Asthma Flashcards
Cause of asthma ?
Airway bronchoconstriction
Allergic stimuli
p-91
Clinical features of Asthma ?
- Dyspnea
- Wheezing
- Cough-Productive
- Curschmann spirals
- Charcot leyden crystals
p-91
Charot leyden crystals in astham ??/
Eosniphils derived crystals
Curschman spirals ?
Spiral shaped mucus plugs
IL-4 fucntion ?
Mediate class switch to IgE
P-91
Pathaogenesis of Astham ??
Hypersensitivity =Type-1
Th2 — IL-4 = IL-5 = IL-10
Phenoptype in CD4+ Tcells
IL-5 function»_space;?
Attracts eosinophils
p-91
IL-10 Function ?
-stimulate TH2 CELLS
-inhibit TH1
P-91
IgE mediated activation of mast cell result in asthma ???
Release of Histamine
Leukotrians C4 D4 E4
P-91
Histamine & Leokotrians function ?
- Bronchoconstriction
- Inflammation
- Edema
p-91
Classical presentation of asthma ?
UW
- Normal CXR
- Sputum eosinophils
- dec FEV1
UW
Common triggers for astham ??
UW
- Exercise
- Cold air
- Respiratory infection
- Dust mites
- Cockroaches
- Pet dender
- Mold
- Pollen
UW
Again same shit»_space;>
Pathogenesis of Asthma ??
UWorld
Over ecxess of Th2 cells == Th1 activity = Th2 Cells over expressed IL-4 IL-5 IL-13 —- B cell lymphocyte – IgE synthesis – Mast cell priming
UW
Occupational asthma causes»_space;>
UW
- Airway inflammation
- Bronchial hyperreactivity
- Variable airflow obstruction triggered by workplace exposure
UW
Tx of asthma ?
UW
1.Bronchodilator
2.Beta-2 receptor agonists
3.Corticosteroids
UW
Tx function in asthma ??
UW
O
Bronchodilator= Relax bronchial smooth muscle
=Releive airway spasm & bronchoconstriction
Beta-2-Agonists(Albuterol) = inc Cyclic AMP level in bronchial smooth muscle
What if chronic airway inflammation is not reduced ?>?
UW
Airway remodelling
Airway hyperresponsiveness
Bronchoconstriction
UW
Why corticosteroids in Asthma ?
UW
Reduce chronic airway inflammation
UW
Young patient – Paroxysmal breathlessness , wheezing — No ingestion of aspirin , pulmonary infection, inhalation of irritants
Dx >?
UW
Atopic / Extrinsic asthma
UW
Second line Tx for allergic rhinitis and bronchial asthma ?
Cromolyn
Nedocromil
UWorld
Improper use of Glucocorticoid for the Tx of asthma fate —
UW
- Dysphonia
- Oropharyngeal candidiasis
UWorld
Cromolyn & nedocromil mechanism in bronchial asthma ??
UW
Mast cell stabilizing agents
That– inhibit mast cell degranultion independent of the triggering stimulus
UWorld
Prevention of adverse effect of glucocorticoids ??
uw
- Spacer during administration
- Rinsing the mouth after each use
UW
Diagnosis of asthma ???
UW
Bronchial challenge Testing
UW
Bronchial challenge testing procedure ??
UWorld
Provocative stimulus = inc Conc of Aerosolized Methacholine = Bronchoconstriction = Asthma patient are Hyperrresponsive = dec FEV1
UWorld
bronchodilator - Glucocorticoids - Beta-2receptor agonists
are -FAILED
What next Tx ???
UW
IgE binding monoclonal AB
=Omalizumab
UWorld
Omalizunab / IgE Binding AB function ??
UWorld
Prevent bninding of IgE to the IgE receptor & prevent release of Histamine & Leukotriens
UWorld
