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Respiratory Physiology > Asthma > Flashcards

Asthma Flashcards

1
Q

What is asthma defined as?

A
  • Increased responsiveness (irritability) of the trachea and bronchus to stimuli
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2
Q

What does the increased irritability of the trachea and bronchi lead to?

A
  • Narrowing of the airway
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3
Q

What two ways can the extent of the narrowed airway be different?

A
  • Randomly

- From treatment

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4
Q

What is the resolution of spontaneous airway narrowing?

A
  • They usually dilate by themselves
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5
Q

What is the reaction the airway has when a sensitive stimulus is breathed in?

A
  • Always narrows
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6
Q

What is the prevalence of asthma in children?

A
  • 10 - 15%
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7
Q

What is the gender distribution in children?

A
  • More boys than girls
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8
Q

What is the prevalence of asthma in adults?

A
  • 5-10%
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9
Q

What is the gender distribution in adults?

A
  • More women than men
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10
Q

How many deaths are a result from asthma in the UK per annum?

A

About 1000

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11
Q

What 2 ways is asthma detrimental to the NHS?

A
  • Lots of admissions, GP time

- Costs the NHS £2.35 billion a year

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12
Q

What are the 3 proven risk factors for the development of asthma?

A
  • Genetic
  • Occupation
  • Smoking
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13
Q

What is atopy?

A
  • Inherited tendency to produce IgE in response to an allergen (hyperallergenic)
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14
Q

Which parent is more influential in the inheritance of familial atopy?

A
  • Maternal atopy 3 times more influential
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15
Q

What two ways can atopy be genetics related?

A
  • Immune genes IL-4 and IL-5

- ADAM-33 gene (airways)

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16
Q

How can occupation lead to asthma?

A

Exposure to certain antigens for an increased time

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17
Q

Give 3 examples of occupational antigens

A
  • Grains
  • Isocyanates
  • Enzymes
  • Drugs
  • Animals
  • Crustaceans
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18
Q

How does smoking lead to the development of asthma?

A
  • If the mother smokes during pregnancy it has been shown to modify oocytes
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19
Q

What is the grandmother effect?

A
  • Essentially how if your mothers mum smoked and so did she during pregnancy then it like amplifies your chances
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20
Q

What are speculative risk factors?

A
  • There is a CORRELATION between the two but asthma isn’t actually CAUSED by it
21
Q

What are examples of speculative risk factors?

A
  • BMI
  • Diet
  • Exposure to microbes
  • Aerosols and cleaning products
  • Dust mites
  • Cats
  • Grass pollen
22
Q

What is the correlation between BMI and asthma?

A
  • High BMI usually indicated obesity

- Obesity is pro inflammatory

23
Q

With reference to exposure to microbes and antigens, SPECULATIVELY how can you reduce your chance of becoming sensitive to them?

A
  • Exposure from an early age

- e.g. living on a farm

24
Q

How do dust mites increase chance of asthma development?

A
  • Produce a lot of shit

- Shit contains an allergenic enzyme

25
What is the correlation between reduced dust mites and asthma?
- Reducing dust mite levels actually increases asthma prevalence
26
What is localised airflow obstruction?
- A tumour | - A foreign body like a pea in the airway
27
What causes generalised airflow obstruction?
- Asthma (reversible) - COPD (irreversible) - Bronchiectasis (airways become unusually wide and fill up with mucus) - Bronchiolitis (bronchiole inflammation) - CF
28
What symptom is NEEDED for an asthma diagnosis?
- A wheeze
29
Why is a wheeze needed for an asthma diagnosis?
- The other common symptoms of asthma fit many other generalised airflow obstructive diseases
30
What other NON VARIABLE symptoms are common with asthma?
- SOB - Chest tightness - Dry cough (wet cough would signify bronchitis
31
What are the variable trigger of asthma?
- Exercise - Pets - Smoke - Perfume - Cold air - Pollen
32
What is daily variation of asthma?
Is it worst at different times of the day
33
What is weekly variation of asthma?
Is it worse at work etc
34
What past medical history is important when diagnosing asthma?
- Childhood asthma - Eczema - Hayfever
35
What past drug history is important when diagnosing asthma?
- Inhalers - Aspirin - B blockers - NSAIDs
36
What family history is important when diagnosing asthma?
- Atopic disease
37
What past social history is important when diagnosing asthma?
- Smoking - Pets - Occupations - Psychosocial
38
Why is phsychosocial history important?
Some asthma symptoms worsen in response to stress
39
What is the technique used to check for obstructive airways disease?
- Spirometry
40
What two things does spirometry read?
- FEV1 | - FVC
41
If the airflows are obstructed what happens to FEV1 and FVC
- FEV1 lower | - FVC the same
42
Why is using spirometry not a good diagnostic tool for asthma?
- Asthma is variable | - The airways could be normal at time of test and a false negative will be given
43
What is the process of carbon monoxide gas transfer?
- Get patient to breathe in a little CO - If the alveoli are working properly then most of the CO should diffuse into the blood - If not then high levels of CO will be detected on exhalation
44
What type of drugs would you use to differentiate asthma from COPD by administering a test run?
- Bronchodilators and corticosteroids - These drugs will always get the airways to open if it is asthma - Will have no effect on COPD (irreversible)
45
By what volume would FEV1 have to change to say that the bronchodilator or the corticosteroid was effective in opening the airways
- 200ml
46
How would you diagnose occupational asthma?
- Get the patient to do spirometry in and out of work
47
What is a specialist way of diagnosing asthma? (last resort almost)
- Checking airway responsiveness to histamine OR the suspected trigger antigen
48
How can nitric oxide be used to diagnose asthma?
- Get the suspected asthma sufferer to breathe in some nitric oxide - Test nitric oxide concentration on exhalation and typically you'd detect a much higher conc of nitric oxide in a asthma sufferer

Respiratory Physiology (16 decks)

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