer 7

1. Smooth muscle construction
2. Excessive production of thick, whitish, bronchial mucus
3. Mucus plugging
4. Hyperinflation of alveoli (air trapping)
5. Potential atelectasis caused by mucous
6. Bronchial wall inflammation

Question 8

What is remodeling?

Answer 8

Permanent structural changes to the airway from chronic inflammation that leads to less responsiveness airway to treatment.

Question 9

The pathologic alterations of the lung during an asthma exacerbation are completely absent/present between episodes.

Answer 9

Absent.

Question 10

Asthma in kids and adults.

Answer 10

Twice as prevalent in boys than girls. But more common in women than men in adults.

Question 11

About how many die per day from asthma in the US?

Answer 11

9

Question 12

Risk factors in Asthma…

Answer 12

Host factor - genetic or intrinsic factors

Environmental factors - triggers or extrinsic factor

Question 13

Host factors are

Answer 13

Genetics
Obesity
Sex and gender

Question 14

Environmental factors are

Answer 14

Allergens
Infections
Occupational tobacco smoke
Diet

Question 15

Other risk factors

Answer 15

Drugs 
Food additives 
Exercise induced bronchospam 
Gastroesophageal reflex 
Sleep 
Emotional stress

Question 16

Diagnosis of Asthma

Answer 16

Table 13-4 on 217

Question 17

Signs and symptoms of asthma

Answer 17

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

Question 18

Intermittent asthma

Answer 18

•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.

Question 19

Mild persistent asthma

Answer 19

•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

Question 20

Moderate persistent asthma

Answer 20

•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

Question 21

Severe persistent asthma

Answer 21

•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

Question 22

Tests for asthma

Answer 22

•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