Asthma Flashcards
What is asthma?
Airway inflammation mediated by immune system.
It can be spontaneous or from a certain stimuli.
How many adults affected?
5-10% more females than males
How many children affected?
10-15% more males than females.
How many people are receiving treatment?
5.4 million
What are the proven risk factors of asthma?
Genetic (atopy)
Occupation
Smoking
Describe the genetic reasoning for asthma.
Atyopy : Inherited tendency to IgE response to allergens
What is the strongest factor for genetic inherited asthma?
Familial atopic tendency
Maternal atopy is most influential (x3 father)
What are the genetic links for asthma?
1) immune response genes: IL-4, IL-5, IgE
2) airway genes; ADAM33
How many cases of adult onset asthma is caused by occupation?
10-15%
Name some examples of things that can cause adult onset asthma.
(7 things)
Isocyanantes - Twin pack paint Colophony - Welding solder flux Labratory animals- Rodent unrinary proteins Grains- wheat proteins, grain mites Enzymes- Subtilin, amylase Drugs- Antibiotics, subutamol Crustaceans- Prawns and crabs
What is the commonest cause of occupationa asthma?
BAKERS - flour
Describe what can happen if a mother smokes during pregnancy?
Decrease in FEV1
Increase in wheezy illness
Increase in airway responsiveness
Increase in asthma and severity
Describe the grand mother effect
If a mum smokes her babies o cytes are modified so when baby grows up her children will be X2 as likely to develop asthma.
Name the possible risk factors for asthma.
Obesity
Diet
Reduced exposure to microbes
Indoor pollution
What is increased Body mass index positively associated with?
Asthma
Wheezing
Airway hyperactivity
What is associated with a decrease in FEV1?
A decrease in vit E, C, D, B-carotene
What is associated with an increased wheeze
A decrease in vit E& C, a decrease in fruit and use of margarine
What is associated with an increase of asthma?
A decrease in selenium,fast food and margarine.
what is associated with a decrease in asthma regarding diet?
Oily fish consumption and butter
What should children be exposed to lightly to decrease risk?
Endotoxin
Glucans
Extracapsular polysaccharide
Name some household cleaners witch can increase the risk of asthma?
Volatile organic compounds
formaldehyde
Fragrances
Name some household allergens
House dust mite
Cat
Grass pollen( timothy grass)
Name the generalised airflow obstruction
Asthma (reversible AFO) COPD (irreversible AFO) Bronchiectasis Bronchiolitis Cystic Fibrosis
Name some of the symptoms of asthma?
Or any respiratory disease
Wheeze Short of breath( dyspnoea) Chest tightness Cough, Paroxysmal,usually dry Sputum (occasional)
Name some triggers of asthma?
Exercise, cold air, smoke, perfume, URTI`s, Pets, Tree, grass pollen, food, aspirin
Probably not asthma if?
Clubbing, cervical lymphadenopathy
Stridor
Assymetrical expansion
Dull percussion note (lobar collapse, effusion)
Crepitations (bronchiectasis, CF, Alveolitis, LVF)
What would you do if spirometery showed airway obstructed and why?
Full pulmonary function testing.
Effectively excluding COPD/Emphysema
How does one measure lung volume?
Helium- measure change in conc when expired to inspired.
If patient is unresponsive tpo bronchodilators what do you do?
Use oral corticosteriods (anti inflammatory)
Name a specialist investigation.
airway responsiveness to methacholine/ histamine- depnding on what you suspect it is?
What is shown with exhaled nitric oxide
People with asthma have higher levels.
Name some useful investigations for asthma?
Chest X-ray - ( Hyperinflated, hyperlucent-NO effeustion, collapse,opacities,interstitial changes)
Skin Prick testing (atopic status)
Total and specific IgE
Full blood count- Eosinophillia
