Class 7 Respiratory 3

Question 1

Allergic Rhinitis

Answer 1

A group of signs and symptoms, mainly in the nose and eyes, triggered by inhaling allergens

Question 2

Names for allergic rhinitis

Answer 2

• Hay fever
• Seasonal allergies

Question 3

Allergic Rhinitis common comorbidities

Answer 3

• Asthma
• Atopic dermatitis - Atopy

Question 4

Allergic Rhinitis Pathogenesis

Answer 4

An acute vasomotor response caused by histamine and related substances released locally in the nose from IgE-coated mast cells.

Question 5

Allergic Rhinitis Clinical Manifestations

Answer 5

Itchy nose and mouth, conjunctivitis, sneezing, sinus and nasal obstruction, coughing, wheezing, and coryza.

Question 6

Allergic Rhinitis Diagnosis

Answer 6

History, symptoms, and skin test.

Question 7

Allergic Rhinitis Treatments

Answer 7

Avoid triggers, antihistamines, decongestants, and injections.

Question 8

Asthma

Answer 8

• Increased bronchial responsiveness to stimuli, classified as reversible COPD
• chronic inflammatory condition with acute exacerbations
• complex disorder involving biochemical, autonomic, immunologic, infectious, endocrine, and psychological factors.

Question 9

Asthma Incidence

Answer 9

The most common chronic disease in adults and children, more prevalent in males (2:1)

Question 10

Extrinsic Asthma

Answer 10

Results from an allergy to specific triggers, primarily affecting children and young adults, and classified as hypersensitivity disorders.

Question 11

Intrinsic Asthma

Answer 11

No known triggers, adult onset, possibly related to viral exposure, and referred to as post-viral asthma

Question 12

Occupational Asthma

Answer 12

Narrowing of the airways caused by workplace exposure

Question 13

Exercise-Induced Asthma

Answer 13

Bronchoconstriction can occur in individuals without other forms of asthma, affecting up to 20% of the healthy population, and is more common in cold temperatures.

Question 14

Asthma Pathogenesis
An inflammatory response in the airway causes:

Answer 14

Cellular infiltration, epithelial disruption, mucosal edema, and mucous plugging

Question 15

Asthma Pathogenesis
The inflammatory mediators produce:

Answer 15

Smooth muscle spasm, vascular congestion, increased vascular permeability, edema formation, production of thick mucous, and impaired mucociliary function

Question 16

Asthma Pathogenesis
Mediators also cause

Answer 16

• Thickening of airway walls
• Increased contractile response of bronchial smooth muscle

Question 17

Asthma Pathogenesis:
Airway hyper-responsiveness, swollen airways, and mucous plugs lead to distal air trapping, resulting in:

Answer 17

Hypoxemia, obstructed airflow, and increased work of breathing.

Question 18

Asthma Clinical Manifestations
⬧Variation

Answer 18

Variation in presentation, cough, shortness of breath (SOB), wheezing, degree (mild, moderate, severe), and frequency.

Question 19

Asthma Clinical Manifestations Duration

Answer 19

• Most attacks are short-lived with asymptomatic periods in between.
• Repeated episodes may lead to barrel chest, elevated shoulders, and hypertonicity of accessory muscles.
• Acute severe asthma (formerly status asthmaticus) is an unresponsive attack requiring emergency care and can be fatal.

Question 20

Asthma Diagnosis

Answer 20

History, clinical manifestation, and pulmonary function tests (FEV-1).

Question 21

Asthma Treatment

Answer 21

Identify and avoid specific triggers, and use medications such as corticosteroids and bronchodilators.

Question 22

Asthma Prognosis

Answer 22

• Asthma may resolve in many children, but for about one in four, wheezing persists into adulthood or relapses later.
• Approximately 4,000 deaths per year in the U.S. are asthma-related, most of which are preventable with treatment, leading to a good prognosis with proper access and adherence.
• Over time, some patients may experience permanent airway remodeling, hindering normal lung function; early aggressive use of anti-inflammatory drugs may help prevent this

Question 23

PNEUMOCONIOSES

Answer 23

Restrictive lung diseases caused by inhalation of mineral dusts and inorganic particulates, resulting in permanent deposition of substantial amounts of particles in the lungs, particularly from inorganic dust like iron ore or coal.

Question 24

PNEUMOCONIOSES Classification

Answer 24

Most are classified as occupational diseases resulting from long-term workplace exposure, with the most common being coal worker’s pneumoconiosis (anthracosis), silicosis, and asbestosis.

Question 25

PNEUMOCONIOSES
⬧ Lung injury caused by mineral particles depends on

Answer 25

duration and concentration of exposure, as well as the size, shape, and solubility of the particles. Large dust particles are retained in nasal mucus and do not reach the lower respiratory tract.

Question 26

PNEUMOCONIOSES
⬧ Biochemical composition of the inhaled dust

Answer 26

Inert particles, such as coal, are less reactive;

silica particles are more reactive and cause greater tissue injury;

and asbestos particles are insoluble, remaining lodged in the lungs permanently.

Question 27

PNEUMOCONIOSES
Incidence and Etiology

Answer 27

Most commonly occurs in miners, sandblasters, stonecutters, asbestos workers, and insulators. Incidence increases with age due to cumulative exposure, though overall incidence is decreasing.

Question 28

Coal worker’s pneumoconiosis

Answer 28

Amorphous carbon particles are retained in the nasal mucosa. Inhaled coal dust is ingested by alveolar macrophages and later expectorated, leading to black lung

Question 29

PNEUMOCONIOSES
Silicosis

Answer 29

Macrophage cell membranes are destroyed, leading to their death and the release of silica, which is then ingested by other macrophages. Dead macrophages release substances that stimulate collagenous nodule formation. Confluent nodules destroy lung parenchyma, causing massive pulmonary fibrosis, with tuberculosis as a common complication.

If caused by volcanic ash, it is referred to as pneumonoultramicroscopicsilicovolcanoconiosis.

Question 30

PNEUMOCONIOSES
Asbestosis

Answer 30

Asbestos particles are engulfed by macrophages, which are activated to release inflammatory mediators, leading to an increased risk of lung cancer.

Question 31

PNEUMOCONIOSES
Clinical Manifestations

Answer 31

Progressive dyspnea, chest pain, chronic cough, and expectoration of mucus.

Question 32

PNEUMOCONIOSES
Management

Answer 32

Diagnosis is based on workplace exposure, chest X-ray, clinical manifestation, and pulmonary function tests. Prevention and safety measures are crucial, but there is no standard treatment, and the prognosis is generally poor.

Question 33

HYPERSENSITIVITY
PNEUMONITIS

Answer 33

Hypersensitivity reaction in the alveoli to inhaled organic particulates, considered an occupational pathology similar to pneumoconiosis, resulting in restrictive lung disease.

Question 34

HYPERSENSITIVITY
PNEUMONITIS Symptoms

Answer 34

Fever, cough, dyspnea, headache, pleuritis, clubbing, honeycomb lungs, bronchiolitis, and crackles

Question 35

HYPERSENSITIVITY
PNEUMONITIS Diagnosis

Answer 35

History, blood tests, X-ray, biopsy, and pulmonary function tests (PFT).

Question 36

HYPERSENSITIVITY
PNEUMONITIS Treatment

Answer 36

Avoid triggers and use anti-inflammatories.