C&C Respiratory Workshop - Week 3

Question 1

Justify hyperinflation of the lungs observed in asthma.

Answer 1

Asthma = obstructive
Expiration is more difficult, because inspiration is active.
In flow-volume loops, obstructive loops dip at end of the expiration phase, because smaller airways have less muscle & power to force air out.
Intrathoracic pressure on exhalation decreases. Increased pressure on exhalation -> alveolar collapse.

Question 2

What treats increased mucous production in asthma?

Answer 2

ICS.

Question 3

What treats immune activation by allergen in asthma?

Answer 3

ICS OR Anti-IgE

Question 4

What treats asthma inflammation?

Answer 4

Anti-leukotrienes.

Question 5

What treats bronchoconstriction in asthma?

Answer 5

Bronchodilators SABA/LABA or anticholinergics.

Question 6

What drives arterial hypoxemia seen in an acute asthma attack?

Answer 6

V/Q mismatch as a result of under-ventilated alveoli.

Question 7

What is the most potent mediator of inflammation & bronchospasm in asthma?

Answer 7

Histamine.

Question 8

What is the most appropriate drug to rapidly reverse acute bronchoconstriction?

Answer 8

Inhaled albuterol/salbutamol.

Question 9

Along with epinephrine, what drug in its parenteral form can be life-saving in severe status asthmatics?

Answer 9

Prednisolone.

Question 10

What drug reduces bronchoconstriction by blocking the action of ACh?

Answer 10

Ipatroprium.

Question 11

Signs of LHF on examination

Answer 11

Fine crackles.

Question 12

Signs of RHF on examination

Answer 12

Increased JVP, ankle oedema, hepatomegaly.

Question 13

What asthma drug classification has a slow onset, but long duration of action?

Answer 13

LABA