Diseases in Pulmonary Medicine: Asthma

Question 1

Physiologic abnormality of asthma

Answer 1

Airway hyperresponsiveness

Question 2

Pathogenesis behind asthma

Answer 2

Imbalance favoring TH2 production over TH1 -> increases IL1, IL5 -> increased eosinophils

Question 3

Putative mediators of asthma

Answer 3

SRS-A (made up of leukotrienes C4, D4, E4); histamine is not a putative mediator

Question 4

Whorls of shed epithelium in mucus plugs seen in asthma

Answer 4

Curschmann spirals

Question 5

Crystalloid made up of eosinophil membrane protein seen in both asthma and amoebiasis

Answer 5

Charcot-Leyden crystals

Question 6

Predominant key cell involved in asthma

Answer 6

None

Question 7

Characteristic feature of asthmatic airways

Answer 7

Eosinophil infiltration

Question 8

Most common allergens to trigger asthma

Answer 8

Dermatophagoides species (dust mites)

Question 9

Most common triggers of acute severe exacerbations

Answer 9

URTI: rhinovirus, respiratory syncytial virus, coronavirus

Question 10

Mechanism of exercise-induced asthma

Answer 10

Hyperventilation

Question 11

Exercise-induced asthma (EIA) is best prevented by regular treatment with

Answer 11

Inhaled corticosteroids

Question 12

Characteristic symptoms of asthma

Answer 12

Wheezing, dyspnea, and coughing

Question 13

Confirms airflow limitation with a reduced FEV1, FEV1/FVC ratio, and PEF

Answer 13

Spirometry

Question 14

Confirms the diurnal variations in airflow obstruction

Answer 14

Measurements of PEF twice daily

Question 15

Most effective bronchodilators in current use

Answer 15

B2-agonists

Question 16

Primary action of B2-agonists

Answer 16

Relax airway smooth-muscle cells of all airways, where they act as functional antagonists

Question 17

Most common side effects of B2-agonists

Answer 17

Muscle tremor and palpitations

Question 18

Most common side effects of anticholinergics

Answer 18

Dry mouth

Question 19

Most common side effects of theophylline

Answer 19

Nausea, vomiting, and headaches

Question 20

Most effective controllers for asthma

Answer 20

Inhaled Corticosteroids (ICS)

Question 21

Most effective anti-inflammatory agents used in asthma therapy

Answer 21

ICS

Question 22

Indicates the need for regular controller therapy

Answer 22

Use of reliever medication >3x a week

Question 23

Most common reason for poor control of asthma

Answer 23

Noncompliance with medication, particularly ICS

Question 24

Drugs that have now been shown to beSAFE in pregnancy and without teratogenic potential

Answer 24

Short-acting B2-agonists, ICS, theophylline