Asthma

Question 1

Population disparities in asthma

Answer 1

Higher in children, boys, women, african americans

Question 2

What are the steps in IgE synthesis?

Answer 2

Th2 stimulates B cells via IL13, IL4. Release of IgE antibodies which sit on mast cells and bind allergens. IL4 and IL5 and histamine produced which attract eosinophils

Question 3

what air contaminants have some evidence of causing asthma

Answer 3

house dust mite, cockroach, RSV, smoke

Question 4

How good is the methacholine challenge

Answer 4

sensitive but not specific

Question 5

What changes do we see on flow vol loop?

Answer 5

concave upward expiratory part. Inspiratory not affected due to neg pressure

Question 6

What does Peak expiratory flow tell us?

Answer 6

variability is a hallmark of asthma

Question 7

What qualifies as persistent asthma, impairment domain?

Answer 7

albuterol >2 days/week, not daily
symptoms>2 days/week, not daily
Nighttime awakening>2 times/month
Minor limitation of normal activity
FEV1<80% predicted

Question 8

what is persistent asthma, risk domain?

Answer 8

2 or more exacerbation requiring oral corticosteroids per year

Question 9

First Rx for persistent asthma? After that? what never to do?

Answer 9

Inhaled corticosteroids. ICS + long acting beta agonist. Never give LABA w/o steroid.