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ESA 3 - Respiratory System > Asthma > Flashcards

Asthma Flashcards

1
Q

What is asthma?

A

A chronic disorder characterised by airway wall inflammation and re-modelling

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2
Q

What kind of pulmonary disorder is asthma?

A

Reversible airflow obstruction

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3
Q

What happens to airways in asthma?

A
  • Thickened smooth muscle
  • Thickened basement membranes
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4
Q

What is the pathological process in asthma?

A

Triggers cause airway smooth muscle to contract

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5
Q

What is the result of airway smooth muscle contraction in asthma?

A
  • Reduced airway radius
  • Increased resistance
  • Reduced airflow
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6
Q

Describe the prevalance of asthma

A
  • Increasing in prevalence
  • More common in developed world
  • Increasing in populations who move from developing to developed countries
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7
Q

How many people in the UK currently recieve treatment for asthma?

A

5.4 million

  • 1.1 million children
  • 4.3 million adults
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8
Q

What are the potential causes of asthma?

A
  • Genetic risk
  • Sensitisation to airborne allergens
  • Hygeine hypothesis
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9
Q

What airborne allergens are assoicated with asthma?

A
  • House Dust Mite
  • Pollens
  • Air pollution
  • Tobacco smoke (Pre/post-natal exposure, active)
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10
Q

What kind of diagnosis is asthma?

A

Clinical

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11
Q

Why is asthma a clinical diagnosis?

A

There is no standard investigation of the type, severity, or frequency of symptoms, not of the findings on investigation

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12
Q

What is asthma defined as?

A

More than one of the symptoms of;

  • Wheeze
  • Cough
  • Breathlessness
  • Chest tightness
  • Variable airflow obstruction
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13
Q

Of what nature is the wheeze in asthma?

A
  • High pitched, expiratory sound
  • Polyphonic
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14
Q

What is meant by polyphonic wheeze?

A

The wheeze is of variable intesity and tone

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15
Q

Where does the wheeze originate in asthma?

A

In the airways which have been narrowed be compression or obstruction

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16
Q

Of what nature is the cough in asthma?

A
  • Often worse at night
  • Exercise induced
  • Dry
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17
Q

What are the potential consequences of an asthmatic cough being worse an night?

A
  • Lack of sleep
  • Poor performance at school
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18
Q

What are the potential consequences of an asthmatic cough being exercise induced?

A

Decreased participation in activities

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19
Q

What does an asthma examination consist of?

A
  • Inspection
  • Percussion
  • Auscultation
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20
Q

What should be inspected when examining for asthma?

A
  • Chest
  • General health
  • Room
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21
Q

What are you looking for when inspecting the chest during an asthma examination?

A
  • Scars and deformities
  • Hyper-expansion (Barrel Chest)
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22
Q

What are you looking for when inspecting general health during an asthma examination?

A
  • Eczema
  • Hay-fever
  • Lethargy
  • Can they speak?
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23
Q

What are you looking for on inspection of the room during an asthma examination?

A
  • Medications
  • Charts
24
Q

What sign on percussion is indicative of asthma?

A

Hyper-resonance

25
Q

What sign on auscultation is indicative of asthma?

A

Polyphonic wheeze

26
Q

What tests are used to assess the condition of a patient suspected with asthma?

A
  • Spirometry - Flow volume loop
  • Allergy testing
  • Chest X-rays
27
Q

What will be shown on a flow volume loop with a patient with asthma?

A
  • Low PEFR
  • Low FEV1/FVC ratio
  • >12% increase in FEV1 following salbutamol
28
Q

Draw a flow volume loop illustrating;

  • A normal person
  • An asthmatic
  • An asthmatic with salbutamol
A
29
Q

How are allergen tests for asthma carried out?

A

Skin prick to aero-allergens, e.g. cat, dog, HDM, then assess blood IgE levels

30
Q

Why are chest x-rays performed in patients suspected to have asthma?

A

To exclude other diseases, inhalation of foreign body, or a pneumothorax

31
Q

What pathophysiological changes underlie the asthmatic condition

A
  • Inflammation
  • Remodelling
32
Q

What cells are responsible for the inflammation in asthma?

A
  • Mast cells
  • Eosionophils
  • Dendritic cells
  • Lymphocytes
33
Q

What happens to mast cells in the asthmatic condition?

A

They are increased in number

34
Q

What do mast cells do in asthma?

A

Release prostaglandins, histamine, etc.

35
Q

Where are large numbers of eosionophils found in asthma?

A

In the bronchial wall and secretions

36
Q

What is the role of dendritic cells in asthma?

A

Have a role in the initial uptake and presentation of allergens to lymphocytes

37
Q

What is the role of lymphocytes in asthma?

A

T-helper lymphocytes (CD4) release cytokines that play a key part in the activation of mast cells

38
Q

What phenotype is related to asthma?

A

Th2

39
Q

Why is the Th2 phenotype related to asthma?

A

Because it favours the production of antibody production by the B lymphocytes to IgE

40
Q

What gets remodelled in asthma?

A
  • Epithelium
  • Basement membrane
  • Smooth muscle
41
Q

Why is the epithelium remodelled in asthma?

A

It gets stressed and damaged

42
Q

What happens to remodelled epithelium in asthma?

A

There is a loss of ciliated columnar cells

43
Q

What happens in remodelling of the basement membrane in asthma?

A

Deposition of collagen causes it to thicken

44
Q

What happens in the remodelling of smooth muscle in asthma?

A

Hyperplasia causing thickening of muscle

45
Q

Can asthma exacerbations occur spontaneously?

A

Yes

46
Q

What are asthma exacerbations most commonly caused by?

A
  • Lack of treatment adherence
  • Respiratory virus infections associated with the common cold
  • Exposure to allergen or triggering drug
47
Q

Give an example of a drug that can trigger asthma?

A

NSAIDs

48
Q

What are the principles in treating asthma?

A
  • Education
  • Primary prevention
  • Pharmacological management
49
Q

What is the purpose of asthma education?

A

Educate patients to correctly regonise symptoms, to use their medication timely, use services appropriately, and to develop their own Personal Asthma Action Plan

50
Q

What measures are taken in the primary prevention of asthma?

A
  • Stop smoking
  • Fresh air
  • Reduce exposure to allergens/triggers
  • Weight loss
51
Q

What drugs are involved in the pharmacological management of asthma?

A
  • ß2-adrenoagonists
  • Anti-inflammatory agents
52
Q

What kind of drugs are ß2 adrenoagonists?

A

Muscarinic antagonists

53
Q

What is the purpose of the use of ß2-adrenoagonists in asthma treatment?

A

Short term relief

54
Q

Give an example of a ß2 adrenoagonist used in asthma treatment?

A

Salbutamol

55
Q

What anti-inflammatory agents are used in the treatment of asthma?

A

Corticosteroids

56
Q

What is the purpose of the use of corticosteroids in the treatment of asthma?

A

Preventer therapies

ESA 3 - Respiratory System (14 decks)

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