Bronchiectasis and Asthma Flashcards
Permanent dilation of bronchi and bronchioles caused by destruction of muscle and elastic tissue
bronchiectasis
What does bronchiectasis result from?
-repeated obstruction and infections
What do repeated obstruction and infections cause?
Causes remodeling, dilation, loss of smooth muscle and elastic tissue, fibrosis
What are the signs and symptoms of bronchiectasis?
- cough
- fever
- expectoration of copious, foul smelling, purulent sputum
What are the components of evaluation of bronchiectasis?
- history and PE
- spirometry
- CT (high resolution)
- Oximetry, arterial blood gas, acid-base assessment
- Sputum assessment
- CBC
- Consider assessing sweat chloride (sweat test) for cystic fibrosis and/or CF genotyping
What does a CBC usually show for bronchiectasis?
usually normal, may show polycythemia secondary to hypoxia
Chronic inflammatory airway disorder
asthma
What are symptoms of asthma caused by?
widespread, reversible bronchoconstriction with obstructive airflow limitation, mucus secretion
There are atopic and _______ causes of asthma.
There are atopic and non-atopic causes of asthma.
What is atopic asthma frequently related to?
type 1 hypersensitivity
Type 1 hypersensitivity is _____ mediated.
Type 1 hypersensitivity is IgE mediated.
What does antigen exposure result in?
pulmonary mast cell degraulation
What does mast cell degranulation cause?
- Histamine, serotonin, eicosanoids (leukotriene) release
- Increased vascular permeability
- Increased mucus production
- Stimulates afferent vagus nerve
Hallmark cells include ____ cells, which are the ______ trigger, and _______, which will be elevated on the CBC.
Hallmark cells include mast cells, which are the primary trigger, and eosinophils, which will be elevated on the CBC.
What does injury caused by chronic inflammation cause?
- fibrosis
- bronchial tissue remodeling
What are some non-atopic causes of asthma?
Stimuli such as cold, exercise, stress, some drugs can result in direct stimulation of vagal afferent nerves
What does vagus nerve stimulation cause?
bronchial smooth muscle constriction
What is the primary effect of non-atopic asthma?
bronchoconstriction
What are the 3 stages of asthma?
- sensitization
- elicitation
- airway remodeling
What does continued stimulation result in?
- fibrosis
- proliferation of goblet cells
- tissue remodeling
What are symptoms of asthma?
- severe dyspnea
- coughing
- wheezing
What do the symptoms of asthma result from?
bronchospasm and mucous production
What are the 4 categories asthma is classified by NHLBI?
- severe persistent
- moderate persistent
- mild persistent
- intermittent
What are classifications and therapy based on?
- age
- frequency and severity of events
