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BST2 > Pathophysiology of bronchial asthma > Flashcards

Pathophysiology of bronchial asthma Flashcards

1
Q

What is bronchial asthma

A

Chronic airway inflammation, associated with airway hyper responsiveness

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2
Q

B. Asthma leads to…

A

bronchoconstriction (Reversible) and airflow limitation

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3
Q

Clinical manifestation of bronchial asthma ?

A

Recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning.

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4
Q

What is Airway hyper-reactivity

A

the tendency for airways to narrow excessively
in response to triggers that have little or no effect in normal individuals

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5
Q

Types of asthma?

A
  1. Atopic asthma
  2. Non-atopic asthma
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6
Q

Non-atopic asthma ..

A
  • Drug-induced asthma
  • Exercise-induced asthma
  • Occupational asthma
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7
Q

Causes of atopic asthma?

A

Causes: environmental allergens, such as dusts, pollens, cockroach or animal dander, and foods

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8
Q

Causes of Non- atopic asthma?

A

✓ Respiratory viral infections,
✓ Air pollutants, e.g., tobacco smoke,
✓ Cold air, stress, exercise

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9
Q

Mechanism of Non-atopic asthma ?

A
  • Chronic airway inflammation and hyperreactivity
  • Skin test - negative
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10
Q

Drug-Induced Asthma

A
  • Aspirin and non-steroidal anti-inflammatory drugs
  • Beta-adrenoceptor antagonists (β-blockers)
  • Oral contraceptive pill
  • Cholinergic agents
  • Prostaglandin F2α
  • Betel nuts contain arecoline
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11
Q

Cause of occupational asthma?

A

Causes: fumes (epoxy resins, plastics), organic and chemical dusts (wood, cotton, platinum), gases (toluene), or other chemicals (formaldehyde, penicillin products).

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12
Q

Mechanism of occupational asthma ?

A

1) Type I hypersensitivity
2) Direct production of bronchoconstrictor substances
3) Hypersensitivity responses of unknown origin

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13
Q

Mast cells release preformed mediators. Role preformed mediators?

A

1) Bronchospasm
2) Increased vascular permeability
3) Mucus production
4) Recruitment of leukocytes

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14
Q

Leukotrienes C4, D4, and E4

A

1) Prolonged bronchoconstriction
2) Increased vascular permeability
3) Increased mucus secretion

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15
Q

Acetylcholine

A
  • Released from intrapulmonary parasympathetic nerves
  • Bronchoconstriction by directly stimulating muscarinic receptors
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16
Q

IL-5 are associated with

A

peripheral blood eosinophilia

17
Q

Galectin-10 (GAL10)

A

is released from eosinophils and forms
Charcot-Leyden crystals

18
Q

These crystals is a…

A

Strong inducers of inflammation and
mucus production

19
Q

Histamine cause?

A

bronchospasam

20
Q

Prostaglandin D2 cause?

A

bronchospasm and vasodilation

21
Q

Platelet activating factor cause?

A

Platelet aggregation and release serotonin

22
Q

Bronchial asthma phatogenesis?

A
  1. Immune response
  2. Genetic susceptibility
  3. Environmental Factors
23
Q

Airborne pollutants can serve as

A

allergens to initiate the Th2 response

24
Q

Infections do not cause asthma by themselves but

A

may be important co-factors

25
Q

viral and bacterial infections are associated with

A

acute exacerbations of the disease

26
Q

Morphology of acute severe asthma (status asthmaticus)

A

Gross & Histology

27
Q

Gross of acute severe asthma

A
  1. Overinflated lungs with small areas of atelectasis
  2. Occlusion of bronchi and bronchioles by thick, tenacious mucus plugs, which often contain shed epithelium.
28
Q

Sputum or bronchoalveolar lavage contains ….

A

1) Curschmann spirals - mucus plugs from subepithelial mucous gland ducts or bronchioles
2) Charcot-Leyden crystals - eosinophil-derived protein galectin-10

29
Q

Histology of acute severe asthma

A

Numerous eosinophils

30
Q

Cause of Airway remodeling

A

Repeated bouts of allergen exposure

31
Q

Airway remodelling results in:

A

1) Bronchial smooth muscle hypertrophy and hyperplasia
2) Epithelial injury
3) Increased airway vascularity
4) Subepithelial mucous gland hypertrophy
5) Subepithelial fibrosis (deposition of type I and III collagens)

32
Q

Acute airflow obstruction is primarily due to

A
  1. bronchocospasm
  2. acute edema
  3. mucus plug
33
Q

Chronic irreversible airway obstruction may be due

A

Airway remodeling

34
Q

What are the Clinical Features of acute asthmatic attack?

A
  1. Lasts up to several hours
  2. Recurrent episodes of wheezing, dyspnea, chest tightness, and cough
  3. Precipitants: exercise (particularly in cold weather), airborne allergens
    or pollutants, and viral upper respiratory tract infections
35
Q

What are the Diagnosis of acute asthmatic attack?

A
  • Difficulty with exhalation (prolonged expiration, wheeze)
  • An increase in airflow obstruction – spirometry, peak flow meter
  • Atopic asthma – eosinophilia, Curschmann spirals, and Charcot-Leyden crystals in the sputum, skin prick test
36
Q

Exacerbations of Asthma: Precipitant?

A

viral infections, moulds, pollens, and air pollutants

37
Q

Clinical feature of

A

BST2 (10 decks)

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