Asthma

Question 1

Cause of asthma ?

Answer 1

Airway bronchoconstriction
Allergic stimuli

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Question 2

Clinical features of Asthma ?

Answer 2

1. Dyspnea
2. Wheezing
3. Cough-Productive
4. Curschmann spirals
5. Charcot leyden crystals

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Question 2

Charot leyden crystals in astham ??/

Answer 2

Eosniphils derived crystals

Question 2

Curschman spirals ?

Answer 2

Spiral shaped mucus plugs

Question 3

IL-4 fucntion ?

Answer 3

Mediate class switch to IgE

P-91

Question 3

Pathaogenesis of Astham ??

Answer 3

Hypersensitivity =Type-1
Th2 — IL-4 = IL-5 = IL-10
Phenoptype in CD4+ Tcells

Question 4

IL-5 function&raquo_space;?

Answer 4

Attracts eosinophils

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Question 5

IL-10 Function ?

Answer 5

-stimulate TH2 CELLS
-inhibit TH1

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Question 6

IgE mediated activation of mast cell result in asthma ???

Answer 6

Release of Histamine
Leukotrians C4 D4 E4

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Question 7

Histamine & Leokotrians function ?

Answer 7

1. Bronchoconstriction
2. Inflammation
3. Edema

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Question 8

Classical presentation of asthma ?

UW

Answer 8

1. Normal CXR
2. Sputum eosinophils
3. dec FEV1

UW

Question 9

Common triggers for astham ??

UW

Answer 9

1. Exercise
2. Cold air
3. Respiratory infection
4. Dust mites
5. Cockroaches
6. Pet dender
7. Mold
8. Pollen

UW

Question 10

Again same shit&raquo_space;>
Pathogenesis of Asthma ??

UWorld

Answer 10

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

Question 11

Occupational asthma causes&raquo_space;>

UW

Answer 11

1. Airway inflammation
2. Bronchial hyperreactivity
3. Variable airflow obstruction triggered by workplace exposure

UW

Question 12

Tx of asthma ?

UW

Answer 12

1.Bronchodilator
2.Beta-2 receptor agonists
3.Corticosteroids

UW

Question 13

Tx function in asthma ??

UW

O

Answer 13

Bronchodilator= Relax bronchial smooth muscle
=Releive airway spasm & bronchoconstriction

Beta-2-Agonists(Albuterol) = inc Cyclic AMP level in bronchial smooth muscle

Question 14

What if chronic airway inflammation is not reduced ?>?

UW

Answer 14

Airway remodelling
Airway hyperresponsiveness
Bronchoconstriction

UW

Question 14

Why corticosteroids in Asthma ?

UW

Answer 14

Reduce chronic airway inflammation

UW

Question 15

Young patient – Paroxysmal breathlessness , wheezing — No ingestion of aspirin , pulmonary infection, inhalation of irritants
Dx >?

UW

Answer 15

Atopic / Extrinsic asthma

UW

Question 16

Second line Tx for allergic rhinitis and bronchial asthma ?

Answer 16

Cromolyn
Nedocromil

UWorld

Question 17

Improper use of Glucocorticoid for the Tx of asthma fate —

UW

Answer 17

1. Dysphonia
2. Oropharyngeal candidiasis

UWorld

Question 17

Cromolyn & nedocromil mechanism in bronchial asthma ??

UW

Answer 17

Mast cell stabilizing agents
That– inhibit mast cell degranultion independent of the triggering stimulus

UWorld

Question 18

Prevention of adverse effect of glucocorticoids ??

uw

Answer 18

1. Spacer during administration
2. Rinsing the mouth after each use

UW

Question 19

Diagnosis of asthma ???

UW

Answer 19

Bronchial challenge Testing

UW

Question 20

Bronchial challenge testing procedure ??

UWorld

Answer 20

Provocative stimulus = inc Conc of Aerosolized Methacholine = Bronchoconstriction = Asthma patient are Hyperrresponsive = dec FEV1

UWorld

Question 21

bronchodilator - Glucocorticoids - Beta-2receptor agonists
are -FAILED
What next Tx ???

UW

Answer 21

IgE binding monoclonal AB
=Omalizumab

UWorld

Question 22

Omalizunab / IgE Binding AB function ??

UWorld

Answer 22

Prevent bninding of IgE to the IgE receptor & prevent release of Histamine & Leukotriens

UWorld