Asthma Flashcards

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1
Q

what is asthma

A

reversible episodes of airway obstruction d/t:

  • muscle hyperactivity (in airways–contraciton/relaxation in excess)
  • Inflm (exudate & swelling compromising airway)
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2
Q

what is atopy

A

genetically induced hypersensitivty some predisposition there

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3
Q

asthma as ______ and ______ forms

A

extrinsic(atopic) & Intrinsic (non-atopic) factors

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4
Q

what is the etiology(cause of asthma)?

A
  • complex
  • genetic & environmental factors
  • hypersensitivity to stimuli (such as allergens, strong odours, a/w irritants, exercise)
  • T cell differnetaiton toward T2H (T1 helper cells propageted in defense to microbes, bacteria, virus, cytokine. T2 helper cells in defense of antigens)
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5
Q

patho of asthma

A
  • stimulus
  • hypersenstivity
  • 2 phased response
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6
Q

there are _____ and _____ triggers of asthma

A

non atopic tiggers: infection, drugs, cold air

atopic triggers: allergens

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7
Q

when do the early and late phases of asthma happen

A

early phase: begins right away only lasts about an hour(not an absolute number could differ)
late phase: peaks a 6 hrs, can last hours or days

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8
Q

what are the manifestations of asthma?

A
  • wheezing (drawing & expelling air forcefully through narrowed airways)
  • dyspnea
  • increased resp effort (pursed lip breathing) (nasal flaring)
  • alt resp statues & ABGS (changes in abgs)
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9
Q

diagnosing asthma

A
  • hx, px
  • pulm function tests (spirometery)
  • labs
  • inhalation challenge tests (testing for hyperresponsivness to inhlaed allergens)
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10
Q

treatment of asthma

A
  • control with decreased meds (chronic control use as little meds as possible)
  • preventative measures: no smoking &avoid allergens & irritants
  • 4 step of drugs
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11
Q

what is the 4 steps of drugs to treat asthma?

A

step 1: short acting bronchodilators (inhaled prn)
step 2: add an inhaled steroid (inhaling so delivering locally into respiratory tract so decreases systemic effects (bad side effects)
step 3: add long acting bronchodilator to steroid
step 4: -short course steroid (ORAL)
-add 3rd drug leukotrine receptor antagonist(blocks inflm, leukotrine mediates allergic response, blocking from happening) or theophyline (potent bronchodilator)

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12
Q

early phase of asthma (simple)

A
  • allergen enters (mast cell already sensitized to allergen)
  • Mast cells–release histamine, leukotrines, interleukings & prostaglandins causing:
  • bronchospasm and
  • infiltration of inflammatory cells with causes release of cytokines, interleukins, & other inflammatory mediator causing airway inflammation
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13
Q

late phase of asthma (simple)

A

airway inflammation which causes edema, impaired mucociliary function, & epithelial injury, causing airflow limitation this can also lead to increased airway responsivness

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14
Q

Acute phase response

A
  • happens right away 5-10 min
  • prior sensitization to allergen (type 1 hypersensitivity)
  • subsequent exposure–allergen binds to igE on mast cells causing mediator release cause inflm
  • mediators open intracellular junctions and allergen enters submucosa
  • increased permeabliity and increasd mucus secretion causes edema of airway
  • bronchospasm via parasympathetic ns)
  • dyspnea & wheezing
  • a/w constriction
  • can last up to one hour
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15
Q

Late phase response

A
  • peaks 4-8 hrs post exposure
  • can last days to wks
  • influx of inflm cells (via chemotaxis)–causing epithelial damage(which will not be reversible)–decrease in mucociliary function (prone to recurrent infections) and hyperesponsiver airways (new triggers-stimuli that were not triggers become triggers, frequent severe episodes)
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16
Q

what is a theory about asthma

A
  • b adrenergic receptors cause bronchodilation
  • a adrenergic receptors cause bronchoconstrction
  • mediated via cAMP (cyclic AMP) which assists in balancing the 2 responses
  • theory: is that lack of b receptor stimulation in asthma (we know that if it is involved it plays a minor role because type 1 hypersensitvity and inflm plays more of a role)
17
Q

b adrenergic receptors cause

A

bronchodilation (Adrenalin binds to receptors & causes smooth muscles to relax)

18
Q

a adrenergic receptors causes

A

bronchoconstriction