Asthma DSA

Question 1

3 components

Answer 1

recurrent airway obstruction
airway hyper-responsiveness
airway inflammation

Question 2

population affected

Answer 2

boys > girls
women > men
most cases onset is before 25

Question 3

mild asthma

Answer 3

edema and hyperemia of mucosa plus mucosal infiltration w/mast cells, eos, and lymphocytes

Question 4

moderate asthma

Answer 4

chemokines
eotaxin
RANTES
macrophage inflammatory protein 1 alpha 
IL8 
cause inflammation and smoothm constriction

Question 5

severe asthma

Answer 5

hypertrophy and hyperplasia of airway glands and smooth m -> severe airway thickening

Question 6

airway obstruction

Answer 6

constriction of smooth mm
thickening of airway epi
liquids in airway

Question 7

Ach

Answer 7

released from intrapulmomary motor nn

stimulates M3Rs -> smooth m constriction

Question 8

Histamine

Answer 8

released from mast cells

Question 9

leukotrienes and lipoxins

Answer 9

derived by lipoxygeneration of AA released from target cell membrane phospholipids during cellular activation

Question 10

NO

Answer 10

produced by airway epi and inflammatory cells

high levels during attack

Question 11

mild intermittent asthma

Answer 11

symptoms present <=2nights/month

Question 12

mild persistents

Answer 12

symptoms present >2days/wk, but 2nights/month

Question 13

moderate persistent

Answer 13

symptoms present daily for >once/night

Question 14

severe persistent

Answer 14

symptoms continual during day and frequent at night

Question 15

PE

Answer 15

wheezing loudest on expiration

Question 16

ABG

Answer 16

often mild hypocanpnea

if PaCo2 normalized during sever attack may indicate impending respiratory failure

Question 17

PFT

Answer 17

obstruction

Question 18

CBC

Answer 18

eos, IgE

Question 19

CXR

Answer 19

often normal, maybe hyperinflation

severe asthma- pneumothorax or pneumomedstiunum

Question 20

sputum

Answer 20

Eos

Question 21

step 1 Tx

Answer 21

intermittent asthma

short acting beta agonist as needed

Question 22

step 2 Tx

Answer 22

Mild persistent asthma
SABA as needed
inhaled corticosteroid
alternates: mast cell stabilizer, leukotriene R antagonist, theophylline

Question 23

step 3 Tx

Answer 23

moderate persistent asthma
SABA as needed
low to med dose inhaled corticosteroid
LABA
alternates: increase in inhaled corticosteroids leukotriene R antagonist, theophylline

Question 24

Step 4 Tx

Answer 24

severe persistent asthma
SABA as needed
high dose corticosteroid 
LABA
prednisone