Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathophysiology of ill-health > Asthma > Flashcards

Asthma Flashcards

1
Q

Definition (& citation)

A

“A Chronic INFLAMMATORY DISORDER of the airways…in susceptible individuals, inflammatory symptoms are usually associated with widespread but variable airflow obstruction and an increase in airway response to a variety of stimuli. Obstruction is often reversible, either spontaneously or with treatment”

(International consensus report 1992 in BTS guidelines for asthma 2007) - BUT - no internationally agreed definition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Symptoms of Asthma

What are they?

What qualities do these symptoms have? (& REF)

A

Wheeze
Shortness of breath
Chest tightness
Cough

Hallmark - these symptoms tend to be:

  • variable
  • intermittent
  • worse at night
  • Provoked by triggers

(BTS 2004)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pathophysiology explaining symptoms (basic)

A

TH2 cell stimulation
IgE mechanism
Arachidonic acid metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are cytokines?

A

Play an important role in nearly all aspects of INFLAMMATION and IMMUNITY. They stimulate immune responses.

Interleukin’s (IL’s) are a group of naturally occurring proteins that mediate communication between cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Examples of cytokines?

A

IL-1,2,3,4,5,6,7,8,9,10,12

Tumour Necrosis Factor ‘TNF’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do cytokines do, generally?

/ how do they do it?

A

Attract white cells to the area and an inflammatory response occurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

TH2 cells - what are they?

What do they secrete?

What are they implicated in?

A

Helper type 2 cells, distinct type of T cell that secretes:

Secrete:
IL-4,5,9,13,17,25 (inflammatory mediators)
Stimulate eosinophil activation and survival (IL-5) or promote mast cell activation (IL-9)

TH2 -type immune responses have been implicated in the development of chronic allergic inflammation and asthma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

THE INFLAMMATORY CASCADE

A
  • TH2 stimulation
  • Mediator/ cytokine / interleukin release
  • Other white cell stimulation -?
  • Mediator/ cytokine / interleukin release
  • Emergence of symptoms of INFLAMMATION and asthma.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What effects do interleukins cause (in asthma)? (6)

A
  • Obstruction of the smooth muscular walls of the bronchioles and terminal bronchioles.
  • Oedema of airway mucosa
  • Increased mucous secretion
  • Cellular infiltration of the airway walls
  • Injury to and shedding of the airway epithelium
  • > this manifests as ASTHMA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is Asthma relevant?

Global

UK

A

Major non-communicable disease

WHO 2016; 383,000 deaths in 2015

80% asthma-related deaths occur in low and middle income countries

5.4 million people currently receiving treatment for asthma in the UK

Every 10 seconds someone is having a potentially life-threatening asthma attack - 3 people die of asthma attack every day in the UK

NHS spends £1 billion per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Asthma relevance?

Mental health

A

Most common chronic disease

SU with MH issues and LD are at increased risk of developing respiratory conditions including asthma

Respiratory disease is the main cause of death in people with learning disabilities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the link between obesity and asthma?

Which sex is link strongest in?

A

Via the activity of pro-inflammatory cytokines

females - from epidemiological data

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are cytokines?

What other areas covered in module are cytokines important for?

A

Cytokines are white blood cells - pro-inflammatory mediators

Pneumonia & sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Asthma - heritable?

chromosomes?

A

‘complex’ heritable disease

number of genes which contribute to persons susceptibility to disease - chromosomes 5,6,11,14

Chromome 5 one of most

Chromosome 5 codes for key molecules in the inflammatory response seen in asthma, including cytokines, growth factors and growth factor receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Risk factors for asthma?

A
  • Genetic predisposition
  • Environmental exposure to inhaled substances which provoke allergic reactions, e.g.
  • indoor allergens e.g. house mites, pet dander
  • outdoorallergens, e.g. moulds, pollens,
  • tobacco smoke

also…

chemical irritants, air pollution, cold air, extreme emotional arousal - e.g. anger, fear , physical exercise, certain medications e.g. beta blockers, aspirin,anti-inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How can aspirin cause asthma attacks?

A

Aspirin acts as a de-regulator of leukotrines

Leukotrienes are substances in the body that cause inflammation and many of the symptoms of athma.

17
Q

How can beta blockers trigger asthma?

A

beta 1 receptors in the heart and kidney

beta 2 receptors are found in the liver, lungs, skeletal muscles, uterus, gastrointestinal tract, vascular smooth muscle

beta 3 receptors found in the fat cells of the body

lower blood pressure but constriction in bronchial tree - can cause asthma

18
Q

Functions of the respiratory system?

Adaptations?

(can then apply to symptoms)

A 
Breathe in oxygen
Breathe out carbon dioxide
Breathe out water
Heat regulation
Influence pH balance, fluid balance
Upper airways warm, moistens and filters
Communication

Adaptions of Respiratory System?

  • concentration gradient: high levels of Oxygen in alveoli, low levels in blood, oxygen diffuses across gradient
  • Very large surface area (tennis court sized)
  • Thin membrane ( encourages movement across)
  • Very good blood supply
  • Adaptable
19
Q

Apply symptoms of asthma to functions of respiratory system?

