Asthma/pumonology/class Notes

Front 1

Bronchial Hyperactivity

Back 1

A pathologic
increase in the bronchconstrictor
response to antigens and irritants caused by
Bronchial inflammation.

Front 2

IgE-mediated disease

Back 2

Disease caused by excessive or misdirected immune response mediated by IgE antibodies

Front 3

Mast cell degranulation

Back 3

Exocytosis of granules from mast cells with release of mediators of inflammation and
bronchconstriction

Front 4

Normal bronchial smooth muscle is controled by what?

Back 4

Vagal Innervation

Front 5

What happens in patients who are treated with B adrenergic blocking drugs (ie: propranolol)?

Back 5

They have increased adrenergic activity, so it manifests as wheezing

Front 6

Allergens can trigger asthma, can antihistimines treat it?

Back 6

no

Front 7

What role do leukotrienes play in the development of asthma?

Back 7

Leukotrienes are primary bronchoconstrictors

Front 8

What is LTD4?

Back 8

same as histamine but
1000x as potent

Front 9

second line agents for treatment of asthma that inhibit the synthesis or action of the LTs are known as what?

Back 9

leukotriene modulators (LTMs)

Front 10

what is the primary reversible component of COPD?

Back 10

Cholinergic activity or sensitivity is often increased in
asthmatics and this increases cholinergic tone of the bronchial smooth
muscle

Front 11

The inflammatory component of COPD is the same as asthma. T/F

Back 11

F / The
inflammatory component of COPD is different from that of Asthma. COPD manifest an increased production of Neutrophils; Asthma manifest as an increased production of eiosionphils.

Front 12

what is COPD

Back 12

A disease state characterized by airflow limitation that is not fully reversible

Front 13

What is the primary cause of COPD

Back 13

Smoking

Front 14

What are the main symptoms of COPD

Back 14

Chronic obstruction
Emphysema
Mucus plugging

Front 15

What events lead to small
airway pathology and increased mucous secretion characteristic of COPD?

Back 15

macrophage activation, resulting from exposure to noxious substances, releases
neutrophil chemotactic factors, including interleukin-8 and LTB4. Also
proteases are released that destroy connective tissues in the lung parenchyma, and
oxidants capable of direct tissue damage are produced.

Front 16

What is the role of proteases in COPD?

Back 16

Proteases destroy connective tissue in the
lungs and produce oxygen radicals that
destroy tissue

Front 17

What limits airflow in COPD?

Back 17

Mucus secretion, fibrosis, and smooth Mucus secretion, severely limits airflow.

Front 18

What activates tissue macrophages?

Back 18

Noxious substances(esp esp cigarette smoke, occupational dust, chemical inhalants)activate tissue macrophages

Front 19

What is asthma?

Back 19

Asthma is a chronic disorder of the airways that causes recurrent and
distressing episodes of wheezing, breathlessness, chest tightness, and
nighttime or early morning coughing.

Front 20

Asthma is considered to be a reversible disease; indeed, many asthma
patients experience remission during adolescence and adulthood. T/F

Back 20

T

Front 21

patients with moderate to
severe asthma experience a decline in lung function each year,
indicating that they may have a progressive form of the disease. T/F

Back 21

F / patients with mild to
moderate asthma experience a decline in lung function each year,
indicating that they may have a progressive form of the disease.

Front 22

Is asthma a progressive disease?

Back 22

Usually not a progressive disease
A sizable minority (about 25%) of asthmatic children
may experience a 1% to 2% decline in predicted lung function per year, even with treatment.

Front 23

What are the characteristics of asthma

Back 23

airway inflammation
acute reversible bronchoconstriction

Front 24

what is a late phase response?

Back 24

reoccurrence of clinical symptoms 4 - 12 hours after antigen exposure mediated by the basophil, histamine, releasing factors (HRF), eosinophils, and platelet activating factors

Front 25

What are the mediators involved in Asthma?

Back 25

leukotrienes, (LTC4 and LTD4) , cytokines and enzymes which when released lead to chronic inflammation

Front 26

What are the goals in asthma therapy?

Back 26

1. Reverse Acute episodes by relaxing bronchial smooth muscle
2. Reduce bronchial inflammation by mediating the inflammation response
3. Prevent reoccurences and manage exacerbations
4. Reduce morbidity and mortality

Front 27

What is the recommended approach to therapy

Back 27

avoid allergens
use of anti inflammatories
use of bronchodilators

Front 28

What is immediated hypersensitivity

Back 28

the result of reexposure to an antigen capable of eliciting an IgE response in a susceptible individual producing a clinical reaction (flushing, urticaria, etc) within seconds to minutes as a result of degranulation of mast cells/basophils

Front 29

Define allergy

Back 29

changed reactivity of the host when meeting an agent on a second or subsequent occasion

Front 30

Allergy is considerded type II hypersensitivity T/F

Back 30

F / Allergy is type I hypersensitivity

Front 31

what are some symptoms of asthma?

Back 31

coughing, chest tightness, wheezing, and difficulty breathing

Front 32

The inflammation of asthma is not present when a person is asymptomatic T/ F

Back 32

F / the inflammation of asthma can be present when a person is asymptomatic

Front 33

Define Epidemiology

Back 33

The study of the distribution and determinates of diseases and injuries in human populations

Front 34

what triggers asthma attacks

Back 34

allergens

Front 35

What is the most prevalent chronic disease and the number one reason for school absences?

Back 35

Asthma

Front 36

What race REPORTS the highest rate of asthma

Back 36

blacks

Front 37

what race actually HAS more asthma?

Back 37

Whites

Front 38

Define atopy

Back 38

a genetic factor characterized by the production of circulating IgE in response to common environmental allergens.

Front 39

Will IgE in the blood predict the development of asthma

Back 39

Yes

Front 40

A parent with asthma will not necessisarily pass on asthma to his/her children

Back 40

F / A person with asthma is 3-6 times more likely to develop asthma than someone who does not have a parent with asthma

Front 41

Type 1 sensitivity

Back 41

Known as immediate or anaphylactic hypersensitivity

Front 42

list the reactions of Type I hypersensitivity

Back 42

Urticaria and eczema
conjunctivitis,
rhinorrhea, rhinitis
asthma, gastroenteritis

Front 43

Poison Ivy is an example of what type hypersensitivity reaction?

Back 43

Type IV

Front 44

Name some common indoor allergens

Back 44

dust mites, cockroaches, fungi (dark, moist, hot), furry animals (pets and pests)

Front 45

What are some common outdoor allergens

Back 45

Trees, grasses, weeds, pollens, fungi (molds and yeasts)

Front 46

What does a person experience when going through an asthma attack?

Back 46

Worsening chest tightness, wheezing, coughing, waking at night, and/or shortness of breath

Front 47

What is PEF

Back 47

Peak Expiratory Flow rate:
a way to measure lung function - measured with a peak expiratory flow meter

Front 48

A peak flow < 60% of your personal best is indicative of?

Back 48

an emergency. take rescue medication, call physician or go to emergency room

Front 49

peak flow < 80% ?

Back 49

take medication and continue to monitor peak flow rate

Front 50

what are some signs of an onset of an attack?

Back 50

itchy watery glassy eyes,
itchy, sore throat
sneezing,
congestion
restlessness
runny nose
dark circles under eyes