ASTHMA

Question 1

Asthma definition

Answer 1

• Most common chronic disease worldwide

* Hyperresponsiveness of an airways in response to allergens

Question 2

Pathophys of asthma

Answer 2

1. Allergen reacts with epithelium on resp tract to release THYMIC STROMAL LYMPHOPOETIN (TSH)
2. TSL stimulates antigen presenting cells
   • T helper cells differentiate to form T Helper 2 cells
3. T helper 2 cells
   • Stimulate plasma cells to release IGe antibodies -> bind to mast cells -> degranulation
   • IL4 -> B cells
   • IL5 -> Eisonophils
   B cell/Eisenophils release histamine/cytokines/prostaglandins

= AIRWAY INFLAMMATION//BRONCHCONSTRICTION

Question 3

Asthma genetics

Answer 3

• Genetic tendency for TH2 expression over TH1

* ATOPY genetic tendency to develop disease

Question 4

Atopy

Answer 4

inherited predesposition to develop allergic disease

Asthma, Eczema, Rhinitis = Atopic triad

Question 5

Clinical symptoms of asthma

Answer 5

• Wheeze ( exp wheeze on exam)
• Chest tightness
• Breathlessness
• Cough

Question 6

4 Steps of asthma management

Answer 6

1. Mild
   • Short attacking B 2 agonist inhaler (salbutamol)
2. Exac of asthma/over use of inhaler
   •Low dose of inhaled sterioid
3. Increase in severity
   • Long acting Beta 2 agonist
   • Low dose inhaled steroid
4. V severe asthma
   • Leukotriene receptor antagonist
   • LABA
   • medium dose of inhaled steroid

5.
• Oral steroid too
• High dose steroid inhaler 
• LABA
• Leukotriene receptor

Question 7

Occupational asthma

Answer 7

• Industrial lung disease

* Symptoms at work vs home

Question 8

Inflammatory response of asthma

Answer 8

1. Inflammatory reaction
2. Mucus production narrows bronchioles
3. Bronchiole muscle spasm
   —->
   Oedema, scarring, fibrosis over time
   ——>
   Thickening of basement membrane

Question 9

Severe Asthma

Answer 9

Neutrophil imapance Asthma

1. Neutrophils release IL8