Asthma Ghanaian Guideline Flashcards
(113 cards)
Asthma is defined by GINA as
Heterogenous disease characterized by chronic inflammation
The chronic airway inflammation in asthma is associated with
Airway hyper-responsiveness that leads to recurrent episodes of wheeze , difficulty in breathing, chest tightness and cough
Asthma is associated with reversible
Airway obstruction that could resolve Spontaneously or with treatment
Asthma related mortality occurs more frequently in
Adults compared to children per WHO report in 2020
Factors associated with asthma deaths are
Previous admission to intensive care unit
# Severe asthma necessitating chronic oral corticosteroids
#Poor daily asthma symptom control with excessive use of SABA (1.4 canisters per month)
#Abnormal forced expiratory volume in 1 second (FEV1)
#Frequent emergency department visits
#Low socioeconomic status
#Family dysfunction
#Patient psychological problems
Asthma is the result of
An interplay between genetic and environmental factors
Atopy is a genetic tendency to
Develop allergic conditions in response to common environmental allergens
The strongest risk factor for the development of asthma
Atopy
Airway hyper-responsiveness is defined as
Excessive reactivity or narrowing of the airway in response to broncho-constrictive
Which other genetic aetiology is closely related to atopy
Airway hyper-responsiveness
Examples of environmental factors include
Indoor allergens ( house dust mites, cockroaches)
#Air pollutants
#Respiratory viruses
#Diet
#Endotoxins
#Seasonal outdoor allergens ( grass, pollens ,molds, animal dander )
Patients with atopic /allergic asthma tend to have positive family history of allergic diseases such as
A)Rhinitis
Eczema
Urticarial
B)And develop asthma in early childhood
C) They are more likely to have peripheral eosinophilia or raised serum IgE levels
D) Positive skin prick test to intradermal injection of allergens
The non-atopic/ non- allergic asthma symptoms are triggered by non allergic factors such as
Stress
Cold
Dry air
Anxiety
Viruses
In adults, occupational exposures to organic and inorganic chemicals could lead to
Development of occupational asthma
In childhood, there is a male preponderance of asthma, as well as asthma related hospital admissions in the pre-pubertal ages . However, after puberty, asthma is more prevalent and severe in
Females and this has been associated with hormonal changes and gender specific environmental exposures
Role of diet in the aetiology of Asthma
Low intake of
# fruits and vegetables
# Dairy fats
#Vitamin C
#Vitamin E
Although not scientifically substantiated , it is believed that infants with shorter periods of breastfeeding (less than 6 months) have
Increased risk of developing asthma
What has been shown to be a risk factor as well as a disease modifier for asthma in both children and adults based on longitudinal studies
Obesity
Weight gain in pregnancy could be associated with
15-30% risk of child developing asthma
According to the hygiene hypothesis, exposure to some germs and bacterial endotoxins helps
Mature the young child’s immune response this protecting against asthma and other allergic diseases
The hygienes hypothesis is supported by
Longitudinal
Epidemiological studies
The hygiene hypothesis explain the
Increased prevalence of asthma in urban dwellings compared to rural settings
Children with asthma from lower socioeconomic backgrounds are at increased risk of being exposed to
Indoor( house dust mite, cockroaches)
Outdoor(biomass fuel, urban pollution) allergens due to poor housing conditions which could exacerbate background asthma symptoms
Exposure to environmental tobacco smoking increases the risk of
Childhood Asthma