Unit 7 Part 2

Question 1

asthma

Answer 1

reversible episodes of airway obstr dt inflm, subside w intervention

Question 2

what causes m spasm in asthma

Answer 2

hyperactivity of aw m. wall

Question 3

why do asthma pts experience inc reoccurence

Answer 3

inc sensitivity to stimuli

Question 4

asthma et

Answer 4

complex trait

Question 5

which pts have inc in asthma

Answer 5

pts with eczema or hay fever

Question 6

common asthma triggers

Answer 6

allergens
aw irritants
exercise
strong odours
cold air

Question 7

basic patho for asthma

Answer 7

trigger -> inc H rxn -> 2 phased response

Question 8

what is it to be said about the 2 phases of asthma response

Answer 8

may not always progress to the 2nd part

Question 9

what does an allergen cause stimulation of

Answer 9

mast cells

Question 10

what do mast cells release when triggered by an allergen

Answer 10

histamine, luekotrenes, interluekins, prostaglandins

Question 11

what does release of mediators by mast cells cause

Answer 11

bronchospasm, vasodilation

Question 12

what is the first part of the late phase

Answer 12

infiltration of inflm cells, rls of cytokines and interluekins

Question 13

in late phase, what does aw inflm do (5)

Answer 13

inc aw response, edema, dec mucociliary fx, epithelial injury, dec air flow

Question 14

2 fx of luekotreines

Answer 14

dx type 1 H reaction

leads to aw inflm

Question 15

what must occur for the acute phase to happen

Answer 15

prior sensitization to allergen

Question 16

what happens in the acute phase during subsequent exposure to an allergen

Answer 16

allergen binds to IgE coated mast cells causing mediator rls and inflm

Question 17

how do allergens enter submucosa in teh acute phase

Answer 17

via intercellular junctions that open dt inflm/med rls

Question 18

what causes aw edema in the acute phase

Answer 18

inc permb and inc mucous sec

Question 19

what fx stimulates bronchospasm (acute phase)

Answer 19

PNS

Question 20

what leads to lumen compromise in the acute phase

Answer 20

exudate, mucous, aw swelling

Question 21

what is dyspnea and wheezing dt

Answer 21

forceful airflow thru lumen

Question 22

what compensatory change occurs in acute phase of asthma, why

Answer 22

aw constr dt ag stimulation to dec amount of air intake

Question 23

peak and duration of acute phase

Answer 23

5-10m

1h

Question 24

what effects inc in the late phase of asthma

Answer 24

inc in other inflm cells
self perpetuating cycle with inc length
inc in vasc perm, edema, aw responsiveness, edema

Question 25

when does the late phase in asthma peak

Answer 25

4-8h

Question 26

how long can the late phase in asthma last

Answer 26

days-wks

Question 27

what does the influx of inflm cells in the late phase cause (2)

Answer 27

epith damage | dec mucociliary fx

Question 28

what is dec mucociliary fx in the late phase related to

Answer 28

inc bact growth rt inc mucous prod

Question 29

what happens during a hyperactive aw response dt inflm

Answer 29

responds to NEW triggers | more freq and sev episodes

Question 30

what receptors cause bronchoconstr

Answer 30

alpha adrenegic receptors

Question 31

what receptors cause bronchodil

Answer 31

beta adrenegic receptors

Question 32

what secondary messenger facilitates physologic bronchoconst/dilation

Answer 32

CAMP

Question 33

what theory is queryed when questioning lack of bronchodilation in asthma

Answer 33

lack of beta receptor stimulation

Question 34

what mnfts occur during an attack

Answer 34

dyspnea,wheezing, immbolization, inc WOB, bronchospasm, coughing, ventilatory compromise

Question 35

why is a pt with an asthma attack immbolized

Answer 35

dt inability to breathe

Question 36

what does inc WOB present with

Answer 36

nasal flaring and accessory m use

Question 37

why does a pt with an asthma attack cough

Answer 37

in attempt to clear sec from URT

Question 38

Dx for asthma

Answer 38

Hx, px, labs, pulm fx tests

Question 39

what is important to remember about pulm fx tests when dxing asthma

Answer 39

you cannot use them to seperate asthma and aCOPD

Question 40

prevention and prophylaxis for asthma attacks

Answer 40

avoid ag's (pt spec) | no smoking, including 2nd hand smoke

Question 41

what 4 step course of drugs is used to tx asthma

Answer 41

inhaled short acting bronchodilator inhaled steroid add long acting bronchodilator short course oral steroid

Question 42

what 3rd drug might be added to the 4step course when txing asthma

Answer 42

leukotrine receptor agonist or theophylline

Question 43

which drugs from the 4 course tx are inc in long phase

Answer 43

inhaled steroids, long acting bronchodilators

Question 44

which drugs from the 4 course tx are usually only used in the short phase

Answer 44

1 and 2