Asthma and OSA Flashcards
Summarize the pathophysiology of asthma (how is it stimulated, what happens to the smooth muscle, what is the result)
- Allergen induced (IgE -> Mast cell release)
- Obstructed airway from:
- Too much mucus (plugs), inflammation, edema
- Exaggerated bronchoconstriction - Permanent remodeling of smooth muscle and other cells that increases airflow obstruction and airway hyperresponsiveness
Explain the role of airway edema in the pathophys of asthma
- As a result of the mast cell release, the airways become swollen (edema), inflamed, and mucus hyper secretion leads to formation of mucus plugs
- Smooth muscles hypertrophy and hyperplasia occurs
Explain the role of bronchoconstriction in the pathophys of asthma
- Exaggerated response due to a wide variety of stimuli
- Due to inflammation
Summarize the remodeling occurs in the airways with asthma?
- Permanent changes that increase airflow obstruction and airway hyper responsiveness
- Thickening of sub-basement membrane
- Sub-epithelial fibrosis
- Smooth muscle hypertrophy and hyperplasia
- Mucus gland hyperplasia and hypersecretion
- Put simply: the lining and muscle aren’t as stretchy and the muscles don’t dilate as well
What is OSA
recurrent upper airway obstruction
What are most common symptoms of OSA
snoring
excessive daytime sleepiness
What are risk factors for OSA
obesity craniofacial abnormalities age smoking menopause alcohol medications
What is the gold standard for dx of OSA
polysomnography (sleep study)
What are the diagnostic criteria for OSA
5 or more obstructive events with risk factors present
OR
15 or more obstructive events with no risk factors present
AND
AHI > 5
OSA txt
weight loss sleep position alcohol advoidance CPAP oral appliance surgery
Epidemiology of Asthma
Incidence is highest in children, but affects all ages and occurs world wide with a preponderance of the disease in developed industrialized countries.