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Pathology Final
Asthma
| Question | Answer |
|---|---|
| What are the 2 types of asthma | Extrinsic asthma-allergic Intrinsic asthma-non allergic |
| What is asthma | A lung disorder characterized by Reversible bronchial smooth muscle constriction,Airway inflammation,Increased airway hyper-responsiveness to various stimuli |
| Status Asthmaticus | does not respond to traditional treatment |
| After puberty asthma is more common in | girls |
| What are the triggers of Asthma? | Infection, exercise, dust, pollens, cold air, air pollution, cigarette smoke, emotional stress |
| what are the anatomic alterations of the lungs | Smooth muscle constriction of bronchial airways (bronchospasm),Excessive production of thick, whitish,bronchial secretions,Mucus plugging,Hyperinflation of alveoli (air-trapping).In severe cases, atelectasis caused by mucus plugging |
| Extrinsic asthma | caused by external or environmental agents Aka Allergic or Atopic Asthma |
| Intrinsic asthma | occurs in the absence of antigen-antibody reaction. |
| Indoor allergens | house dust, furred animal dander,cockroach, fungi, molds, yeast, mites |
| Outdoor alergens | Pollen, molds,fungi, yeast |
| Hypersensitiviy reaction | Excessive amounts of immunoglobulin E(IgE)production in response to antigens |
| Asthma that is family related (genetic predisposition) | Extrinsic Asthma |
| Exposure to certain antigens | antibodies formed, attach surface of mast cells in bronchial walls |
| Repeated exposure to antigens | antigen-antibody reaction degranulation of mast cell release chemial mediators |
| Chemical mediators | histamine, leukotrines, prostagladins neutrophil chemotactic factors NCF eosionphil chemotactic |
| Stimulates parasympathetic nerve cells in the airway | bronchoconstriction, mucous hypersection,dilation of blood vessels,tissue edema |
| Occupational Asthma | triggered by exposure to agent in work environment immunologically mediated |
| High risk work environments for occupational asthma | farming and agriculture painting cleaning work plastic manufacturing |
| Asthmatic episode that cannot be directly linked to a specific antigen or extrinsic factor,not hypersensitive, Normal IgE levels, Onset usually after age 40 | Intrinsic asthma |
| Other risk factors of Intrinsic Asthma | obesity, sex(male is a sex risk factor for asthma in children), infections, exercise induced asthma,outdoor/indoor pollution, drugs, food additives, food preservatives, gastroesophageal reflux, sleep, emotional stress, perimenstrual asthma |
| Early response to allergic exposure | seen within minutes of exposure to antigen;resolves in 1hr |
| Late response to allergic exposure | begins several hours after exposure, but last much longer |
| Biphasic response to allergic exposure | early response followed by late response |
| Diagnostic/Monitoring tests for asthma | spirometry, Peak expiratory flow,Responsiveness to methacholine, histamine, mannitol, or exercise challenge Positive skin tests with allergens or measurement of specific IgE in serum |
| Classifications of asthma severity | intermittent, mild persistent, moderate persistent, severe persistent |
| Intermittent | Symptoms less than once a week Brief exacerbations Nocturnal symptoms not more than twice a month FEV1 or PEF > 80% predicted PEF or FEV1 variability < 20% |
| Mild Persistent | Symptoms more than once a week but less than once a day Exacerbations may affect activity and sleep Nocturnal symptoms more than twice a month FEV1 or PEF > 80% predicted PEF or FEV1 variability < 20 - 30% |
| Moderate Persistent | Symptoms daily Exacerbations may affect activity and sleep Nocturnal symptoms more than once a week Daily use of inhaled short-acting β2-agnonist FEV1 or PEF 60 - 80% predicted PEF or FEV1 variability > 30% |
| Severe Persistent | Symptoms daily Frequent nocturnal asthma symptoms Limitation of physical activities FEV1 or PEF < 60% predicted PEF or FEV1 variability > 30% |
| Vital signs for asthmatic | increased RR(tachypnea), HR(tachycardia), BP(hypertension) |
| Subjective inspection | dyspnea and chest tightness |
| Objective inspection | Use of accessory muscles I:E ratio > 1:3 Cyanosis Cough and sputum production During exacerbation, may have excessvie amount of thick, tenacious, white mucus Large number of eosinophils and other WBCs |
| Physical assessment of asthmatic | Pulses paradoxus,Hyperresonance to percussion Wheezing Decreased, absent breath sounds Decreased heart sounds |
| Decreased blood pressure during inspiration | Pulses paradoxus |
| Chest xray | Not recommended for routine evaluation Often normal or may demonstrate hyperinflation Should be obtained in pts suspected of a complicating cardiopulmonary process, i.e. pneumonia |
Created by:
CMILLS
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