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Respiratory PDA > Asthma > Flashcards

Asthma Flashcards

1
Q

What disease is asthma classified as?

A

A chronic inflammatory disease of the airways

increased responsiveness of the bronchi to stimuli (allergens)

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2
Q

What group of people have the highest rate of asthma?

A

African Americans ranging from 15-24 years of age

The most common childhood chronic disease

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3
Q

What are the clinical hallmarks (symptoms) of asthma?

A

Recurrent and episodic bouts of
* Coughing
* SOB
* Chest tightness
* Wheezing

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4
Q

T/F: Asthma is irreversible.

A

False

Reversible with treatment but not curable

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5
Q

Why does atopy cause asthma?

A

atopy is the result of too much IgE which cause inflammatory mediator secretion

wheezing infants and continues throughout life

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6
Q

What controls the bronchial smooth muscle tone?

A

Autonomic nervous system

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7
Q

What kind of stimulation causes bronchodilation?

A

Sympathetic stimulation

via epinephrine release

Hence why beta agonists are used

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8
Q

What type of ANS stimulation causes bronchial constriction?

A

Cholinergic stimulation

Hence why antimuscarinics are used

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9
Q

When do you use bronchoprovocation?

A

When the patient’s spirometry readings are normal but doctor thinks they may have asthma

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10
Q

What is bronchoprovocation?

A

Another spirometry test but after inhalation of methacholine or histamine

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11
Q

What are the main immune symptoms or features of asthma?

A

Inflammatory cell infiltration
* Eosinophils mainly
Edema
Mast cell activation
Airway remodeling
Collagen deposition

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12
Q

What determines a patient’s degree of airway obstruction and narrowing?

A

Diameter of the airways lumen

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13
Q

What influences the airway’s lumen size?

A

Airway smooth muscle contraction
Mucus plugging
Edema (swelling)
Over inflation due to trapped air

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14
Q

What occurances happen in nocturnal asthma?

A

Decreased levels of circulating catecholamines and steroids
Increased vagal tone
Increase in mucus and mediator release

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15
Q

What is Idiosyncreatic asthma?

A

Adult onset asthma

usually have aspirin and nsaid sensitivities

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16
Q

What is the early stage of asthma?

A

Airway inflammation due to an initial exposure to stimuli and mediator release

Bronchospasm response

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17
Q

What is the late stage of asthma?

A

Chemotactic inflammation where the mediators from early phase cause infiltration of eosinophils and neutrophils

Causes epithelial injury (remodeling)

18
Q

What does IgE do to cause asthmatic episodes?

A

Attaches to mast cells, basophils, and macrophages

degranulation of mast cells

19
Q

What response occurs after mast cell degranulation?

A

Release of numerous inflammatory mediators
* Histamine
* leukotrienes
* prostaglandins
* cytokines

20
Q

What interleukins stimulate B cells to increase production of IgE?

A

IL 4 and IL 13

Released from TH2 T cells

21
Q

What interleukins increase eosinophil recruitment and activation?

A

IL 3 and IL 5

Released by TH2 T cells and mast cells

22
Q

What are the symptoms for early phase inflammation (airway inflammation)?

A

Bronchospasms
Increased vascular permeability
Increased mucus production

23
Q

What information is needed for an asthma diagnosis?

A

History and patterns of symptoms
Measurments of lung function
Measure of airway responsiveness
Measure of allergic status to see risk factors

24
Q

How do you measure airway responsiveness?

A

Bronchoprovocation - response to stimuli
Response to albuterol

25
Q

How do you measure lung function?

A

Spirometry
Peak expiratory flow

26
Q

What do you use for nocturnal asthma?

A

LABA

27
Q

Why are asthma symptoms common during sleep?

A

Increase in parasympathetic tone
Lose catecholamines and glucocorticoids

Increased mediator release

28
Q

What inflammatory mediator causes airway remodeling?

A

Neutrophils

collagen deposition under basement membrane

29
Q

What are the symptoms of stage 1 asthma?

A

less than 2 nightime symptoms per month
2 or less symptoms per week
Brief reactions
Good lung function

30
Q

What is the FEV1 of stage 1 asthma?

A

80% or greater

31
Q

What is the peak expiratory flow variability in stage 1 asthma?

A

less than 20%

32
Q

What are the symptoms of stage 2 (mild persistent) asthma?

A

Greater than 2 symptoms a week but less than 1 per day.
2-4 nighttime symptoms per month
Exacerbations that require systemic steroids (more than 2 times a year)

33
Q

What is the FEV1 of stage 2 asthma?

A

Over 80%

34
Q

What is the Peak expiratory flow variability of stage 2 asthma?

A

20-30%

35
Q

What are the symptoms of stage 3 (Moderate persistant) asthma?

A

Daily symptoms (use of SABA)
More than 2 episodes a year
More than 1 nighttime symptoms a week but not nightly

36
Q

What is the FEV1 of stage 3 asthma?

A

60-80%

37
Q

What is the PEF variability of stage 3 asthma?

A

over 30%

38
Q

What are the symptoms of stage 4 (severe persistent) asthma?

A

Continual symptoms and use of SABA
Frequent nighttime symptoms
Limited physical abilities
Frequent episodes

39
Q

What is the FEV1 of stage 4 asthma?

A

less than 60% of predicted

40
Q

What is the PEF variability of stage 4 asthma?

A

Over 30%

Respiratory PDA (5 decks)

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