Asthma

Question 1

movement of air from the atmosphere into and out of the lungs

Answer 1

ventilation

Question 2

nose, nasal passages, mouth, pharynx and larynx.

Answer 2

upper airway passages

Question 3

trachea, bronchi, and bronchioles

Answer 3

lower airway

Question 4

the movement of blood through the lungs

Answer 4

perfusion

Question 5

the movement of gases between the roughly 1 million alveoli or air filled sacs within the lungs and the capillaries that supply the alveoli

Answer 5

diffusion

Question 6

_____ moves from the air that is in the alveoli to the blood flowing through the pulmonary capillaries

Answer 6

oxgyen

Question 7

___ passes from the blood into the alveoli

Answer 7

carbon dioxide

Question 8

completing the respiration process, carbon dioxide is expelled.

Answer 8

expiration

Question 9

chronic reactive airway disorder characterized by increase resistance to air flow due to episodic airway obstruction.

Answer 9

asthma

Question 10

is initiated by diverse, non-immune mechanisms

Answer 10

intrinsic (non-atopic)

Question 11

triggered by irritant receptors and vagal reflex

Answer 11

intrinsic

Question 12

initiated by type 1 hypersensitive response to an extrinsic antigen

Answer 12

extrinsic (atopic)

Question 13

Mast cells, which in people which asthma are in a pre-sensitized state, react to antigens and release histamine, leukotrienes, interleukins and prostaglandins.

Answer 13

early phase

Question 14

occurs 4-8 hours after exposure to an asthmatic trigger. Release of inflammatory mediators induces the migration and activation of other inflammatory cells: basophils, eosinophils, and neutrophils.

Answer 14

late phase

Question 15

higher prevalence in

Answer 15

boys and women

Question 16

highest prevalence in ____

Answer 16

women between 45 and 64

Question 17

risk factors for childhood asthma

Answer 17

family history, high exposure to airborne allergens, exposure to tobacco smoke, low birth weight and RDS

Question 18

risk factors for adult onset asthma

Answer 18

occupational exposures to low molecular weight sensitizers, exposure to infectious agents, allergens or pollution, women- smoking, obesity, hormonal influences

Question 19

adults tend to experience more exacerbations in the ____ months

Answer 19

winter

Question 20

• exposure to allergen/antigen

- type I IgE mediated hypersensitivity reaction

Answer 20

extrinsic asthma (atopic/allergy asthma)

Question 21

respiratory tract infection, exercise, hyperventilation, cold air, drugs/chemicals, irritants, hormonal changes, emotional upsets, airborne pollutants, GERD, etc.

Answer 21

intrinsic asthma (non-atopic asthma)

Question 22

• allergen binds to preformed IgE on sensitized mast cells on mucosal surface of airways
• mast cell activation releasing inflammatory mediators
• increase mucus secretion, increased vascular permeability and bronchoconstriction

Answer 22

early phase response

Question 23

• release of inflammatory mediators causes recruitment of neutrophils, eosinophils, basophils, T lymphocytes (TH2)
• cause epithelial injury and edema, increased mucus, changes in mucociliary function

Answer 23

late phase response

Question 24

are cellular bags of granules found in large numbers in the skin and linings of GI and respiratory tract. They are activated by several means including physical injury, chemical agents, immunologic and infectious means. They degranulate releasing histamine, chemotactic factors and cytokines which can an immediate effect.

Answer 24

mast cells

Question 25

- is a potent vasodilator that causes increased vascular permeability through retraction of endothelial cells - causes smooth muscle to contract causing bronchoconstriction when simulated in the bronchi

Answer 25

histamine

Question 26

- functions are similar and complementary to that of histamine. - more potent and stimulate slower and more prolonged effects compared to histamine. - cause slow and sustained constriction of the bronchioles

Answer 26

Leukotrienes

Question 27

causes vasodilation, increased vascular permeability and bronchoconstriction

Answer 27

Prostaglandin D2

Question 28

are cytokines that attract immune and inflammatory cells. They primarily function to attract leukocytes.

Answer 28

chemotactic chemokines

Question 29

are proteins that modulate the function of other cells.

Answer 29

cytokines

Question 30

- increases the activation and migration of inflammatory cells (specifically eosinophils and neutrophils) and contributes to airway remodeling. - causes endothelial cells to express adhesion molecules

Answer 30

TNF alpha

Question 31

alter muscarinic receptor function resulting in increased levels of acetylcholine which causes bronchial smooth muscle contraction and mucus secretion

Answer 31

TNF-alpha and IL-1

Question 32

stimulates activation, proliferation and production of antigen-specific. IgE by B cells

Answer 32

IL-4

Question 33

activates and promotes eosinophil activity

Answer 33

IL-5

Question 34

causes a more exaggerated inflammatory response through activation of basophils, neutrophils, and eosinophils.

