Skin and Respiratory system Flashcards
What is bronchial asthma?
spasm of bronchi, swelling of bronchial mucosa and excessive excretion of viscous mucus leading to breathing insufficiency
How is asthma diagnosed?
chest tightness, shortness of breath, wheezing when breathing out, rapid, shallow breathing, neck muscles tighten, coughing with thick, clear or yellow sputum.
What is the difference between intrinsic and extrinsic?
Extrinsic/atopic is generally considered an immunological mediated condition so IgE increase.
Intrinsic is a bronchial reaction due to chemicals, cold air, exercise, infection but not necessarily IgE response.
What is the pathophysiology of asthma?
Enviro trigger->increase T helper cell response-> mast cells (IgE), Eosinophils -> inflammatory mediations leads to either bronchial constriction or increased mucus production.
What is the most potent chemical mediator?
lipoxygenase products or leukotrienes stimulate bronchial constriction
How does Arachidonic acid link to lipoxygenase products?
Asthmatics have an imbalance of Arachidonic acid metabolism lead to an increase of lipoxygenase products because COX is down regulated in favour of LOX leading to an increase of leukotrienes
What is the conventional treatment for asthma?
Mild intermittent asthma needs a bronchodilator (inhaled beta-agonists).
Mild persistent asthma needs daily inhaled corticosteroid.
Moderate persistent asthma needs an inhaled corticosteroid and a long acting beta agonist.
Severe asthma needs high dose corticosteroids.
What is the aetiology of asthma?
earlier weaning, earlier introduction of solid foods to infants, replacing breastfeeding with infant formulas, inherited dysbiosis, viral infection/bacterial infection, food additive (colourings and preservatives)
What are some sources of sulphites?
prepared salads, salad dips in restaurants, wine and beer
Explain the link between asthma and food allergy.
food allergies can result in asthmatic having leaky guts so there is an increased antigen load on immune system causing an increase of bronchoconstrictive compounds into circulation.
Explain how C.albicans can cause asthma.
overgrowth of yeast in GIT tract can cause allergic conditions like asthma and C.albicans can produce acid protease.
Explain how asthma can be linked to salt.
increased salt intake increases bronchial reactivity and mortality from asthma
What is the link between asthma and obesity?
Increased leptin levels alter immune system causing pro inflammatory changes.
Obese people have different breathing patterns.
High oestrogen levels in adipose tissue linked to asthma
Explain the hygiene hypothesis.
Minimising exposure to infectious agents due to hygiene life choices leads to a dominance of Th2 immune responses which encourages atopic diseases/ asthma. Natural antigens stimulate Th1 response
What is the link between asthma and antibiotics?
Those prescribed antibiotics before their first birthday were more than twice as likely to get asthma because antibiotic contribute to excessive hygienes and disrupted normal gut and respiratory flora
What are some nutritional consideration for asthma?
Diet high in fruit and vege lead to lower risk of respiratory health.
High intake of apple and moderate red wine = less asthma severity.
Following a mediterranean diet during pregnancy is protective for asthma.
Onions and garlic = inhibit lipoxygenase and cycloxygenase enzymes
Omega 3 and fish more than 1 a week reduces risk of asthma.
Explain why increasing ratio of omega 3 to omega 6 helps with asthma.
Reduces availability of arachidonic acid which leads to significant shift in leukotriene synthesis
Explain the link between asthma and tryptophan.
Children with asthma have a defect in tryptophan metabolism and reduced serotonin. Serotonin normally constricts the bronchial so reduce tryptophan rich food is important
Explain how antioxidants help asthma.
inhibit leukotriene formation and histamine release from mast cells; increased epithelial lining integrity of respiratory tract; protects lungs from free radicals
How is magnesium helping with asthma?
Magnesium is natural bronchial dilator, stabilises mast cells and relaxes muscles opening airways
What is the dietary protocol for asthma?
increase fruit and vegetables in diet include onion and garlic; decrease sources of arachidonic acid (meat and dairy); increase cold water fish in diet; eliminate food additive, decrease salt/sugar and any know allergens.
Explain how to carry out allergen identification diet for asthma.
Food allergy needs to be identified so put the client on a hypoallergenic diet then re-introduce high allergy foods every 3 days like eggs, fish, nuts and peanuts. ONLY USE IN HEALTHY CLIENTS WITH NO MAJOR NUTRIENT DEFICIENCIES
What is another dietary protocol for asthma?
Vegan diet with only water and no caffeine, sugar and additives. This will eliminate major food allergies, alter prostaglandin metabolism, decrease arachidonic acid and increase antioxidant intake.
What supplements are for asthma?
EPA, B6, vit C, vit E, magnesium, selenium, probiotics
How is acne vulgaris diagnosed?
open comedones, close comedones, superficial pustules, nodules
How is acne conglobata diagnosed?
cysts - modules that do not discharge
Large deep pustules - break and lead to scars
Explain the pathophysiology of acne.
Sebum (oil) which normally drains to surface, gets blocked by excess skin cells (hyperkeratinisation) lining the follicle causing bacteria to grow.
Explain how a whitehead forms.
Trapped sebum and bacteria below skin surface a whitehead is formed
Explain how black head forms.
pore opens to surface and sebum oxidises turning brown/black
Explain what happens with inflammatory acne.
black or whitehead ruptures to the surface by picking or touching the skin leading to inflammatory acne.
What is a papule?
occurs when there is a break in follicular wall, WBC rush in and pore becomes inflamed
What is a pustule?
forms several days later when WBC make their way to the surface of skin (zit or pimple)