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IM Pulmo > Finals > Flashcards

Finals Flashcards

1
Q

What is the peak age of onset for bronchial asthma?

A

3 years

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2
Q

What are two key defining features of bronchial asthma?

A

Variable respiratory symptoms and variable expiratory airflow limitation, usually reversible.

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3
Q

What spirometric findings indicate obstructive ventilatory impairment in asthma?

A

Low FEV1 and FEV1/FVC ratio.

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4
Q

What increase in FEV1 after bronchodilator inhalation denotes reversibility?

A

> 200 mL and >12% increase.

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5
Q

List three common endogenous risk factors for asthma.

A

Genetic predisposition, airway hyperresponsiveness, obesity.

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6
Q

Name three environmental triggers for asthma exacerbation.

A

Indoor allergens, passive smoking, respiratory infections.

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7
Q

What is atopy, and how is it related to asthma?

A

Atopy is an exaggerated IgE-mediated immune response to allergens and a major risk factor for asthma.

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8
Q

Which interleukins are associated with asthma and atopy on Chromosome 5q?

A

IL-4, IL-5, IL-9, and IL-13.

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9
Q

What is the ‘hygiene hypothesis’ in the context of asthma?

A

It suggests that exposure to endotoxins and infections results in a protective TH1 immune response, reducing asthma risk.

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10
Q

How does obesity contribute to asthma?

A

Pro-inflammatory adipokines from fat stores and reduced anti-inflammatory adipokines worsen asthma control.

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11
Q

Name the clinical features characteristic of asthma.

A

Wheezing, dyspnea, coughing, worse at night, and increased mucus production.

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12
Q

What is ‘cough-variant asthma’?

A

A form of asthma where the primary symptom is a non-productive cough.

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13
Q

What is the significance of a positive methacholine or histamine challenge test in asthma diagnosis?

A

It confirms airway hyperresponsiveness.

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14
Q

What are the major types of asthma phenotypes?

A

Allergic asthma, non-allergic asthma, late-onset asthma, asthma with fixed airflow limitation, and asthma with obesity.

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15
Q

Which drugs are classified as short-acting beta-agonists (SABAs)?

A

Albuterol and terbutaline.

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16
Q

What is the primary function of long-acting beta-agonists (LABAs)?

A

They provide bronchodilation with a duration of 12-24 hours and are used for maintenance therapy.

17
Q

What are two key side effects of inhaled corticosteroids (ICS)?

A

Oral thrush and dysphonia.

18
Q

How does omalizumab work in asthma therapy?

A

It is an anti-IgE biologic agent that reduces IgE levels and allergic responses.

19
Q

What is brittle asthma, and what are its two types?

A

A severe form of asthma with chaotic lung function variability; Type 1 involves persistent variability, and Type 2 involves sudden unpredictable lung function falls.

20
Q

What constitutes uncontrolled asthma based on the asthma control questionnaire?

A

Daytime symptoms more than twice/week, night waking, reliever needed more than twice/week, or activity limitation due to asthma.

21
Q

What is the first-line treatment for acute severe asthma?

A

High doses of short-acting beta-agonists (SABAs) via nebulizer or pMDI with spacer.

22
Q

What is the role of magnesium sulfate in asthma management?

A

It is given intravenously or nebulized in severe asthma not relieved by initial therapy to reduce bronchoconstriction.

23
Q

What differentiates asthma-COPD overlap (ACO) from asthma or COPD alone?

A

ACO shows features of both diseases, such as airway hyperreactivity and partially reversible airflow limitation.

24
Q

What is the mechanism of action of theophylline in asthma?

A

It inhibits phosphodiesterases, increasing cyclic AMP, and has anti-inflammatory effects at lower doses.

25
Q

What is the most common genetic predisposition implicated in asthma?

A

Polymorphisms of genes on Chromosome 5q, including those affecting TH2 cells and interleukins.

26
Q

What structural changes occur in the airway during asthma?

A

Thickened basement membrane, airway smooth muscle hyperplasia, and mucous plugging.

27
Q

What role do mast cells play in asthma pathophysiology?

A

They release histamine, prostaglandin D2, and leukotrienes, initiating bronchoconstrictor responses.

28
Q

Describe the stepwise approach to asthma therapy.

A

Progression from SABA as needed, low-dose ICS, ICS/LABA, to high-dose ICS and additional controllers based on severity.

29
Q

What are common side effects of LABAs?

A

Tremors, palpitations, muscle cramps, and hypokalemia.

30
Q

What dietary factors are linked to increased asthma risk?

A

Low intake of antioxidants, high sodium, and omega-6 fatty acids.

IM Pulmo (4 decks)

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