Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory Revision > Asthma > Flashcards

Asthma Flashcards

1
Q

What type of hypersensitivity reaction is Asthma?

A

Type 1 hypersensitivity reaction
(IgE hypersensitivity)
Asthma is an inflammatory disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What nerve system is dominant in the airways?

A

Parasympathetic division
It is carried by Nerve X (Vagus nerve) - The ganglia of the nerves are inside the bronchi and bronchioles
Parasympathetic division causes contraction of smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the effect of parasympathetic innervation of the bronchioles/airways?

A

Bronchial smooth muscle contraction mediated by ACh acting upon the M3 muscarinic receptors
Increased mucus secretion mediated by ACh acting upon M3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What types of transmitters can be used to dilate the airways?

A

Vasoactive Intestinal peptide

Nitric oxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What effect does the sympathetic system have on the bronchial smooth muscle?

A

Dilation of smooth muscle - Activated by Beta 2 receptors.
Decreased mucus secretion by Beta 2 adrenoceptors
Increased mucociliary clearance - mediated by Beta 2 adrenoceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the pathological changes associated with chronic asthma?

A 
Increased mass of smooth muscle (Hyperplasia and hypertrophy) - narrowing the airways
Basement membrane thickening 
Hyperresponsiveness 
Colagen disposition 
Accumulation of interstitial fluid 
Increased secretion of mucus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does hyper-responsiveness and hyper-reactivity of the airways occur in asthma?

A

Exposure of C fibres (Irritant receptors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How can the hyper-responsiveness of the airways be tested?

A

Provocation tests with inhaled bronchoconstrictors (Spasmogens)
e.g. histamine or methacholine

The less drug needed to induce hyper-reactivity the more severe the asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Explain the phases of an asthma attack?

A

Early phase - caused by the bronchospasm in relation to a stimulation
Late phase - Inflammatory response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Explain the development of allergic asthma?

A

Presentation of antigen
Phagocytosis of antigen by dendritic cells
T -helper 2 cells produce IL 4 to activate B cells
B cells become plasma cells and secrete IgE
T helper 2 cells produce IL 5 and activate Eosinophils
Mast cells activated by IL4 and IL 13 from TH2
Dendritic cell presents antigen to Mast cell - causes degranulation and release of Histamines and Leukotrienes (LTC4 and LTD4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Release of what factors promote inflammation in the airways?

A

LTC4

Platelet activating factor (PAF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the two different types of drugs in Asthma?

A

Relievers:
SABA - salbutamol
LABA - salmeterol
CysLT1 antagonists - Montelukast

Controllers:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe how Beta 2 agonists work? (e.g. salbutamol/salmeterol)

A

Antagonists to all spasmogens
Acton the Beta 2 receptor
Causes phosporylation of Protein Kinase A - inhibits enzyme
Prevents MLCK causing contraction

Increase mucus clearance and decrease release from Mast cells and Neutrophils
Increase cGMP - promotes broncho dilation
Help with nocturnal symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are LABA’s useful for (salmeterol) ?

A

Nocturnal asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What type of medications are contraindicated in asthma?

A

Beta blockers

ACE inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do cysteinyl leukotrienes receptor antagonists cause bronchodilation?

A

Antagonise competitvely on the CystLT1 receptor on Mast cells.
e.g. Montelukast/Zafirlukast
This is used as an add on therapy for mild/persistent asthma and Exercise induced asthma

17
Q

What are the effects of Xanthines?

A

e.g. Theophylline and Aminophylline

Combine bronchodilator and anti-inflammatory actions
Inhibits release from mast cells
Increases mucus clearance

18
Q

What are the side effects of Beta 2 agonists?

A

Tachycardia
Tremor
Anxiety

19
Q

What are the two types of asthma ?

A

Extrinsic asthma - trigger factor known

Intrinsic asthma - no known trigger

20
Q

What is the histopathology of inflammation in asthma?

A

Epithelial detached

Disordered cells

21
Q

What is the clinical syndrome of asthma?

A

Episodic symptoms
Diurnal variability
Associated atopy
Wheeze

22
Q

How is asthma diagnosed?

A 
Reduced forced expiratory ratio (<75%) 
Provocation testings (with exercise/histamine)
23
Q

What are two types of steroids the adrenal gland prodces?

A

Mineralocorticoids - e.g. aldosterone. Regulates salt and water
Glucocorticoids - e.g. cortisol. Reduce inflammation

24
Q

What are the effects of inhaled steroids and how do they work?

A

e.g. Beclomethosone

Steroids are lipophilic molecules and they enter the cells by diffusion of the plasma membrane
Steroid combines with GR-alpha
Transports to the nucleus
Combines with the Glucocorticoid response elements in the promoter regions (GRE)
Switch on or switch off specific genes

Reduce Inflammation
Decrease the formation of TH 2 cells
Reduces Interleukin cytokines
Reduce the recruitment of inflammatory cells

25
Q

What are the side effects of steroids in the oropharynx?

A

Dysphonia - hoarse and weak voice

Oropharyngeal candidiasis

26
Q

What effects do cromolins have and who are they usefull for?

A

They are Mast cell stabilisers e.g. sodium cromoglicate
Weak anti-inflammatory effect
Decrease the sensitivity with irritant receptors with sensory C fibres
Most effective in young children

27
Q

What are the effects of monoclonal antibodies in asthma and how do they work?

A

Monoclonal antibodies direct against IgE (e.g. Omalizumab)

Binds the IgE via the FC region to prevent attached of FC epsilon receptors on Inflammatory cells

28
Q

What is fexofenadine and what is it used for?

A

Useful for seasonal asthma

Anti-histamine

29
Q

What are features of a severe asthma attack?

A

Peak flow < 50
Tachycardia > 110
Tachyponea
Cannot finish sentences

30
Q

What type of spirometry does asthma show?

A

Obstructive spirometry

31
Q

What is the treatment for acute asthma?

A
  1. Oxygen - high flow
  2. Bronchodilators (Nebulise with Oxygen)
  3. Nebulised Ipratropium
  4. IV bronchodilators
  5. Steroids - IV Prednisolone/ IV hydrocortisone
  6. Magnesium
  7. Aminophylline
  8. CXR
32
Q

What are precipitate an asthma attack?

A

Exercise
Beta blockers
Ibuprofen

33
Q

What treatment can be given if an allergenic trigger is found for the asthma?

A

H1 receptors antagonists

34
Q

What is the function of the M1, M2, M3 receptor?

A

M1 - enhance the cholinergic response
M2 - inhibit ACh release
M3 - Mediate bronchoconstriciton and Muscus secretion

Part of Parasympathetic system

35
Q

What anticholinergics are used in asthma?

A

SAMA (short acting Muscarnic antagonist) - Ipratropium

LAMA (long acting) - Tiotropium

36
Q

What are the features of a fatal asthma attack?

A

Peak flow < 33%
Cyanosis
Silent chest
PaCO2 >6

Respiratory Revision (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions