L1W1 Pathogenesis & Phenotype

Question 1

Factors coz pathophysiological change in airway? (2)

Answer 1

1. Immunological mechanism:
   - Antigen & antibody react(mast cell) -> cell disruption & release mediator
2. Neural mechanisms:
   - Parasym-> bronchoconstriction & inc mucus secretion
   - Sympa-> bronchodilatation

Question 2

Early-Phase Response Asthma (4) (m, char, inc, symp)

Answer 2

• Peaks 30-60m post exposure, subside 30-90m later
• Char by bronchospasm
• Inc mucus secretion, edema, inc amount tenacious sputum
• Wheezing, cough, chest tightness, SOB

Question 3

Late-Phase Response Asthma(4) (char, inc, inc, dmg)

Answer 3

• Char by inflammation
• Histamine & mediator inc airway
reactivity coz hyper-response to allergen & other stimuli
• Inc airway resistance-> air trap(alveoli) & hyperinflation(lung)
• Untreated-> irreversible lung dmg

Question 4

PATHOGENESIS OF BA?(5) (RIP ME)

Answer 4

• Pathology
• Inflammation
• Inflammatory mediators
• Effects of inflammation
• Airway remodelin

Question 5

ASTHMA INFLAMMATION
(Inflam/structural cell-> mediator-> eff)

Answer 5

Infam cell
-mast cell, eosi/baso/neutrophil

Struc cell
-epithelial, sm ms, endothelial

Mediator
-histamine, adenosine, nitric oxide, cytokine

Effect
-broncospasm, plasma exudate, mucus secr, structure change

Question 6

AIRWAY PATHOLOGY IN ASTHMA? (5) (CE BM SM Dmg EB)

Answer 6

a) Absence ciliated epithelium
b) BM thick
c) Sm ms hypertrophy & hyperplasia
d) Dmg epithelium expose nerve terminal to inhaled irritant substances.
e) Endobronchial mucus plug

Question 7

Def asthma phenotype?

Answer 7

• Recognizable cluster of demographic, clinical &/ pathophy char

Question 8

Most common phenotypes asthma? (5) (ANA AO PALO)

Answer 8

1. Allergic:
   - child, fam, eosi, well ICS
2. Non-allergic:
   - sputum(neutro/eosi/paucigranulocytic), xwell ICS
3. Adult-onset(late-onset):
   - F, >dose ICS, job asthma
4. Persistent airflow limitation:
   - incomplete reversible, remodel
5. Obesity: