deck_1570037 Flashcards
Describe the epidemiology of asthma
• Increasing in prevalence• More common in the developed world • Increases in populations who move from developing to developed countries
How many adults currently receive tratment for asthma?
• 5.4 million
What are the potential causes of asthma?
• Genetic risk• Sensitisation to airborne allergens ○ House dust mite ○ Pollens ○ Air pollution ○ Tobacco smoke• Hygiene hypothesis
hat is the definition of asthma?
• One or more of the following recurring symptoms ○ Wheeze ○ Cough ○ Breathlessness ○ Chest tightness ○ Variable airflow obstruction
What is a wheeze?
• High pitched expiratory sound• Originates in airways compressed or obstructed• Wheeze is of variable intensity and tone
Outline the type of cough one may develop in asthma
• Cough that’s worse at night• Cough which is exercise induced• Dry cough
What are the three parts of the examination of a suspected asthma patient?
• Inspection• Percussion• Auscultation
What do you look for in the inspection of an asthma patient?
• Chest ○ Scars/deformities ○ Hyper expansion• General health ○ Eczema, hay fever ○ Lethargu ○ Can they speak?
What are you looking for in percussion of an asthma patient?
• Hyper-resonance
What are you looking for in auscultation of an asthma patient?
• Polyphonic wheeze
Give three tests used in the investigation of an asthma patient?
• Spirometry - Flow volume loop• Allergy testing• Chest x-rays
What will you see in the spirometry of an asthmatic?
• Low PERF?• Low FEV/FVC ratio• >12% increase in FEV1 following salbutamol
What will you see in the allergy testing of an asthmatic?
• Skin prick to aero allergens• Blood IgF levels to specific aero-allergens
What will you see in Chest X ray of asthmatic?
• Peformed to exclude other disease/inhalation of foreign body/pneumothorax
Outline the pathophiologyical changes underlying asthma
• Increased mast cells• Increased eosinophils• Increased dendritic cells
What role do mast cells play in asthma?
• Release prostaglandins/histamine
What role do eosionphils play is asthma?
Large numbers in bronchial wall of asthmatics
What role do dendritic cells and lymphocytes have in asthna?
• Dedritic cells have a role in the initial uptake and presentation of allergens to lymphocytes• T-Helper lymphocytes (CD4) release cytokines that play a key part in the activation of mast cells• Th2 phenotype favour the production of antibody production by B lymphocytes to IgE.
What occurs in remodelling in asthma?
• Epithelium ○ Stressed and damaged with a loss of ciliated columnar cells• Basement membrane ○ Deposition of collagens, causing it to thicken• Smooth Muscle ○ Hyperplasia causing thickening of the muscle
Give three causes of asthmatic attacks?
• Lack of treatment adherence• Respiratory virus infections associated with common cold• Exposure to allergens or triggering drug
What are three treatments for asthma?
• Education • Primary prevention• Pharmacological management
What does education do for asthma patients?
• Educates people to correctly recognise their symptoms ○ To use services appropriately ○ To develop own personal asthma action plan
What is primary prevention of asthma?
• Stop smoking• Get fresh air• Reduce exposure to allergens• Lose weight
What is involved in the pharmacological management of asthma?
• B2 adrenoagonists ○ Muscarinic antagonists• Anti inflammatory agents
