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13 Cards in this Set

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Asthma Def
Reversible airway obstruction and Nonspecific bronchial hyper-reactivity
Asthma presentation
- common is cough, dyspnea, wheezing and chest tightness
- there can also be Allergic shiner or Atopic Dermatitis
Asthma arterial blood gases
low PO2 (V/Q mismatch) and low PCO2
Intrinsic asthma
- (absence of atopy)
- No allergic or family hx
– Usually adult onset following severe resp illness
- Sx usually perennial
- More refractory to treatment
Extrinsic asthma
– Strong family hx w/ onset at a young age
– Other allergic problems
– hx of specific allergic association triggers (pollen, animal dander)
– correlation with skin and inhalation responses to specific antigens
asthma histolgy
- edema and cellular infiltrates (esp. eos and lymphos)
- epi damage, hypertrophy and hyperplasia of SM layer, thickened BM, ↑ mucus secreting apparatus
IgE in asthma
- Ag binds the IgE Ab and crosslinks it – this activates the mast cell
- it degranulates, releases bronchoconstricting and inflammation mediators (histamine and leukotrienes)
- causes an increase in permeability, which give the Ag more exposure to IgE
Asthma PFTs and B-agonist response
- reversible w/ B agonist
- PFT's show obstructive
asthma inhalation challenge
- (methacholine) causes decrease in flow rates at concentrations that do not affect nonasthmatics
- correlates with severity of disease and Worsens with repeated allergen-induced “late phase”
- COPD pts dont do well eihter, but do better than asthmatics
asthma and DLCO
there is increased DLCO, which is weird, but useful for dx
Th1 phenotype
- will see presence of older sibling, early exposure to daycare
- TB, measles, or HepA
- rural environment
- after birth
Th2 phenotype
- widespread use of Abs, western lifestyle, urban environment
- diet, sensitization or house-dust mites and cockroaches
- in utero and assocated w/ IgE
asthma and aspirin
when pts take aspirin, this shunts AA to the leukotriene pathway, which causes bronchoconstriction