A
  • Concentration gradient - less oxygen in alveoli, could be full of fluid
  • Very large surface area (tennis court sized)
  • Thin membrane - thicker in asthma
  • Very good blood supply
  • Adaptable

Similar to pneumonia

20
Q

Oxygen, carbon dioxide, nitrogen

IN (conc. in atmosphere)

OUT

A

Oxygen IN = 21%
Oxygen OUT = 16.5% (use a quarter)

Carbon dioxide IN - 0.04%
Carbon dioxide OUT - 4%

Nitrogen IN 76%

21
Q

Oxygen Journey in the body…?

Mouth -> Respiratory system -> Cardiovascular system -> where does it end up?

A

Enters nose / mouth,

Nasopharynx, oropharynx, laryngopharynx, larynx, down trachea, trachea splits at carina to right and left bronchus, through bronchial tree, through bronchus, through bronchioles, terminal bronchioles, down into alveoli

In alveoli it diffuses across alveoli capillary membrane, into red cell erythrocytes, binds to haemoglobin (forming oxyhaemoglobin)

oxyhaemoglobin is pumped into tissues

Out of red cell, through interstitial space, through cell membrane, through cytoplasm, ends up in mitochondria

22
Q

How is oxygen used by mitochondria?

AKA Aerobic Respiration

A

Glucose + oxygen -> mitochondria-> Adenosine Triphosphate (ATP) , CO2 and H2O, and heat)

ATP is the energy source for muscles to work

More ATP required? more heat, water and carbon dioxide generated

23
Q

Normal vital signs:

Respiratory rate, depth, pattern

Blood pressure - systolic and diastolic

Heart rate, rhythm and amplitude

Temperature

Blood

A

RCUK

12-20 resp rate, normal depth and regular

60-100 BPM

110-140 / 60-90

36.0-37.5 centigrade

Blood glucose 4-8mmol)

24
Q

Normal arteriole blood gas values?

A

pH - 7.35 - 7.45

PaO2 - 11-14 Kpa (kilapascals - British) -OR- 80-100 mmHg (mercury based scale)

PaCO2 - 4.7-6.0 Kpa -OR- 25-45mmHg

Lactate (0.5-1.00mmol/l)

25
Q

Respiratory (organ) Failure Type 1:

A

Type 1 - Characterised by:

Arteriole oxygen level less than 8Kpa, CO2 level is normal (less than 6Kpa)

26
Q

Respiratory (organ) Failure Type 2:

A

Type 2 - Characterised by:

Arteriole oxygen level is less than 8Kpa, CO2 level is higher than 6Kpa

(tends to be COPD, emphysema)

Raised CO2 - AKA Hypercapnia - occurs as a result of decreased alveolar ventilation

27
Q

Aerobic Respiration - Process?

A

Glucose -> glycolysis in cytoplasm -> pyruvate -> Kreb’s cycle -> electron transport phosphorylation

= 36 ATP (38 including ATP used in process)

28
Q

Relationship Between pH and Respiratory Rate

MEGA PRINCIPLE

A

What happens to resp rate with asthma attack? chest infection? low BP? stop excreting urine?

Respiratory rate will increase

Whenever acidotic, pH calls.

Chemo-receptors

29
Q

Carbon dioxide - how is it carried in blood stream?

A
  • 7% dissolved in plasma
  • 23% is combined with globin to form carbinohaemoglobin
  • 70% COMBINED WITH WATER AS CARBONIC ACID
30
Q

How does Carbonic Acid break down?

A

In the presence of the enzyme carbonic anhydrase, carbonic acid breaks down into HYDROGEN and BICARBONATE ions

(water) + (carbon dioxide)
(2 x hydrogen + 1 x oxygen) + (1 carbon + 2 x oxygens)
H2O + CO2 = H2CO3 (carbonic acid)

Splits (dissociates) in bloodsteam to H(hydrogen) and HCO3 (bicarbonate)

travel to alveoli, reform to H2CO3, this dissociates into water and carbon dioxide - we breathe these out

31
Q

pH - what is the H?

pH of stomach

A

P = power
H =hydrogen

More hydrogen in body, more acid (pH goes down) Stomach =1-3
Less hydrogen in body, less acid

Really strong acid? Loads of hydrogen…

Carbon dioxide essentially functions as an acid, as CO2 goes up, acid goes up

32
Q

pH

Normal pH? Compatible with life?

A
  1. 35-7.45
  2. 8 - Non-compatible with life (cell death)

Nucleus won’t work, mitochondria, golgi apparatus, Endoplasmic reticulum

Excessive acidosis? Heart, brain won’t work,

33
Q

Humans are acid producers - how?

A

making acids all the time

Breakdown of proteins, fats, carbohydrates,

34
Q

Factors Affecting pH

A
  • Carbon dioxide - more CO2 = more hydrogen
  • Renal System - urine is acidic, if not excreting= retaining
  • The Buffer system - Chemicals like haemoglobin, fibrinogen, co2 to a degree, ‘cancel out’ acids with alkalines
  • Cell Activity - lactic acids if starved of oxygen, basicallly
35
Q

Falling pH?

Process

A

Detected by chemo-receptors
Medulla Oblongata (brainstem)->
Phrenic and respiratory nerves (neck)->
Stimulate lungs - Increased respiratory rate (to breathe out CO2)

Acidosis - generally bad for you, sub-optimal organ function, 6.8 = cell death

Pathophysiology of ill-health (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions