Asthma

Question 1

what are the three cardinal features of asthma?

Answer 1

airway nflammation
reversible airflow obstruction
airway hyperresponsiveness

Question 2

what type of T cell is present in allergic asthma?

Answer 2

Th2 cells

Question 3

what are the cytokines associated with allergic asthma and Th2 cell response?

Answer 3

IL4,5,13

Question 4

what is a common Xray finding with asthma?

Answer 4

hyperinflated lungs with flattened diaphragm

Question 5

name the seven immune cells that can be present in airway inflammation of asthma

Answer 5

B cell
T cell
Innate lymphoid cell
eosinophil
neutrophil
mast cells 
dendritic cells

Question 6

what is the first step in starting allergic asthma reaction

Answer 6

dendritic cell recognizes antigen

Question 7

what is the second step in allergic asthma response?

Answer 7

dendritic cell presents the antigen to the T cells and makes Th2 cells

Question 8

what do Th2 cells in allergic asthma release that stimulates B cells? What do B cells release in response?

Answer 8

T cells release IL-4 and B cells respond to the IL-4 by releasing IgE

Question 9

in allergic asthma, the IgE from the B cells are in charge of what?

Answer 9

mast cell degranulation by crosslinking

Question 10

mast cell degranulation leads to three important responses…name them

Answer 10

bronchoconstriction
vasodilation
mucus production

Question 11

in allergic asthma, Th2 cells release a cytokine that induces eosinophils…what cytokine is it?

Answer 11

IL-5

Question 12

in allergic asthma, what do eosinophils cause?

Answer 12

inflammation in the airways

Question 13

Th2 cells in allergic asthma release IL-13, what are its functions (2)

Answer 13

mucous cell metaplasia…goblet cells

airway smooth muscle hypertrophy

Question 14

in late onset eosinophilic asthma, what are the three cytokines released from epithelial cells that drive the asthmatic reaction?

Answer 14

IL-25
IL-33
TSLP

Question 15

what are the cytokine mediators that lead to the response in late onset eosinophilic asthma?

Answer 15

IL5 and 13…ac

Question 16

compared to allergic asthma, what key cytokine and immune response is missing in late onset eosinophilic asthma?

Answer 16

IL-4 and mast cell degranulation via IgEs

Question 17

in late onset eosinophilic asthma, the cytokines IL-25,33 and TSLP all go to a cell and make it secrete other cytokines…what is this type of cell?

Answer 17

innate lymphoid cell

Question 18

what cytokines does the innate lymphoid cell secrete?

Answer 18

IL- 5 and IL-13

Question 19

what does AERD stand for?

Answer 19

aspirin exacerbated respiratory disease

Question 20

explain how AERD occurs

Answer 20

since Aspirin blocks the cyclooxygenase pathway from arachidonic acid…the acid mainly goes down the lipoxygenase pathway and into leukotrienes

Question 21

what is the symptom triad for AERD

Answer 21

aspirin use
nasal polyps
asthma

Question 22

what type of T cell is in neutrophilic asthma?

Answer 22

Th17 cell

Question 23

what cytokine is really important in neutrophilic asthma? what cell secretes it?

Answer 23

IL-17

Th17 cell

Question 24

what is IL-17s role in neutrophilic asthma?

Answer 24

leads to a chemokine for neutrophils to migrate out of vasculature

Question 25

is eosinophilic asthma sensitive to steroids?

Answer 25

yes

Question 26

is neutrophilic asthma sensitive to steroids?

Answer 26

yes

Question 27

which type of asthma is severe and which type is mild/moderate? choices of eosinophilic or neutrophilic

Answer 27

eosinophilic is mild | neutrophilic is severe

Question 28

name the three hallmarks of airway remodeling in asthma

Answer 28

thickened basement membrane airway smooth muscle hyperplasia mucous metaplasia

Question 29

what is asthma affect on DLCO?

Answer 29

it is sometimes elevated or normal

Question 30

what is an odd trigger of asthma that is important to remember?

Answer 30

STRESS

Question 31

name the four symptoms usually seen in asthma presentation

Answer 31

cough dyspnea chest tightness wheezing

Question 32

does wheezing occur during expiration inspiration or both? what about stridor?

Answer 32

wheezing is during expiration...stridor can be during both

Question 33

what is a chemical that induces asthmatic airway hyperresponsiveness but does not induce in normal airway?

Answer 33

methacholine

Question 34

explain why methacholine is used for asthma testing

Answer 34

methacholine causes hyperesponsiveness in the asthmatic airways but does not in normal airways

Question 35

what are three diagnostic tests for asthma?

Answer 35

spirometry peak flow variability methacholine challenge testing

Question 36

what chemical do inflammed epithelial cells release that can be tested for asthma?

Answer 36

nitric oxide (NO)

Question 37

in what type of asthma will NO be elevated from the epithelial cells?

Answer 37

eosinophilic

Question 38

what cells release NO in eosinophilic asthma?

Answer 38

epithelial cells

Question 39

what type of asthma is induced sputum used for? is this common?

Answer 39

eosinophilic...cause can see the eosinophils...not common

Question 40

name the rescue asthma treatment

Answer 40

albuterol

Question 41

what are the three controller asthma medication options

Answer 41

inhaled glucocorticoids long acting beta agonists leukotriene modifier

Question 42

what is the leukotriene modifier that is used for asthma?

Answer 42

montelukast