Pathophysiology

Question 1

What three things happen in the progression of asthma?

Answer 1

1. Narrowing of airways
2. Hypersensitivity to bronchoconstricting stimulants
3. Increased inflammatory mediators

You get:

Goblet cell hypertrophy
Loss of cilia
Basement membrane thickening and fibrosis
Smooth muscle hypertrophy and sensitivity

Question 2

What is a the characteristic in the blood results of extrinsic asthma?

Answer 2

Raised IgE and eosinphils

Question 3

What are the inflammatory cells key to the asthma response?

Answer 3

IgE

Mast cells

TH2

Eosinophils

Leukotrienes

Question 4

What class of Lymphocytes play a key role in extrinsic asthma?

Answer 4

TH2

Question 5

What are the two phases of asthma attack?

Answer 5

1. Early
2. Late

Question 6

What happens in the early phase of an asthma attack and after how long does it occur?

Answer 6

It occurs in minutes and antigen cross linking with IgE on mast cells leads to degranulation and the release of histamine, prostaglandins and leukotriens.

This causes inflammation, vasoconstriction and mucuous production.

Only in extrinsic asthma

Question 7

What happens in the late phase of an asthma attack and after how long does it occur?

Answer 7

It occurs after 3-12 hours

Eosinophils, Th2 and, macrophages and basophils cause:

Airway inflammation, mucous production and oedema

Bronchoconstriction due to PSNS activation

Question 8

What drugs should be avoided in asthma and why?

Answer 8

NSAIDS/Aspirin

B blockers

They block COX2 action and this increases the levels of leukotrienes which increase inflammation