Asthma

Question 1

Who discovered oxygen and in what year?

Answer 1

Joseph Priestly in 1772

He referred to it as dephlogisticated air.

Question 2

What is hypoxia?

Answer 2

Oxygen deprivation

Question 3

What is hypoxaemia?

Answer 3

Low levels of oxygen in the blood

Question 4

What are some causes of hypoxaemia?

Answer 4

• Cardiac issues
• Local/regional blood supply compromise
• Shunt or venous admixture
• Hypoventilation
• Ventilation-perfusion mismatch

Question 5

What does the oxygen dissociation curve represent?

Answer 5

The relationship between oxygen saturation and partial pressure of oxygen

Question 6

What is the primary use of oxygen therapy?

Answer 6

To prevent hypoxia

Question 7

What are the effects of high-pressure oxygen on respiration?

Answer 7

• Causes respiratory depression
• Reduces ability to exchange CO2

Question 8

What maintains hypoxic drive in the body?

Answer 8

Carotid and aortic sinus receptors

Question 9

What is respiratory failure?

Answer 9

A syndrome where gas exchange fails in one or both means

Question 10

What are the two types of respiratory failure?

Answer 10

• Hypoxemic (Type I)
• Hypercapnic (Type II)

Question 11

What characterizes Type I respiratory failure?

Answer 11

Arterial PaCO2 < 60 mm Hg

Question 12

What are common causes of Type I respiratory failure?

Answer 12

• COPD
• Pneumonia
• Asthma
• Pulmonary oedema
• Pulmonary fibrosis
• Pneumothorax
• Pulmonary embolism
• Bronchiectasis
• Obesity

Question 13

What characterizes Type II respiratory failure?

Answer 13

Arterial PaCO2 > 50 mm Hg

Question 14

What are common causes of Type II respiratory failure?

Answer 14

• COPD
• Severe Asthma
• Drug overdose
• Poisoning
• Myasthenia gravis
• Polyneuropathy
• Poliomyelitis
• Primary muscle disorders
• Obesity-hypoventilation syndrome
• Pulmonary oedema
• Tetanus

Question 15

What is the recommended fractional oxygen concentration?

Answer 15

About 0.6

Question 16

What are the risks associated with oxygen therapy?

Answer 16

• Oxygen toxicity
• Carbon dioxide narcosis

Question 17

What are key characteristics of asthma?

Answer 17

• Recurrent
• Exaggerated bronchoconstrictor responses
• Inflammation of the airway

Question 18

What is the genetic component associated with asthma?

Answer 18

Chromosome 17q21

Question 19

What causes the immediate contraction of airway muscle in asthma?

Answer 19

Release of mediators from mast cells after allergen re-exposure

Question 20

What are the mediators released during an asthma attack?

Answer 20

• Histamine
• Tryptase
• Prostaglandin D2
• Leukotrienes
• Platelet activating factor

Question 21

What physiological changes occur in asthma?

Answer 21

• Increased airway resistance
• Rapid respiratory rate
• Low arterial Pco2

Question 22

What is the purpose of the GINA 2014 asthma treatment algorithm?

Answer 22

To determine the patient’s asthma treatment regimen and level of control

Question 23

What are common drugs used in asthma treatment?

Answer 23

• Anti-IgE antibodies
• Cromolyn
• Adrenaline and salbutamol
• Calcium channel blockers
• Antihistamines
• Leukotriene receptor antagonists
• Theophylline

Question 24

What do adrenoceptor agonists do in asthma treatment?

Answer 24

• Relax bronchial smooth muscle
• Prevent secretion of mediator compounds

Question 25

What are methylxanthines and their effects?

Answer 25

* Theophylline * Theobromine * Caffeine They inhibit phosphodiesterase, increasing cAMP levels.

Question 26

What is the role of corticosteroids in asthma treatment?

Answer 26

* Inhibit production of inflammatory cytokines * Reduce bronchial hyperactivity * Potentiate the action of β agonists

Question 27

What do leukotriene pathway inhibitors do?

Answer 27

Block the action of leukotrienes, which are involved in the inflammatory response

Question 28

What is the effect of disodium cromoglycate on mast cells?

Answer 28

Inhibits mast cell degranulation ## Footnote Disodium cromoglycate alters the functions of delayed sodium channels and inhibits cell activation.

Question 29

What are leukotrienes elaborated from?

Answer 29

The action of 5-lipoxygenase on arachidonic acid

Question 30

What is LTB4 known for?

Answer 30

It is a powerful neutrophil chemoattractant involved in asthma

Question 31

Name two LTD4 receptor antagonists.

Answer 31

* Zafirlukast * Montelukast

Question 32

What is the role of omalizumab?

Answer 32

Targets the portion of IgE that binds to its receptor without provoking IgE to action

Question 33

True or False: Omalizumab can be used in all patients.

Answer 33

False ## Footnote Its use is restricted to patients with allergic sensitization.

Question 34

What is the main rescue treatment for acute asthma?

Answer 34

Rapid-acting β-agonist via a rescue inhaler

Question 35

What are the side effects of inhaled corticosteroids?

Answer 35

Thrush

Question 36

Fill in the blank: Zileuton acts at the _______ receptor.

Answer 36

CysLT1

Question 37

What is the primary action of long-acting β-agonists?

Answer 37

Act for up to 12 hours

Question 38

What are the potential toxicities of β-agonists?

Answer 38

* Lactic acidosis * Hypokalaemia

Question 39

What is theophylline classified as?

Answer 39

A methylxanthine

Question 40

What is the mechanism of action of methylxanthines?

Answer 40

* Inhibit phosphodiesterase (PDE) * Inhibit cell surface receptors for adenosine * Enhance histone deacetylation

Question 41

What kind of agents are antimuscarinic agents?

Answer 41

Competitive antagonists of Ach at its receptor site

Question 42

Name two examples of antimuscarinic agents.

Answer 42

* Ipratropium * Tiotropium

Question 43

What do glucocorticoids mediate?

Answer 43

Inhibition of inflammatory cytokines

Question 44

What are the effects of corticosteroids on the bronchial tree?

Answer 44

Inhibit infiltration by lymphocytes, mast cells, and eosinophils

Question 45

What are the two classifications of antitussives?

Answer 45

* Opioids * Non-opioids

Question 46

What is the primary function of expectorants?

Answer 46

Enhances the secretion of sputum

Question 47

What are mucokinetics?

Answer 47

Bronchial secretion enhancers

Question 48

Name a contraindication for the use of antitussives.

Answer 48

Asthma

Question 49

What is the cough center located in?

Answer 49

The medulla

Question 50

What type of cough lasts more than 8 weeks?

Answer 50

Chronic

Question 51

What is the definition of an antitussive?

Answer 51

Cough suppressant

Question 52

What is the role of cough expectorants?

Answer 52

Enhances the secretion of sputum