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Flashcards in deck_1570037 Deck (24):

Describe the epidemiology of asthma

• Increasing in prevalence• More common in the developed world • Increases in populations who move from developing to developed countries


How many adults currently receive tratment for asthma?

• 5.4 million


What are the potential causes of asthma?

• Genetic risk• Sensitisation to airborne allergens ○ House dust mite ○ Pollens ○ Air pollution ○ Tobacco smoke• Hygiene hypothesis


hat is the definition of asthma?

• One or more of the following recurring symptoms ○ Wheeze ○ Cough ○ Breathlessness ○ Chest tightness ○ Variable airflow obstruction


What is a wheeze?

• High pitched expiratory sound• Originates in airways compressed or obstructed• Wheeze is of variable intensity and tone


Outline the type of cough one may develop in asthma

• Cough that's worse at night• Cough which is exercise induced• Dry cough


What are the three parts of the examination of a suspected asthma patient?

• Inspection• Percussion• Auscultation


What do you look for in the inspection of an asthma patient?

• Chest ○ Scars/deformities ○ Hyper expansion• General health ○ Eczema, hay fever ○ Lethargu ○ Can they speak?


What are you looking for in percussion of an asthma patient?

• Hyper-resonance


What are you looking for in auscultation of an asthma patient?

• Polyphonic wheeze


Give three tests used in the investigation of an asthma patient?

• Spirometry - Flow volume loop• Allergy testing• Chest x-rays


What will you see in the spirometry of an asthmatic?

• Low PERF?• Low FEV/FVC ratio• >12% increase in FEV1 following salbutamol


What will you see in the allergy testing of an asthmatic?

• Skin prick to aero allergens• Blood IgF levels to specific aero-allergens


What will you see in Chest X ray of asthmatic?

• Peformed to exclude other disease/inhalation of foreign body/pneumothorax


Outline the pathophiologyical changes underlying asthma

• Increased mast cells• Increased eosinophils• Increased dendritic cells


What role do mast cells play in asthma?

• Release prostaglandins/histamine


What role do eosionphils play is asthma?

Large numbers in bronchial wall of asthmatics


What role do dendritic cells and lymphocytes have in asthna?

• Dedritic cells have a role in the initial uptake and presentation of allergens to lymphocytes• T-Helper lymphocytes (CD4) release cytokines that play a key part in the activation of mast cells• Th2 phenotype favour the production of antibody production by B lymphocytes to IgE.


What occurs in remodelling in asthma?

• Epithelium ○ Stressed and damaged with a loss of ciliated columnar cells• Basement membrane ○ Deposition of collagens, causing it to thicken• Smooth Muscle ○ Hyperplasia causing thickening of the muscle


Give three causes of asthmatic attacks?

• Lack of treatment adherence• Respiratory virus infections associated with common cold• Exposure to allergens or triggering drug


What are three treatments for asthma?

• Education • Primary prevention• Pharmacological management


What does education do for asthma patients?

• Educates people to correctly recognise their symptoms ○ To use services appropriately ○ To develop own personal asthma action plan


What is primary prevention of asthma?

• Stop smoking• Get fresh air• Reduce exposure to allergens• Lose weight


What is involved in the pharmacological management of asthma?

• B2 adrenoagonists ○ Muscarinic antagonists• Anti inflammatory agents