Asthma Flashcards
Are asthma rates consistent throughout the provinces?
No, highest in Atlantic, lowest in BC and Prairie Provinces
What type of reaction is asthma?
A hypersensitivity reaction
What can low birthweight and RDS contribute to?
Childhood asthma
True or false: obesity, hormonal influences contribute to adult onset asthma.
True
Are asthma episodes reversible
yes, typically with or without medication
Atopic/ allergy asthma is known as what?
Extrinsic asthma
Type 1 IgE mediated hypersensitivity reaction describes what?
Extrinsic asthma
Cold air, hyperventilation, hormonal changes and GERD lead to what kind of asthma?
Intrinsic asthma
What is a key feature of asthma?
Epithelial cell activation and injury of the bronchi
In what phase of asthma does the allergen bind to performed IgE on sensitized mast cells on mucosal surface on airways?
Early phase, within 10-20 minutes and can last up to 2 hours
What cell in the early phase of asthma is responsible for releasing histamine, chemotactic chemokines, leukotrienes, PG D2, cytokines and PAF?
Mast cell activation
What causes the recruitment of neutrophils, eosinophils, basophils, T lymphocytes in the _ phase of asthma?
- late phase
- the release of inflammatory mediators in the early phase
What causes epithelial injury, edema, increase mucus and changes in mucociliary function?
inflammatory cells
What causes an increase in migration and activation of inflammation in asthma?
Cytokines such as TNF-alpha, IL-4,5
What role do T Lymphocytes (TH2) play in asthma?
Skewed to be pro-inflammation so they further direct the release of inflammatory mediators.
What cell acts directly on smooth muscle causing constriction in the early phase of asthma?
Histamine
What cells stimulate the increase in mucus production?
Leukotrienes
In mucus hypersecretion: _ cell hyperplasia and _ gland hypertrophy
- goblet cell
- submucosal
Th2 release _ and _ that lead to upregulation of mucus production in asthmatic patients
- IL9 and IL-13
True or false: Airway remodeling is very helpful in asthma for patients to be able to return to 80% of their FEV
False, airway remodeling is not something good
The increase in deposition of _ and other proteins lead to thickening of the lamina reticularis with _ fibrosis and _ vascularity in the airwar wall contributing to _
collagen, subepithelial, increased
_ and _ caused by mismatch of ventilation and perfusion
hypercapnia and hypoxemia
What are common symptoms of an asthma attack?
dyspnea, SOB, cough, chest tightness, cough, wheezing
True or false: upon auscultation of lungs of a patient with an asthma exacerbation it is common to hear crackles
True, indicates a deep tissue infection
What type of vital signs would you expect to see a patient having an asthma attack?
tachypnea, tachycardia, hypoxemia
Normal values of: pH_, pCO2, HCO3
- pH 7.35-7.45
- pCO2 35-45
- HCO3 22-26
Initial lab values would show an asthmatic patient having respiratory _ with hyperventilation and +/-_ if left untreated can lead to +
- alkalosis, hypoxemia
- acidosis, hypoxemia
_ offers the single most objective measurement of lung function available
spirometry
_shows how controlled a patient’s asthma is and if it is getting worse
peak flow monitor
what type of test alerts us that the patient needs to administer a SABA
peak flow monitor
What medication would we administer for quick relief that may cause tachycardia?
SABA (albuterol)[ventolin]
What is an alternative to SABA?
Anticholinergic
What is a third line reliever that is not able to stop/reverse the acute phase of asthma?
systemic corticosteroids (prednisone) NSAID
Which LABA is co-administered with a corticosteriod?
salmeterol (servent)
What long term control medication would we administer to stabilize mast cells?
cromolyn (intal)
Which long term control medication would we give for atopic asthma? Blocks IgE
Omalizumab (xolair)
