ASTHMA Flashcards

1
Q

WHAT IS ASTHMA and what happens to the lungs

A

Asthma is a chronic respiratory disease that involves the narrowing and swelling of the airways, leading to difficulty in breathing. The main feature of asthma is recurrent attacks of bronchospasm. The bronchi become inflamed, and the muscles around them tighten. At the same time, the lining of the airways produces excess mucus, further narrowing the airways and making it harder for air to pass through. This results in symptoms like wheezing, coughing, and shortness of breath

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2
Q

What is bronchospasm

A

a sudden constriction of the muscles in the walls of the bronchi, the air passages that lead from the trachea to the lungs.

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3
Q

what tiggers bronchospasms

A

These bronchospasms are often triggered by allergic reactions, such as exposure to pollen, pet dander, or dust mites. In other cases, asthma can be triggered by environmental factors, such as cold air, exercise, or irritants like smoke. Asthma can also have a hypersensitivity component, where the immune system overreacts to harmless substances.

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4
Q

what is the role of smooth muscles in the bronchioles and what happens to them during asthma?

A

Smooth muscles contract and relax, controlling the diameter of the airways. in conditions like asthma, these smooth muscles can become hyperreactive and constrict, leading to airway narrowing and difficulty in breathing

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5
Q

what are the two main causative factors to trigger asthma

A

Intrinsic and extrinsic

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6
Q

what is intrinsic asthma and what causes it?

A

Intrinsic asthma differs from allergic (extrinsic) asthma in that it is not triggered by allergens, and it is more likely to occur in individuals who have long-standing respiratory conditions such as chronic bronchitis or infections. In intrinsic asthma, various stimuli cause the airways to become hyper-responsive, leading to bronchoconstriction and inflammation.
-infection
exposure to cold
-drugs[such as aspirin]
-stress
-inhalation of irritants

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7
Q

what is bronchoconstriction

A

it is the tightening of the smooth muscles surrounding the airways, leading to narrowed air passages

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8
Q

what is inflammation

A

its when swelling and increased mucus production in the airways, which further obstructs airflow

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9
Q

what are symptoms of asthma?

A

-wheezing
-shortness of breath
-coughing
-chest tightness

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10
Q

what is the management of asthma?

A

-bronchodilators[salbutamol, ipratropium bromide, Hydrocortisone
-Inhaled corticosteroids
-Avoidance of triggers

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11
Q

what is Extrinsic Asthma?

A

(also known as allergic asthma) is the most common form of asthma, typically triggered by an allergic reaction to external allergens. . In extrinsic asthma, exposure to specific allergens triggers an exaggerated immune response, resulting in airway inflammation, bronchoconstriction, and increased mucus production.

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12
Q

What triggers extrinsic asthma

A

-pollen
-dust mites
-mold spores
-food allergies
-pet dander
-food allergies

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13
Q

what is IGE and how does it help against asthma?

A

IGE is an antibody that is produced by the immune system and it helps fight infection. IGE is triggered in people with asthma when they get exposed to pollen dust mites or pet dander. example]
First exposure (Sensitisation): when you get exposed to pollen your immune system mistakenly thinks it’s harmful.
Your body produces IgE antibodies, which then attach to special cells in your body called mast cells. These cells are now “armed” and ready for future exposure.
Re-exposure (Allergic Reaction):
The next time your exposed to pollen, the IgE antibodies on your mast cells recognise the pollen as an allergen.
This causes the mast cells to release chemicals like histamine, which leads to the following:
Tightening of airways (bronchoconstriction): The muscles around your airways squeeze, making it harder to breathe.
Mucus production: Your airways produce extra mucus, clogging the passages.
Swelling (inflammation): The walls of your airways become swollen, narrowing the space for air to pass through.

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14
Q

what is the immune response to asthma

A

-histamine is released which causes the blood vessels to become leaky leading to swelling[oedema]
-kinins are also released these are chemicals that cause blood vessels to vasodilate and muscles around the airway to bronchoconstrict
-prostaglandins also causes blood vessels to vasconstrict which can lower blood pressure and reduce blood flow to the lungs, mucus is produced by goblet cells in the airways.
-Leukotrienes-white blood cells

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15
Q

what happens to the vagus nerve during asthma attack?

