Pulm - Asthma; Obstructive Sleep Apnea

Question 1

Asthma is reversible bronchoconstriction most often due to ________ stimuli (________ asthma).

Answer 1

Asthma is reversible bronchoconstriction most often due to allergic stimuli (atopic asthma).

Question 2

Asthma is associated with what other conditions?

Answer 2

Allergic rhinitis;

eczema;

family history of atopy

Question 3

Asthma is a type ____ hypersensitivity reaction.

Answer 3

Asthma is a type I hypersensitivity reaction.

Question 4

Asthma is a result of induced T_H__ CD₄ T cells in genetically susceptible individuals.

Answer 4

Asthma is a result of induced T_H2 CD₄ T cells in genetically susceptible individuals.

Question 5

The induced T_H2 CD₄ T cells secrete IL-4 (mediates ____________), IL-5 (attracts ____________), and IL-10 (stimulates T_H2 T cells and inhibits T_H1 T cells).

Answer 5

The induced T_H2 CD₄ T cells secrete IL-4 (mediates IgE switching), IL-5 (attracts eosinophils), and IL-10 (stimulates (stimulates T_H2 T cells and inhibits T_H1 T cells).

Question 6

The induced T_H2 CD4 T cells secrete IL-4 (mediates IgE switching), IL-5 (attracts eosinophils), and IL-10 (stimulates _______ cells and inhibits _______ cells).

Answer 6

The induced T_H2 CD4 T cells secrete IL-4 (mediates IgE switching), IL-5 (attracts eosinophils), and IL-10 (stimulates T_H2 T cells and inhibits T_H1 T cells).

Question 7

The T_H2 T cells induced in cases of allergic asthma lead to eosinophil recruitment (via IL-5).

What do these eosinophils secrete in the early-phase reaction of asthma?

Answer 7

Histamine;

Leukotrienes C₄, D₄, and E₄

Question 8

The T_H2 T cells induced in cases of allergic asthma lead to eosinophil recruitment (via IL-5).

What do these eosinophils secrete in the late-phase reaction of asthma?

Answer 8

Major basic protein

Question 9

Severe, unrelenting asthma attacks can result in s______ ________ and ______.

Answer 9

Severe, unrelenting asthma attacks can result in status asthmaticus and death.

Question 10

Asthma is characterized by a productive cough. What two pathognomonic findings will be present in the sputum?

Answer 10

Curschmann spirals (spiral-shaped mucus plugs);

Charcot-Leyden crystals

Question 11

Some individuals are susceptible to an asthma induced by what medication?

Answer 11

Aspirin

Question 12

Name some non-atopic asthma inducers.

Answer 12

Exercise and stress;

viral infection

Question 13

What is the greatest risk factor for obstructive sleep apnea?

Answer 13

Neck size

Question 14

Obstructive sleep apnea arises due to either increased ________ tissue or decreased radius of _______ structures.

Answer 14

Obstructive sleep apnea arises due to either increased soft tissue or decreased radius of bony structures.

Question 15

How is obstructive sleep apnea diagnosed?

Answer 15

Polysomnography

Question 16

Patients with obstructive sleep apnea have ________ (normal/abnormal) PaO₂ during the day and ________ (normal/abnormal) nocturnal PaO₂.

Answer 16

Patients with obstructive sleep apnea have normal PaO₂ during the day and abnormal nocturnal PaO₂.

Question 17

Obstructive sleep apnea is characterized by a nocturnal stop in normal respiration of ~_____ seconds at a time.

Answer 17

Obstructive sleep apnea is characterized by a nocturnal stop in normal respiration of ~10 seconds at a time.

Question 18

Obstructive sleep apnea’s most damaging effects (e.g. increased pressure on the right heart that can eventually lead to atrial fibrillation and even sudden death) are due to what effect?

Answer 18

Hypoxic pulmonary vasoconstriction

Question 19

How can obstructive sleep apnea be managed?

Answer 19

CPAP;

weight loss;

surgery

Question 20

How can one differentiate central sleep apnea from obstructive sleep apnea?

(Think in terms of breath effort and nasal airflow.)

Answer 20

CSA: there will be periods of no nasal airflow, thoracic movements, or abdominal movements

OSA: thoracic and abdominal movements will be paradoxically present even as nasal airflow is null (attempted breath)