SAQ 4 Flashcards
26 year old F present to GP with a dry cough and a wheeze, she has a slight fever, but is otherwise well.
She has a past medical history of asthma, which is well controlled with SABA and ICS and she takes no other medications except the COCP, which she has been on for 12 years.
What is the pathophysiology of asthma?
Chronic inflammatory airway disease with intermittent airway obstruction
Type 1 hypersensitivity reaction- At first exposure, the plasma cells release IgE which attach themselves to mast cells. At second exposure, IgE cross over and link, causing mast cell degranulation. This increases histamines and leukotrienes. This causes inflammation and swelling in airways and increased mucus production and smooth muscle contraction.
26 year old F present to GP with a dry cough and a wheeze, she has a slight fever, but is otherwise well.
She has a past medical history of asthma, which is well controlled with SABA and ICS and she takes no other medications except the COCP, which she has been on for 12 years.
Name 2 ddx?
Acute exacerbation of asthma
Allergic bronchopulmonary aspergillosis
26 year old F present to GP with a dry cough and a wheeze, she has a slight fever, but is otherwise well.
She has a past medical history of asthma, which is well controlled with SABA and ICS and she takes no other medications except the COCP, which she has been on for 12 years.
She is diagnosed with Allergic bronchopulmonary aspergillosis.
What blood tests would you use to confirm the diagnosis and what would the results be?
Aspergillus IgE level- raised
Total IgE- raised
Eosinophils- raised
26 year old F present to GP with a dry cough and a wheeze, she has a slight fever, but is otherwise well.
She has a past medical history of asthma, which is well controlled with SABA and ICS and she takes no other medications except the COCP, which she has been on for 12 years.
She is diagnosed with Allergic bronchopulmonary aspergillosis.
What type of hypersensitivity reaction is this?
Type 1 and Type 3
26 year old F present to GP with a dry cough and a wheeze, she has a slight fever, but is otherwise well.
She has a past medical history of asthma, which is well controlled with SABA and ICS and she takes no other medications except the COCP, which she has been on for 12 years.
She is diagnosed with Allergic bronchopulmonary aspergillosis.
Outline type 3 hypersensitivity reaction?
Involves immune complexes between IgM or igG or antigens
Targets soluble antigens
Tissue damage is causes by the deposition of immune complexes in host tissues
26 year old F present to GP with a dry cough and a wheeze, she has a slight fever, but is otherwise well.
She has a past medical history of asthma, which is well controlled with SABA and ICS and she takes no other medications except the COCP, which she has been on for 12 years.
She is diagnosed with Allergic bronchopulmonary aspergillosis.
Her infection clears up, however she keeps presenting to the doctor with recurrent chest infections which she needs antibiotics for. Her GP refers her to the RESP clinic where they perform a CXR and high resolution pulmonary CT.
They both show chronic dilation of the bronchi.
What are the named signs seen on cxr and CT for this condition?
Cxr- tram track sign
CT- signet ring
