Unit 7 Part 2 Flashcards
asthma
reversible episodes of airway obstr dt inflm, subside w intervention
what causes m spasm in asthma
hyperactivity of aw m. wall
why do asthma pts experience inc reoccurence
inc sensitivity to stimuli
asthma et
complex trait
which pts have inc in asthma
pts with eczema or hay fever
common asthma triggers
allergens aw irritants exercise strong odours cold air
basic patho for asthma
trigger -> inc H rxn -> 2 phased response
what is it to be said about the 2 phases of asthma response
may not always progress to the 2nd part
what does an allergen cause stimulation of
mast cells
what do mast cells release when triggered by an allergen
histamine, luekotrenes, interluekins, prostaglandins
what does release of mediators by mast cells cause
bronchospasm, vasodilation
what is the first part of the late phase
infiltration of inflm cells, rls of cytokines and interluekins
in late phase, what does aw inflm do (5)
inc aw response, edema, dec mucociliary fx, epithelial injury, dec air flow
2 fx of luekotreines
dx type 1 H reaction
leads to aw inflm
what must occur for the acute phase to happen
prior sensitization to allergen
what happens in the acute phase during subsequent exposure to an allergen
allergen binds to IgE coated mast cells causing mediator rls and inflm
how do allergens enter submucosa in teh acute phase
via intercellular junctions that open dt inflm/med rls
what causes aw edema in the acute phase
inc permb and inc mucous sec
what fx stimulates bronchospasm (acute phase)
PNS
what leads to lumen compromise in the acute phase
exudate, mucous, aw swelling
what is dyspnea and wheezing dt
forceful airflow thru lumen
what compensatory change occurs in acute phase of asthma, why
aw constr dt ag stimulation to dec amount of air intake
peak and duration of acute phase
5-10m
1h
what effects inc in the late phase of asthma
inc in other inflm cells
self perpetuating cycle with inc length
inc in vasc perm, edema, aw responsiveness, edema
when does the late phase in asthma peak
4-8h
how long can the late phase in asthma last
days-wks
what does the influx of inflm cells in the late phase cause (2)
epith damage
dec mucociliary fx
what is dec mucociliary fx in the late phase related to
inc bact growth rt inc mucous prod
what happens during a hyperactive aw response dt inflm
responds to NEW triggers
more freq and sev episodes
what receptors cause bronchoconstr
alpha adrenegic receptors
what receptors cause bronchodil
beta adrenegic receptors
what secondary messenger facilitates physologic bronchoconst/dilation
CAMP
what theory is queryed when questioning lack of bronchodilation in asthma
lack of beta receptor stimulation
what mnfts occur during an attack
dyspnea,wheezing, immbolization, inc WOB, bronchospasm, coughing, ventilatory compromise
why is a pt with an asthma attack immbolized
dt inability to breathe
what does inc WOB present with
nasal flaring and accessory m use
why does a pt with an asthma attack cough
in attempt to clear sec from URT
Dx for asthma
Hx, px, labs, pulm fx tests
what is important to remember about pulm fx tests when dxing asthma
you cannot use them to seperate asthma and aCOPD
prevention and prophylaxis for asthma attacks
avoid ag’s (pt spec)
no smoking, including 2nd hand smoke
what 4 step course of drugs is used to tx asthma
inhaled short acting bronchodilator
inhaled steroid
add long acting bronchodilator
short course oral steroid
what 3rd drug might be added to the 4step course when txing asthma
leukotrine receptor agonist or theophylline
which drugs from the 4 course tx are inc in long phase
inhaled steroids, long acting bronchodilators
which drugs from the 4 course tx are usually only used in the short phase
1 and 2
