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Respiratory Week 3 > Asthma > Flashcards

Asthma Flashcards

1
Q

what are the three cardinal features of asthma?

A

airway nflammation
reversible airflow obstruction
airway hyperresponsiveness

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2
Q

what type of T cell is present in allergic asthma?

A

Th2 cells

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3
Q

what are the cytokines associated with allergic asthma and Th2 cell response?

A

IL4,5,13

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4
Q

what is a common Xray finding with asthma?

A

hyperinflated lungs with flattened diaphragm

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5
Q

name the seven immune cells that can be present in airway inflammation of asthma

A 
B cell
T cell
Innate lymphoid cell
eosinophil
neutrophil
mast cells 
dendritic cells
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6
Q

what is the first step in starting allergic asthma reaction

A

dendritic cell recognizes antigen

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7
Q

what is the second step in allergic asthma response?

A

dendritic cell presents the antigen to the T cells and makes Th2 cells

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8
Q

what do Th2 cells in allergic asthma release that stimulates B cells? What do B cells release in response?

A

T cells release IL-4 and B cells respond to the IL-4 by releasing IgE

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9
Q

in allergic asthma, the IgE from the B cells are in charge of what?

A

mast cell degranulation by crosslinking

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10
Q

mast cell degranulation leads to three important responses…name them

A

bronchoconstriction
vasodilation
mucus production

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11
Q

in allergic asthma, Th2 cells release a cytokine that induces eosinophils…what cytokine is it?

A

IL-5

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12
Q

in allergic asthma, what do eosinophils cause?

A

inflammation in the airways

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13
Q

Th2 cells in allergic asthma release IL-13, what are its functions (2)

A

mucous cell metaplasia…goblet cells

airway smooth muscle hypertrophy

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14
Q

in late onset eosinophilic asthma, what are the three cytokines released from epithelial cells that drive the asthmatic reaction?

A

IL-25
IL-33
TSLP

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15
Q

what are the cytokine mediators that lead to the response in late onset eosinophilic asthma?

A

IL5 and 13…ac

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16
Q

compared to allergic asthma, what key cytokine and immune response is missing in late onset eosinophilic asthma?

A

IL-4 and mast cell degranulation via IgEs

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17
Q

in late onset eosinophilic asthma, the cytokines IL-25,33 and TSLP all go to a cell and make it secrete other cytokines…what is this type of cell?

A

innate lymphoid cell

18
Q

what cytokines does the innate lymphoid cell secrete?

A

IL- 5 and IL-13

19
Q

what does AERD stand for?

A

aspirin exacerbated respiratory disease

20
Q

explain how AERD occurs

A

since Aspirin blocks the cyclooxygenase pathway from arachidonic acid…the acid mainly goes down the lipoxygenase pathway and into leukotrienes

21
Q

what is the symptom triad for AERD

A

aspirin use
nasal polyps
asthma

22
Q

what type of T cell is in neutrophilic asthma?

A

Th17 cell

23
Q

what cytokine is really important in neutrophilic asthma? what cell secretes it?

A

IL-17

Th17 cell

24
Q

what is IL-17s role in neutrophilic asthma?

A

leads to a chemokine for neutrophils to migrate out of vasculature

25
Q

is eosinophilic asthma sensitive to steroids?

A

yes

26
Q

is neutrophilic asthma sensitive to steroids?

A

yes

27
Q

which type of asthma is severe and which type is mild/moderate? choices of eosinophilic or neutrophilic

A

eosinophilic is mild

neutrophilic is severe

28
Q

name the three hallmarks of airway remodeling in asthma

A

thickened basement membrane
airway smooth muscle hyperplasia
mucous metaplasia

29
Q

what is asthma affect on DLCO?

A

it is sometimes elevated or normal

30
Q

what is an odd trigger of asthma that is important to remember?

A

STRESS

31
Q

name the four symptoms usually seen in asthma presentation

A

cough
dyspnea
chest tightness
wheezing

32
Q

does wheezing occur during expiration inspiration or both? what about stridor?

A

wheezing is during expiration…stridor can be during both

33
Q

what is a chemical that induces asthmatic airway hyperresponsiveness but does not induce in normal airway?

A

methacholine

34
Q

explain why methacholine is used for asthma testing

A

methacholine causes hyperesponsiveness in the asthmatic airways but does not in normal airways

35
Q

what are three diagnostic tests for asthma?

A

spirometry
peak flow variability
methacholine challenge testing

36
Q

what chemical do inflammed epithelial cells release that can be tested for asthma?

A

nitric oxide (NO)

37
Q

in what type of asthma will NO be elevated from the epithelial cells?

A

eosinophilic

38
Q

what cells release NO in eosinophilic asthma?

A

epithelial cells

39
Q

what type of asthma is induced sputum used for? is this common?

A

eosinophilic…cause can see the eosinophils…not common

40
Q

name the rescue asthma treatment

A

albuterol

41
Q

what are the three controller asthma medication options

A

inhaled glucocorticoids
long acting beta agonists
leukotriene modifier

42
Q

what is the leukotriene modifier that is used for asthma?

A

montelukast

Respiratory Week 3 (14 decks)

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