Asthma - 210

Question 1

What is the pathophysiology behind asthma?

Answer 1

Bronchial hyperreactivity causing bronchospasm. Bronchial inflammation

Question 2

When is peak flow lowest in an asthmatic?

Answer 2

Early in the morning

Question 3

Is asthma obstructive or restrictive on spirometry?

Answer 3

Obstructive

Question 4

Which type of asthma is more common?

Answer 4

Extrinsic, IgE mediated. This is atopic

Question 5

Which form of asthma more commonly develops in later life?

Answer 5

Intrinsic (non-allergic)

Question 6

What cells when found in the airways correlate with the severity of asthma?

Answer 6

Eosinophils

Question 7

What happens following eosinophil degranulation in asthma?

Answer 7

Major basic protein causes epithelial cell damage, mast cells release mediators (histamine, PGs, leukotrienes, etc) which cause bronchoconstricton

Question 8

What medication is useful in cold-air induced and aspirin induced asthma?

Answer 8

Leukotriene receptor antagonists e.g. montelukast

Question 9

What is the mechanism of action of B2 agonists?

Answer 9

Increase cAMP production to relax bronchial smooth muscle, inhibit the release of inflammatory mediators and increase mucus clearance

Question 10

Describe the BTS guidelines for adults

Answer 10

1) B2 agonist
2) Inhaled steroid
3) LABA
4) Consider trials of increase steroid or addition of 4th drug
5) Daily steroid tablet