Asthma

Question 1

What are the disease classifications ?

Answer 1

Topographic - region of the body or system
Anatomic - organ or tissue
Physiological - function or effect
Pathological - nature of disease process
Aetiologic - cause

Question 2

Describe and explain asthma

Answer 2

This is a disease that involves (sometimes) sever periods of bronchial obstructions, with people that have hypertension or hyper-responsive airways

Question 3

Name the four types of asthma

Answer 3

Allergic asthma - (atopic asthma)
Seasonal asthma - hayfever/cold air
Occupational asthma
Non-allergic asthma

Question 4

What is allergic asthma (atopic asthma) ?

Answer 4

The most common form of asthma in the uk, this is triggered in the body by allergens such as pollen, animal dander and moulds
Around 80% of people will suffer from a secondary comorbidity such as hayfever, eczema or food allergy and usually have to take daily medications to prevent

Question 5

What is seasonal asthma ?

Answer 5

Theses individuals will only experience these at certain times of the year
Spring summer - hayfever
Winter - cold air
And will only take their medications when they feel the need to help with exacerbations

Question 6

What is occupational asthma ?

Answer 6

This is directly related to an. Individuals line of work, and is usually started in adulthood.
Triggers can be:
bakers - flour
NHS staff - powder off latex gloves
Farmers - animal dander

Question 7

What is non-allergic asthma ?

Answer 7

Rarest type of asthma, not triggered by any allergens
Most misunderstood type, can be caused by exercise, stress

Question 8

Describe the aetiology of asthma

Answer 8

Although this is not completely understood, there is thought to be a combination of genetic and environmental factors that contribute to this disease. Mad euphoria for more then 100 genes and the mutation of these genes increase the risk of asthma

Question 9

What four change happen to an asthmatic person in the bronchi and bronchioles ?

Answer 9

Inflammation of mucosa
Oedema of the mucosa
Contractions of the smooth muscles
Mucus hyper-secretion

Question 10

What is bronchoconstriction ?

Answer 10

The narrowing and constriction of the airways

Question 11

What happens to the allergen when it enters the system ? (1)

Answer 11

Allergens enter the system by being ingested by the antigen presenting cell which then presents it on its surface and introduces it to help the T helper cell

Question 12

What does the immune response then do to the allergen ? (2)

Answer 12

The T helper cell links with the B lymphocyte (WBC) as they function in the hormonal immunity component of the adaptive immune system by secreting antibodies.
Activated B lymphocytes form plasma cells that introduce Immunoglobulin E (IgE) antibodies

Question 13

What happens to the IgE when they are introduced ? (3)

Answer 13

When introduced by the plasma cells they attach themselves to the mast cells, sensitising them

Question 14

What happens when the mast cells are sensitised ? (4)

Answer 14

After sensitisation the allergens (E.g animal dander) will bind with the IgE on the mast cells which will then release their inflammatory chemicals and cytokines

Question 15

What are the mast cells inflammatory chemicals ?

Answer 15

Histamine
Leukotrienes
Bradykinin
Prostaglandin

Question 16

When the mast cells inflammatory chemicals have been released (degranulation), these factors will occur within the airways:

Answer 16

Inflammation of the mucosa
Oedema of the mucosa
Mucus hyper secretion
Bronchospasm

Question 17

Name some of the symptoms of asthma

Answer 17

Wheezing - expiratory sound, air forcing way through narrow airways

Coughing - lining of airways irritated and inflamed, mucus hyper secretion

Tightness in chest - inflammation of the airways

Question 18

Clinical signs of acute exacerbation ?

Answer 18

Tachycardia
Cyanosis - sp02 low
Wheezing
Use of accessory muscles for breathing

Question 19

How is asthma diagnosed ?

Answer 19

Has to be clinically diagnosed by a professional, but there are no biomarkers for asthma. Diagnostic tests can help with a confirmation of diagnosis

Question 20

How would a clinical assessment be taken to determine if someone has asthma ?

Answer 20

Ask about patient family history
History of recurring symptoms (wheezing, cough, SOB)
Can they vary over time ?

Question 21

What medications can be used for asthma therapy ?

Answer 21

Inhaled medications E.g salbutomol inhaler

Question 22

What are the benefits of inhaled medications

Answer 22

These have a targeted delivery, reduced dosing, reduced side effects and come in different forms (dry powder inhaler or liquid plus propellants

Question 23

Describe the aim of asthma therapy

Answer 23

The aim would be to reduce the amount or severity of asthma symptoms in patients by allowing the airways to dilate therefore allowing air to flow more easily. This would be done by inhaled deliver of medication to release the smooth muscle contractions happening within the bronchi, leaving less pressure on the mucosa

Question 24

Side effects of inhaled medications ?

Answer 24

Tachycardia/palpitations
Tremors, swelling, agitation
Rare cases - metabolic problems

Question 25

What are inhaled steroids ?

Answer 25

These are medications that are for prevention rather then reliever of symptoms. They are called by their trade names and are different for different types of lung depositions

Beclomenthasone (brown inhaler) usually taken twice a day, anti inflammatory effect, reducing oedema and secretions in the airways

Question 26

Side effects of inhaled steroid medications ?

Answer 26

Oral candida (oral thrush)
Hoarse voice, sore throat
Adrenal suppression (reduced cortisol production)