Asthma Flashcards
What are some theories for the cause of Asthma?
Genetic risk Sensitisation to airborne allergens o House Dust Mite o Pollens o Air pollution o Tobacco smoke (Pre-/post natal exposure, active) Hygiene hypothesis
What are some of the signs/symptoms of Asthma?
Wheeze Cough Breathlessness Tight chestness Airflow obstruction Barrel chest (From hyper expansion) Polyphonic wheeze on auscultation
How can you test a patient to see if they have Asthma?
Spirometry – Flow Volume Loop Allergy Testing (Skin prick to aero-allergens, e.g. cat, dog, HDM, Blood IgE levels to specific aero-allergens Chest X-Rays
Why do you do a chest x ray in patients with suspected Asthma?
Performed to exclude other diseases/inhalation of foreign body/pneumothorax
What would the results of a Spirometry - Flow volume loop be in a patient with Asthma?
Would have Low PEFR
Low FEV1/FVC Ratio
>12% increase in FEV1 following salbutamol
What are the pathological changes in Asthma?
Inflammation
Remodelling
What happens in inflammation during Asthma?
Mast cells (Increased in asthma, Release prostaglandins, histamine etc)
Eosinophils (Large numbers in the bronchial wall and secretions of asthmatics)
Dendritc Cells and Lymphocytes (Dendritic cells take up the allergen and present it to the Lymphocyte. T-Helper lymphocytes (CD4) release cytokines that play a key part in the activation of mast cells)
What remodelling occurs in Asthma?
Epithelium (Stressed and damaged with a loss of ciliated columnar cells) Basement membrane (Deposition of collagens, causing it to thicken) Smooth Muscle (Hyperplasia causing thickening of the muscle)
What can commonly bring on an acute worsening of Asthma (Asthma attack)
Lack of treatment adherence
Respiratory Virus Infections associated with the common cold
Exposure to allergen or triggering drug (e.g. NSAID)
Briefly, what are the 3 main approaches to treating Asthma?
Education
Primary prevention
Pharmacological management
How does education help treat patients with Asthma?
Educate patients to correctly recognise their symptoms, to use their medication timely, use services appropriately and to develop their own Personal Asthma Action Plan.
What primary preventions can be done to attempt to treat Asthma?
Stop smoking
Fresh air
Reduce exposure to allergens/triggers
Weight Loss
What are the 2 classes of drugs used to treat Asthma?
Beta2-adrenoagonists (Muscarinic antagonists, Short term relief E.g. Salbutamol
Anti-inflammatory agents (Corticosteroids, Preventer therapies)
Define Asthma attack
An acute worsening of Asthma symptoms which can be life threatening
