Diseases in Pulmonary Medicine: Asthma Flashcards
Physiologic abnormality of asthma
Airway hyperresponsiveness
Pathogenesis behind asthma
Imbalance favoring TH2 production over TH1 -> increases IL1, IL5 -> increased eosinophils
Putative mediators of asthma
SRS-A (made up of leukotrienes C4, D4, E4); histamine is not a putative mediator
Whorls of shed epithelium in mucus plugs seen in asthma
Curschmann spirals
Crystalloid made up of eosinophil membrane protein seen in both asthma and amoebiasis
Charcot-Leyden crystals
Predominant key cell involved in asthma
None
Characteristic feature of asthmatic airways
Eosinophil infiltration
Most common allergens to trigger asthma
Dermatophagoides species (dust mites)
Most common triggers of acute severe exacerbations
URTI: rhinovirus, respiratory syncytial virus, coronavirus
Mechanism of exercise-induced asthma
Hyperventilation
Exercise-induced asthma (EIA) is best prevented by regular treatment with
Inhaled corticosteroids
Characteristic symptoms of asthma
Wheezing, dyspnea, and coughing
Confirms airflow limitation with a reduced FEV1, FEV1/FVC ratio, and PEF
Spirometry
Confirms the diurnal variations in airflow obstruction
Measurements of PEF twice daily
Most effective bronchodilators in current use
B2-agonists
Primary action of B2-agonists
Relax airway smooth-muscle cells of all airways, where they act as functional antagonists
Most common side effects of B2-agonists
Muscle tremor and palpitations
Most common side effects of anticholinergics
Dry mouth
Most common side effects of theophylline
Nausea, vomiting, and headaches
Most effective controllers for asthma
Inhaled Corticosteroids (ICS)
Most effective anti-inflammatory agents used in asthma therapy
ICS
Indicates the need for regular controller therapy
Use of reliever medication >3x a week
Most common reason for poor control of asthma
Noncompliance with medication, particularly ICS
Drugs that have now been shown to beSAFE in pregnancy and without teratogenic potential
Short-acting B2-agonists, ICS, theophylline
