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Respiratory system > Asthma > Flashcards

Asthma Flashcards

1
Q

What is meant by asthma?

A

Chronic inflammatory disease

of the airways of the lungs

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2
Q

What parts of the airways are affected with asthma?

A

Conducting zone

bronchi and bronchioles

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3
Q

What causes an acute episode of asthma?

A

Environmental triggers are inhaled into the bronchi and bronchioles

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4
Q

What are some examples of environmental triggers that cause acute episodes of asthma?

A

Allergens - pollen, mould, pets, dust

Viral infection

Tobacco smoke

Smoke

Exercise

Cold air

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5
Q

How do environmental triggers cause an acute episode of asthma?

A

Stimulate an immune response in the bronchi and bronchioles

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6
Q

What are the main types of cells immune involved in asthma?

A

Mast cells

T cells

Eosinophils

Neutrophils

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7
Q

How are mast cells activated?

A

Have IgE on their surface

IgE binds to allergen

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8
Q

What do mast cells do when they are activated?

A

Degranulate

which releases histamine

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9
Q

What does the immune response cause in acute episode of asthma?

A

Inflammation of the bronchi and bronchioles

  • mucosal oedema
  • more and thicker mucus secreted
  • bronchoconstriction
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10
Q

What are the effects of inflammation of the bronchi and bronchioles in an acute episode of asthma?

A

Narrowing of bronchi and bronchioles
increased airway resistance
worse with expiration

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11
Q

What are the effects of repeated inflammation of the bronchi and bronchioles?

A

Desquamation of epithelium

Mucous glands hyperplasia

Smooth muscle hyperplasia

Bronchial hyper-reactivity

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12
Q

What is meant by bronchial hyper-reactivity?

A

Bronchial smooth muscle is more sensitive
contracts more easily
contracts in spasms

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13
Q

Why does repeated inflammation of the bronchi and bronchioles cause bronchial hyper-reactivity?

A

Damage to mucosa of bronchi and bronchioles

exposes sensory nerve endings

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14
Q

What are the symptoms of asthma?

A

Wheezing

Shortness of breath

Chest tightness

Cough

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15
Q

How do the symptoms of asthma vary?

A

Vary in occurrence, frequency, intensity

-worse at night, early morning

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16
Q

Why are symptoms of asthma worse at night/early morning?

A

Natural bronchoconstriction at this time

narrows airways further

17
Q

How is asthma diagnosed?

A

History of airway inflammation and airway hyper-reactivity, symptoms

Wheezing on auscultation

Reduced expiratory air flow

Eosinophil count

18
Q

How is reduced expiratiry air flow measured with asthma?

A

Spirometry - low FEV1, same FVC, low FEV1/FVC ratio

Volume-time graph - flatter gradient, same peak

Flow-volume graph - lower peak, scooped shape, reaches same volume

Abnormalities show with acute episodes, reverse with bronchodilator, treatment

19
Q

What are the problems with measuring reduced expiratory air flow with asthma?

A

May not show when being measured

because asthma varies in occurence, frequency and intensity of symptoms

20
Q

How can the airways be challenged to react in order to measure reduced expiratiory airflow?

A

Give histamine
won’t affect a normal person’s airways
will cause airways of person with asthma to narrow

21
Q

What are eosinophils measured in with asthma?

A

Blood

Induced sputum

22
Q

How is asthma treated?

A

6 weeks inhaled corticosteroids

B2 agonist used when symptomatic

23
Q

What is an example of an inhaled corticosteroid?

A

Budesonide

24
Q

What is an example of a B2 agonist?

A

Salbutamol

25
Q

How do corticosteroids treat asthma?

A

Reduce inflammation

26
Q

How does a B2 agonist treat the symptoms of asthma?

A

Bronchodilation

27
Q

What is an asthma exacerbation?

A

Worsening of symptoms

doesn’t respond to usual treatment

28
Q

What are the signs of a severe asthma exacerbation?

A

Altered consciousness

Cardiac arrythmias

Hypotension

Cyanosis

Silent chest

Low pO2, low O2 saturation

Normal or high pCO2

29
Q

How is a moderate asthma exacerbation treated?

A

Oxygen

Nebulised salbutamol

Oral corticosteroid

30
Q

What is an example of an oral corticosteroid?

A

Prednisolone

31
Q

How is a severe asthma exacerbation treated?

A

Nebulised anticholinergic

IV magnesium or IV aminophylline

33
Q

Why is there wheezing on auscultation with a patient with asthma?

A

Sound of air moving through narrowed, obstructed airways

33
Q

What is an example of an anticholinergic

A

Ipratropium

Respiratory system (32 decks)

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