csv-export Flashcards
With asthma, it is found to have contracted airway smooth muscle, mucosal thickening from ___a___ and cellular infiltration, and ___b____ that block smaller airways.
a) edema
The pathophysiology of asthma involves the release of chemical mediators from ________ and _________.
mast cells and eosinophils
An example of of a chemical mediator that contracts smooth muscle is ___a____, which is released by ___b_____.
a) histamine
Besides the release of chemical mediators, another pathophysiological method of asthma involves abnormality in regulation of smooth muscle ____a____, which is due to an increase in ____b______ activity..
a) tone
Besides the release of chemical mediators and abnormalities of smooth muscle, another pathophysiological method of asthma involves chronic airway inflammation due to an increased number of inflammatory cells even between acute attacks.
TRUE
The early reaction phase of an asthma attack is also called “slow reacting substance of anaphylaxis” and involves leukotrienes.
FALSE
The acute phase of an asthma attack is usually due to ____a_____ release, which happens in seconds, and within a few minutes you will start making ____b____.
a) histamine, tryptase
After a few minutes into an asthma attack, after leukotrienes and PGs are being made, ___a____ are activated to release ___b_____.
a) t-cells (T lymphocytes)
During the late reaction of an asthma attack, interleukins activate _________. Give some specific examples of these…
eosinophils
Neutrophils release ________ during late reaction phase of an asthma attack to cause cellular infiltration and edema.
proteases, PAF
e) TNF
c) leukotrienes
d) leukotrienes
a) interleukins
Over hours of time of an asthma attack, you will get cytokine production that will release __________. What are some examples?
interleukins
What are some anatomical differences that you can see within an asthmatic’s bronchi versus a normal patient’s bronchi?
smooth muscle and epithelium are much thicker
What are signs and symptoms of asthma?
wheezing
e) all of the above
e) all of the above
B2-agonists relax smooth muscle dependent of whatever is causing contraction.
FALSE
e) all of these are SA-B2 agonists
d) formoterol
g) all of the above
c) ipratropium
g) all of the above
f) b & c
g) none of the above
f) a & d
e) hypertension
e) hypertension
Ipratropium and tiotropium help in reversing bronchospasm, but only do so by blocking contraction due to ________.
ACh
Ipratropium + albuterol (Combivent) has a (a) slower/faster onset and (b) less/more bronchodilation effect than B2 agonists.
a) slower
e) triamcinolone
d) ipratropium
e) dry mouth
b) dizziness
e) none of the above
c) ipratropium and tiotropium
Theophylline inhibits ___(a)____, which causes the metabolism of cAMP to (b)decrease/increase and cGMP to (c) decrease/increase.
a) phosphodiesterase (PDE 4, 5)
Theophylline works antagonistically on which receptor?
Adenosine receptor antagonist
Besides theophylline working mechanistically to inhibit phosphodiesterases PDE 4,5 and antagonize adenosine receptor A2B, is works with anti-inflammation actions to inhibit inflammatory mediators in which stage of response? (early or late response?)
late
f) convulsions
c) hyperglycemia
What is the dose of Theophylline that may cause CNS effects like convulsions and cardiac effects like arrhythmias?
doses >20mcg/ml
What are the therapeutic levels for Theophylline?
5-20mcg/ml
At what dose range can theophylline cause nausea, vomiting, and cardiac effects?
15-20mcg/dl
At what dose range can Theophylline cause toxic effects, leading to seizures and arrhythmias?
30-40mcg/ml
e) theophylline
c) cromolyn
Cromolyn stabilizes ___a____ and must be taken (b) before/after antigen insult.
a) mast cells
The mechanism in which Cromolyn and Nedocromil works is unknown, but they are thought to work on _________ involving granules moving to membranes.
Ca++
g) none of the above
b) they inhibit anti-inflammatory cascade
Corticosteroids works up to __a__ weeks for maximal effects and can cause ____b____.
a) 8 weeks
f) all of the above are examples of corticosteroids
d) metoproterenol
d) none of the above
c) control inflammation
f) none of the above
b) Zafirlukast, CYP2C9 & CYP3A4
Montelukast is a __a___ antagonist that inhibits the __b___ receptor that mediates inflammation, bronchial constrictions, and mucous secretions.
a) LTD4
What agents are effective to use in Aspirin-induced asthma and where in the pathway does it work?
leukotriene anatagonists
____a____ converts arachidonic acid into PGG2, whereas ______b______ converts arachidonic acid into 5-HPETE.
a) cyclooxygenase
5-HPETE is converted into ___a___, and which ones (after this conversion) are considered to be the “slow reacting substances of anaphylaxis? (b)”
a) LTA4
Which one does the opposite and contracts blood vessels and activates platelets? (b)
a) PGI2
After cyclooxygenase converts arachidonic acid into PGG2, which one is involved in muscle contraction?
PGE2
