Chronic Asthma- Etiology, Triggers, Clinical Presentation

Question 1

Asthma definition

Answer 1

INTERMITTENT OR PERSISTENT presence of highly variable degrees of AIRFLOW OBSTRUCTION from airway wall INFLAMMATION and bronchial smooth muscle CONSTRICTION and in some patients, persistent changes in airway structure occur.

Question 2

Asthma etiology: genetics

Answer 2

Atopic triangle- eczema, AR, asthma

Question 3

Caveat about the atopic triangle

Answer 3

Having one condition in the atopic triangle doesn’t always lead to asthma, and not all asthmatics are atopic

Question 4

Asthma etiology: environmental factors

Answer 4

Socioeconomic status, exposure to secondhand smoke in infancy or utero, allergen exposure, urbanization, RSV infection, smaller family sizes, decreased exposure to common childhood infectious agents

Question 5

Asthma triggers

Answer 5

Respiratory infections, allergens, the environment, emotions, exercise (especially in cold, dry climates), drugs (ASA, NSAIDs, nonselective beta-blockers), occupational stimuli

Question 6

Clinical presentation of asthma: symptoms

Answer 6

dyspnea, chest tightness, coughing, wheezing or whistling sounds when breathing

MAY NOT BE PRESENT AT TIME OF EXAM

Question 7

Clinical presentation of asthma: signs

Answer 7

expiratory wheezing on auscultation, dry hacking cough, signs of atopy, decreased O2 sat in flare-up/exacerbation

MAY NOT BE PRESENT AT TIME OF EXAM

Question 8

Asthma triggers: most significant trigger in children

Answer 8

Viral respiratory infections

Question 9

Asthma triggers: most important precipitants of severe asthma exacerbations

Answer 9

The environment

Question 10

Asthma triggers: ASA/NSAIDs are more of an issue in patients with what issues?

Answer 10

Atopy, nasal polyps

Question 11

Clinical presentation: what signs/Sx would make it more likely to be asthma?

Answer 11

> 1 type of symptom (SOB, wheeze, chest tightness)
Sx worse at night or in the early morning
Sx varying over time and in intensity
Sx have identifiable triggers

Question 12

Clinical presentation: what signs/Sx make it less likely to be asthma?

Answer 12

Chronic production of sputum
Isolated cough with no other respiratory symptoms
SOB is associated with dizziness, lightheadedness, peripheral tingling
Chest pain
Excercise-induced dyspnea with stridor