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PMP 201 Patient-Centred Learning > Asthma Pathophys > Flashcards

Asthma Pathophys Flashcards

1
Q

Asthma

A
  • Obstructive disease
  • Resistance to the flow of air
    through the airways during
    inspiration and expiration
  • FEV1 is <80% significant reduce compare to normal
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2
Q

Factors effecting degree of resistance

A
  • Airway diameter
    – Laminar or turbulent flow
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3
Q

Symptoms of asthma

A
  • Dyspnoea
  • Wheezing shortness of breath
  • Tight chest
  • Cough
  • Chronic unproductive cough
  • Night-time wakening with breathlessness
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4
Q

Asthma effect on airways

A
  • Chronic inflammatory disorder of the airways
  • Canbe reversible and induced by many stimuli
  • Obstructive disorder
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5
Q

3 main factors of asthma

A
  • Airway constriction
  • Airway hypersensitivity and responsiveness
  • Mucous hyper-secretion
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6
Q

Causes of asthma: genetic factors

A
  • Cytokine response
    profiles
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7
Q

Causes of asthma: Environment

A
  • Allergens
  • Pollutants
  • Infection
  • Stress
  • Symptoms and chronic changes
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8
Q

Age impact on asthma

A
  • Altered the immune and adaptive immune response
  • Causes symptoms and chronic changes
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9
Q

Genetic impact on inflammation with asthma

A
  • Intrinsic vulnerability interacting due to infection or allergy
  • Inflammation depending on phenotype
  • Bronchospasm
  • Airway remodelling
  • Airway obstruction
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10
Q

Allergens effect asthma

A

House dust mite, pollen,
moulds, animals

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11
Q

Chemicals effecting asthma

A
  • Paints
  • Hairspray
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12
Q

Drugs effecting asthma

A
  • Aspirin
  • ß-blockers
  • NSAIDs
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13
Q

Food triggers of Asthma

A
  • Colouring
  • Nuts
  • Preservatives
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14
Q

Environmental trigger for asthma

A
  • Smoking
  • Wood dust
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15
Q

Extrinsic asthma

A
  • Caused by specific triggers
  • Allergens specific trigger
  • Smoking and occupational agent
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16
Q

Intrinsic trigger

A
  • Non-specific
  • Cold dry air
  • Exercise
  • Virus
17
Q

Atopy

A
  • Develop IgE antibodies to common antigens
  • 1/3 +ve skin prick test - history of eczema and family history of asthma
  • Early onset 98% - skin test
  • Late onset 76% - skin test
18
Q

Hypersensitivity

A
  • Allergen is presented on the dendric cells in lung
  • Attach to Th0 helper lympocytes differentiate to Th2 lympocytes
  • Activate B cells to make IgE
  • Secreate cytokines stim mast cels and endothelial cells attracting eosinophils
19
Q

Hypersensitivity: Sensitisation

A
  • Antigen present on dendric
  • Activate helper T cells change to secrete Th2 cytokines
  • Activates B-cells
  • Plasma cells secrete antibodies
20
Q

IgE antibodies

A
  • Binding to Fc receptor on mast cell (granulocytes and some mediators eg histamines)
  • Fc region bind to mast cell in lung
21
Q

Mast degranulation

A
  • Rexposure to allergen
  • Allergen bind to IgE on mast cell
  • Cross linking Ige RECEPTOR
  • Cause mast cell degranulation
  • Release histamine and inflammatory mediators (Vasodilation increase mucus)
  • Attracts eosinophils
  • Stimulate cytokines
22
Q

Asthma Biphasic (Early phase)

A
  • Increased resistance to airflow
  • Peak 30-60 mins after allergen exposure
  • Subsidised 30-90 min later
  • Drop in peak flow response to inflammatory mediators from mast cells
23
Q

Asthma biphasic (Late phase)

A
  • Can occour long time after allergen exposure 6+ hrs
  • Can cause night time asthma
  • Continuation of inflammation
    characterised by an influx of eosinophils intothe lungs
24
Q

Leukotrine

A
  • Immediate constriction of airways and mucus production
  • Immediate response (sensitsation and challenge)
25
Q

Late asthmatic response

A
  • Mucus hypersecreation
  • Damage to epithelial can cause airways remodelling
  • Caused by eosinophil
26
Q

Recurrent attacks hyperresponsive

A
  • Days and weks after
  • Smooth muscle growth from build up of cytokines
27
Q

Bronchoconstriction

A
  • Narrowing of airways smooth muscle contraction
  • Increased mucous decrease diameter
  • Air trapping hyperinflation
28
Q

Mucous plugging and hyperinflation

A
  • Inspiration of air is allowed into alveolus
  • In exhalation the mucus plug can impede exhalation of air flow
  • Turbulent air flow around blockage cause characteristics wheezing
29
Q

Theraputic goals

A
  • Minimum symptoms day and night
  • Minimal need for reliever inhaler
  • No excerbation
  • No limitation to activity and normal lung function
30
Q

Reliever inhaler

A

Open the airways of a patient suffering an asthma attack

31
Q

Preventer inhaler

A

Intervene in the remodelling
process

32
Q

Vasodialation and increased permiability

A
  • Inflammation causes swelling of tissue due to OEDEMA
  • Swelling and decrease in diameter

PMP 201 Patient-Centred Learning (51 decks)

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