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Respiratory > Asthma > Flashcards

Asthma Flashcards

1
Q

What is asthma?

A

Asthma is an obstructive disease meaning that it affects the airways.

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2
Q

What are the different types of asthma?

A

Type 2 high/low - relates to TH2 inflammation
Early/late onset
Atopic/non-atopic
Extrinsic/intrinsic

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3
Q

What are some of the characteristics of asthma?

A

Reversible airflow obstruction
Airway hyperresponsiveness
Type 2 airway inflammation - eosinophil is the usual effector cell.

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4
Q

What is the dynamic evolution of asthma?

A
  1. Bronchoconstriction causing brief symptoms
  2. Chronic airway inflammation causing exacerbations of airway hyperresponsiveness.
  3. Airway remodelling causing fixed airway obstruction when collagen is laid down
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5
Q

What are some of the hallmarks of remodelling in asthma?

A
  1. Thickening of the basement membrane.
  2. Collagen deposition in the submucosa
  3. Hypertrophy of smooth muscle
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6
Q

What is type 2 inflammation in asthma?

A 
This is the presence of one or more of - 
Presence of cytokines IL4/5/13
Raised total or specific IgE
Blood or sputum eosinophilia
Raised FeNO
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7
Q

What is FeNO?

A

Fractional exhaled nitric oxide

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8
Q

What are some of the triggers that can cause asthma symptoms to occur or worsen?

A 
Allergens
Exercise
Viral infection
Smoke
Cold
Chemicals
Drugs - NSAIDS, Beta blockers
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9
Q

What are the clinical features and symptoms of asthma?

A 
Episodic diurnal variation
Non- productive cough
Triggers - in extrinsic asthma
Associated T2 comorbidities
Responsiveness to steroids or beta- agonists
Family history of asthma
Wheezing due to turbulent airflow.
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10
Q

How is asthma diagnosed?

A 
By history and examination.
Diurnal varitation peak flow rate.
Reduces forced expiratory ratio.
Reversibility to inhaled salbutamol >15%
Provocation testing
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11
Q

What is the forced expiratory ration that is an indication of asthma?

A

FEV1/FVC < 75%

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12
Q

What is provocation testing?

A

This is done to identify bronchospasm.

This can be done by exercise or chemical stimulants e.g. histamine, methacholine, mannitol

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13
Q

What is the role of leukotrienes in asthma?

A
  1. Contraction and proliferation of airway smooth muscle cells.
  2. Influx of eosinophils to the area.
  3. Decreased mucous transport.
  4. Increased mucous secretion
  5. Oedema
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14
Q

What are some type 2 comorbidities in asthma?

A

Chronic rhinosinusitis with nasal polyps.
Atopic dermatitis
Allergic rhinitis
Eosinophilic oesophagitis

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15
Q

What are some of the signs of T2 asthma?

A

Sensitive airway smooth muscle
Airway hyperresponsiveness
Mucous production
Exacerbations of symptoms

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16
Q

What are some of the biomarkers of type 2 inflammation with asthma?

A

High IgE

High FENO - fractional exhaled nitric oxide

17
Q

What are the common types of T2 asthma?

A

Allergic asthma
Exercise induced asthma
Late-onset eosinophilic asthma

Respiratory (16 decks)

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