A

It over stimulates through excessive coughing causing a reflex bronchoconstriction and bronchospasm.Because of this, air gets trapped in the lungs, making it hard to breathe out properly. When someone tries to forcefully exhale, it can lead to the collapse of the bronchi (the airways).
As a result, the amount of air left in the lungs (residual volume) increases, which makes coughing less effective and prevents mucus from being cleared. In severe cases, it can lead to irregular heartbeats (arrhythmias) and depression of the central nervous system (CNS).

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16
Q

what is atelectasis?

A

Its when the airways become completely obstructed and this is when hypoxia is induced and respiratory muscles such as diaphragm and intercostal activity increases to demand more oxygen which leads to labored breathing
-side note collaposed lung

17
Q

what is hypoxaemia and what does it do during asthma

A

Abnormally low levels of oxygen in the blood, it causes vasconstriction in the pulmonary vessels and it makes the problem worse by increasing the workload of the right side of the heart.

18
Q

why does metabolic and respiratory acidosis occur in asthma and what is it

A

In cases where the body cannot get enough oxygen and cannot effectively remove carbon dioxide (CO2), the result is a build-up of CO2 in the blood, leading to respiratory acidosis. This happens because CO2 dissolves in the blood and forms carbonic acid, lowering blood pH.

19
Q

How does pulmonary vasoconstriction help during an asthma attack?

A

This narrowing is the body’s attempt to redirect blood to better-ventilated parts of the lungs, but it compounds the problem by restricting blood flow, increasing pressure in the pulmonary circulation

20
Q

why is their an increased workload on the right side of the heart during an asthma attack and how does that affect the right side

A

The right side of the heart pumps blood to the lungs. When pulmonary vasoconstriction occurs due to hypoxaemia, the right ventricle has to work harder to push blood through the narrowed vessels. This increased pressure (known as pulmonary hypertension) strains the right side of the heart, which can lead to right heart failure if the condition persists.

21
Q

Why are leukocytes specifically [eosinophils] produced during asthma?

A

Eosinophils play a key role in the body’s immune response, especially in fighting off multicellular parasites and certain infections. However, in asthma, they are over-activated in response to allergens or irritants. They release chemicals that cause airway narrowing and inflammation the chemicals can cause long term swelling and damage the airway making asthma worse overtime.

22
Q

what does prolonged increased of leukocytes particularly eosinophils do to the lungs?

A

they cause prolonged inflammation and prolonged bronchoconstriction and tissue damage

23
Q

what do eosinophils release?

A

chemical mediators including leukotrienes

24
Q

what do leukotrienes do?

A

chemicals that contributes to the inflammatory response, leukotrienes cause the smooth muscles around the airway to tighten and increase mucus production and lead to prolonged inflammation

25
Q

what are chemotactic factors and what do they do?

A

they are small molecules released by mast cells that act as a signal to attract other immune cells particularly white blood cells to the site of inflammation. they move along a concentration gradient from low to high

26
Q

what are cytokines and what do they do?

A

they are signalling proteins also released by mast cells. these proteins are crucial for cell to cell communication, and they influence the behaviour of other immune cells. cytokines help coordinate the immune response by activating, attracting and increasing the production of white blood cells.

27
Q

what happens when mast cells are activated ?

A

they release both chemotactic factors and cytokines. these chemicals signal other immune cells especially eosinophils and neutrophils to move to the inflamed area, this causes more inflammation and further bronchoconstriction which leads to hypoxia

28
Q

what do short acting B2 agonists do during asthma such as salbutamol?

A

they are used to provide quick relief during asthma. They work by stimulating B2 receptors in the lungs which causes bronchodilation.
-side note: bronchodilators

29
Q

what do long acting B2 agonists do during asthma such as salmeterol?

A

they have similar mechanism of action but work over a longer period. they are used as maintenance in asthma management to prevent symptoms, but they must be used alongside anti-inflammatory medication (like inhaled corticosteroids)

30
Q

what are side effects of b2 agonists ?

A

-tremors
-uterus (uterine relaxation)
-and they can prevent premature labour
-Decreased effect with age
-they also affect the heart as the heart has b1 and b2 receptors which are affected by the beta 2 agonist , they increase heart rate

31
Q
A