Clinical Case Studies - Asthma

Question 1

What is asthma?

Answer 1

A chronic, inflammatory disease that is characterised by reversible airway obstruction.

Question 2

Describe the pathology of asthma

Answer 2

• Inflammation - IgE, Mast Cells → degranulation, Interleukins/histamine - broncoconstriction
• Excess mucus production
• Smooth muscle cell hyperplasia
• Obstruction of small airways
• Poor air flow

Question 3

Describe the histological features of asthma

Answer 3

• Whorls of shed epithelium (Curschman spirals)
• Eosinophils
• Charcot-Leyden crystals
• Smooth muscle hyperplasia
• Mucus plugs
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Question 4

What are the symptoms of an exacerbation of asthma? What are some triggers?

Answer 4

• Shortness of breath
• Wheezing
• Coughing
• Dust, pets, weather
• Emotion
• Drugs - eg beta blockers, NSAIDs

Question 5

What investigations are useful for asthmatics?

Answer 5

• Peak expiratory flow rate
• Spirometry
• Bloods
• Sputum sample
• CXR - pneumothorax/consolidation