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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
What sign on auscultation is indicative of asthma?
Polyphonic wheeze
26
What tests are used to assess the condition of a patient suspected with asthma?
* Spirometry - Flow volume loop * Allergy testing * Chest X-rays
27
What will be shown on a flow volume loop with a patient with asthma?
* Low PEFR * Low FEV1/FVC ratio * \>12% increase in FEV1 following salbutamol
28
Draw a flow volume loop illustrating; * A normal person * An asthmatic * An asthmatic with salbutamol
29
How are allergen tests for asthma carried out?
Skin prick to aero-allergens, *e.g. cat, dog, HDM*, then assess blood IgE levels
30
Why are chest x-rays performed in patients suspected to have asthma?
To exclude other diseases, inhalation of foreign body, or a pneumothorax
31
What pathophysiological changes underlie the asthmatic condition
* Inflammation * Remodelling
32
What cells are responsible for the inflammation in asthma?
* Mast cells * Eosionophils * Dendritic cells * Lymphocytes
33
What happens to mast cells in the asthmatic condition?
They are increased in number
34
What do mast cells do in asthma?
Release prostaglandins, histamine, etc.
35
Where are large numbers of eosionophils found in asthma?
In the bronchial wall and secretions
36
What is the role of dendritic cells in asthma?
Have a role in the initial uptake and presentation of allergens to lymphocytes
37
What is the role of lymphocytes in asthma?
T-helper lymphocytes (CD4) release cytokines that play a key part in the activation of mast cells
38
What phenotype is related to asthma?
Th2
39
Why is the Th2 phenotype related to asthma?
Because it favours the production of antibody production by the B lymphocytes to IgE
40
What gets remodelled in asthma?
* Epithelium * Basement membrane * Smooth muscle
41
Why is the epithelium remodelled in asthma?
It gets stressed and damaged
42
What happens to remodelled epithelium in asthma?
There is a loss of ciliated columnar cells
43
What happens in remodelling of the basement membrane in asthma?
Deposition of collagen causes it to thicken
44
What happens in the remodelling of smooth muscle in asthma?
Hyperplasia causing thickening of muscle
45
Can asthma exacerbations occur spontaneously?
Yes
46
What are asthma exacerbations most commonly caused by?
* Lack of treatment adherence * Respiratory virus infections associated with the common cold * Exposure to allergen or triggering drug
47
Give an example of a drug that can trigger asthma?
NSAIDs
48
What are the principles in treating asthma?
* Education * Primary prevention * Pharmacological management
49
What is the purpose of asthma education?
Educate patients to correctly regonise symptoms, to use their medication timely, use services appropriately, and to develop their own Personal Asthma Action Plan
50
What measures are taken in the primary prevention of asthma?
* Stop smoking * Fresh air * Reduce exposure to allergens/triggers * Weight loss
51
What drugs are involved in the pharmacological management of asthma?
* ß2-adrenoagonists * Anti-inflammatory agents
52
What kind of drugs are ß2 adrenoagonists?
Muscarinic antagonists
53
What is the purpose of the use of ß2-adrenoagonists in asthma treatment?
Short term relief
54
Give an example of a ß2 adrenoagonist used in asthma treatment?
Salbutamol
55
What anti-inflammatory agents are used in the treatment of asthma?
Corticosteroids
56
What is the purpose of the use of corticosteroids in the treatment of asthma?
Preventer therapies

ESA 3 - Respiratory System (14 decks)

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