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Pathology Final

Asthma

QuestionAnswer
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