Asthma Flashcards
(40 cards)
What disease is asthma classified as?
A chronic inflammatory disease of the airways
increased responsiveness of the bronchi to stimuli (allergens)
What group of people have the highest rate of asthma?
African Americans ranging from 15-24 years of age
The most common childhood chronic disease
What are the clinical hallmarks (symptoms) of asthma?
Recurrent and episodic bouts of
* Coughing
* SOB
* Chest tightness
* Wheezing
T/F: Asthma is irreversible.
False
Reversible with treatment but not curable
Why does atopy cause asthma?
atopy is the result of too much IgE which cause inflammatory mediator secretion
wheezing infants and continues throughout life
What controls the bronchial smooth muscle tone?
Autonomic nervous system
What kind of stimulation causes bronchodilation?
Sympathetic stimulation
via epinephrine release
Hence why beta agonists are used
What type of ANS stimulation causes bronchial constriction?
Cholinergic stimulation
Hence why antimuscarinics are used
When do you use bronchoprovocation?
When the patient’s spirometry readings are normal but doctor thinks they may have asthma
What is bronchoprovocation?
Another spirometry test but after inhalation of methacholine or histamine
What are the main immune symptoms or features of asthma?
Inflammatory cell infiltration
* Eosinophils mainly
Edema
Mast cell activation
Airway remodeling
Collagen deposition
What determines a patient’s degree of airway obstruction and narrowing?
Diameter of the airways lumen
What influences the airway’s lumen size?
Airway smooth muscle contraction
Mucus plugging
Edema (swelling)
Over inflation due to trapped air
What occurances happen in nocturnal asthma?
Decreased levels of circulating catecholamines and steroids
Increased vagal tone
Increase in mucus and mediator release
What is Idiosyncreatic asthma?
Adult onset asthma
usually have aspirin and nsaid sensitivities
What is the early stage of asthma?
Airway inflammation due to an initial exposure to stimuli and mediator release
Bronchospasm response
What is the late stage of asthma?
Chemotactic inflammation where the mediators from early phase cause infiltration of eosinophils and neutrophils
Causes epithelial injury (remodeling)
What does IgE do to cause asthmatic episodes?
Attaches to mast cells, basophils, and macrophages
degranulation of mast cells
What response occurs after mast cell degranulation?
Release of numerous inflammatory mediators
* Histamine
* leukotrienes
* prostaglandins
* cytokines
What interleukins stimulate B cells to increase production of IgE?
IL 4 and IL 13
Released from TH2 T cells
What interleukins increase eosinophil recruitment and activation?
IL 3 and IL 5
Released by TH2 T cells and mast cells
What are the symptoms for early phase inflammation (airway inflammation)?
Bronchospasms
Increased vascular permeability
Increased mucus production
What information is needed for an asthma diagnosis?
History and patterns of symptoms
Measurments of lung function
Measure of airway responsiveness
Measure of allergic status to see risk factors
How do you measure airway responsiveness?
Bronchoprovocation - response to stimuli
Response to albuterol