Answer 34

IL-8

Question 35

impairs the clearance of mucus, contributes to bronchoconstriction and increases fibroblast secretion.

Answer 35

IL-13

Question 36

induces platelet aggregation, increases vascular permeability through endothelial cell retraction, activates neutrophils and is a potent eosinophil chemoattractant

Answer 36

PAF

Question 37

are mostly produced by mast cells, eosinophils and basophils are the leukotrienes that play a major role in the pathophysiology of asthma. They were initially called “slow reacting substance of anaphylaxis” due to their effect on bronchial smooth muscle of slow and prolonged contraction and hence, bronchoconstriction.

Answer 37

Cysteinyl leukotrienes

Question 38

- play an important role in the pathogenesis of extrinsic asthma. - act as growth factors for mast cells as well as recruiting and activating eosinophils by stimulating the differentiation of B cells into IgE producing plasma cells.

Answer 38

T lymphocytes (TH2)

Question 39

neutrophils, eosinophils, and basophils

Answer 39

granulocytes

Question 40

are first on scene and the predominant phagocytes in the early inflammatory phase.

Answer 40

neutrophils

Question 41

controlling the release of specific mediators from mast cells

Answer 41

eosinophils

Question 42

bind to IgE which is secreted by plasma cells and release histamine and mediators of inflammation such as IL-4.

Answer 42

basophils

Question 43

What is mucus secretion triggered by?

Answer 43

the inflammatory response

Question 44

What stimulates increased mucus production?

Answer 44

Leukotrienes

Question 45

What produces mucus in the airways?

Answer 45

submucosal glands and goblet cells

Question 46

what is the most damaging effect of mucus hypersecretion?

Answer 46

airway obstruction by mucus plugs which is caused by mucus hypersecretion and increased plasma exudation.

Question 47

- begins early in the disease process | - declining lung function

Answer 47

airway remodeling

Question 48

the result of an inability to adequately ventilate and an abnormal ventilation-perfusion relationship where parts of the lung that are well perfused are not adequately ventilated.

Answer 48

dyspnea

Question 49

results from air trapping and resultant hyper inflation of the lungs.

Answer 49

chesr tightness

Question 50

results as the asthmatic patient tries to clear his or her airway of mucus

Answer 50

coughing

Question 51

is the result of the passing of air through narrowed airway

Answer 51

wheezing

Question 52

triggered by lung receptors responding to increasing lung volume and alveolar hypoxia.

Answer 52

hyperventilation

Question 53

causes vasoconstriction which in turn decreases vascular perfusion contributing to ventilation-perfusion mismatch.

Answer 53

hypoxia

Question 54

causes a decrease in serum carbon dioxide resulting in respiratory alkalosis usually accompanied with hypoxemia

Answer 54

hyperventilation

Question 55

the most helpful result is an ____

Answer 55

arterial blood gas

Question 56

provides information about ventilation through the pCO2 and PO2 values

Answer 56

arterial blood gas

Question 57

will initially cause respiratory alkalosis which may be accompanied with hypoxemia or a low PO2 during an asthma attack.

Answer 57

hyperventilation

Question 58

pH=7.50, pCO2=29, HCO3=22, PO2=70

Answer 58

respiratory alkalosis and hypoxemia

Question 59

pH=7.32, pCO2=49, HCO3=27, PO2=70

Answer 59

respiratory acidosis and hypoxemia

Question 60

____ infections are more common.

Answer 60

viral

Question 61

___ offers the single most objective measurement of lung function available

Answer 61

spirometry

Question 62

bronchial provocation tests cause _____

Answer 62

bronchoconstriction

Question 63

____ is confirmed when post challenge data shows a 12% or greater improvement

Answer 63

reversible airway obstruction

Question 64

assesses peak expiratory flow (PEF) by comparing to patient's personal best

Answer 64

peak flow monitoring

Question 65

PEF >80% of personal best

Answer 65

green zone

Question 66

PEF 50-80% of personal best

Answer 66

yellow zone

Question 67

PEF <50% of personal best

Answer 67

red zone

Question 68

address inflammation and airway obstruction

Answer 68

long-term control medications

Question 69

reverse acute airflow obstruction

Answer 69

long-term control medications

Question 70

block the COX and lipoxygenase pathways in the inflammatory process.

Answer 70

corticosteroid medications

Question 71

stabilize the membrane of a sensitized mast cell after an antigen-IgE interaction preventing the release of inflammatory mediators such as histamine.

Answer 71

mast cell stabilizers

Question 72

is anti-IgE antibody that prevents binding of IgE to basophils and mast cells.

Answer 72

Monoclonal antibody SC injections