Allergies and Respiratory Infections Quiz

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Questions and Answers

Which of the following is NOT considered a risk factor for respiratory infections?

Dust mites

Obesity

High IgE levels

Regular exercise (correct)

What type of reaction is characterized by the early release of mediators like histamine?

Immediate hypersensitivity reaction (correct)

Late allergic reaction

Chronic inflammation

Autoimmune response

Which of the following allergens is associated with both indoor and outdoor pollution?

Pollen from plants

Cockroach debris (correct)

Environmental tobacco smoke

Cat dander

Which factor is NOT part of the genetic risk factors for respiratory conditions?

Race Signup and view all the answers

What is one of the infections that can act as a risk factor for respiratory issues?

Atypical bacterial infections Signup and view all the answers

Which of the following are clinical features associated with asthma episodes?

Chest tightness Signup and view all the answers

What is the purpose of lung function tests in asthma diagnosis?

To measure airway obstruction Signup and view all the answers

Which signs might be observed during a physical examination of a patient experiencing an asthma attack?

Pulsus paraduxus Signup and view all the answers

Which diagnostic tool is used to assess eosinophilic inflammation in suspected asthma?

Exhaled Nitric Oxide (FeNO) Signup and view all the answers

What would be a common differential diagnosis for asthma?

Cardiac asthma Signup and view all the answers

Which statement correctly describes the management goals for asthma?

Reduction of symptoms and maintenance of normal activity Signup and view all the answers

In which population is asthma most common?

Children Signup and view all the answers

What is one of the primary components of asthma?

Airway Inflammation Signup and view all the answers

Which blood test is particularly useful for identifying allergens in asthma patients?

IgE level testing Signup and view all the answers

In asthma management, why is patient education important?

To reduce exposure to allergens and improve treatment adherence Signup and view all the answers

Which mediator is NOT typically involved in asthma inflammation?

Insulin Signup and view all the answers

What is the primary result of bronchoconstriction in asthma?

Airway obstruction Signup and view all the answers

What occurs in mild asthma as opposed to severe asthma?

Variable airway limitation Signup and view all the answers

Which of the following cells is involved in the inflammatory response in asthma?

Basophils Signup and view all the answers

What does increased permeability of blood vessels in asthma lead to?

Edema Signup and view all the answers

Which type of asthma has a greater prevalence in females compared to males?

Adult onset asthma Signup and view all the answers

What level of respiratory rate is typically seen in severe respiratory arrest?

<blockquote> 30/minute </blockquote> Signup and view all the answers

Which characteristic is common in patients who are moderately breathless?

Uses accessory muscles Signup and view all the answers

What pulse rate indicates a state of severe respiratory distress?

<blockquote> 120 beats/minute </blockquote> Signup and view all the answers

What is the typical PEF or FEV% predicted value for a patient in imminent respiratory arrest?

< 25% Signup and view all the answers

Which symptom is associated with severe respiratory distress?

Loud wheeze throughout inhalation and exhalation Signup and view all the answers

How is alertness commonly affected in patients experiencing imminent respiratory arrest?

Drowsy or confused Signup and view all the answers

What defines a patient who can still lie down comfortably?

Mild breathlessness Signup and view all the answers

Which of the following indicates pulsus paradoxus in a respiratory distress patient?

<blockquote> 25 mmHg </blockquote> Signup and view all the answers

What is the primary purpose of the annual influenza vaccine in asthma management?

To prevent respiratory infections Signup and view all the answers

Which characteristic defines partly controlled asthma according to the severity classification?

Daytime symptoms occurring more than twice a week Signup and view all the answers

In what situation should systemic steroids be considered for asthma management?

In cases of impending respiratory failure Signup and view all the answers

What percentage of predicted lung function indicates uncontrolled asthma?

Less than 80% Signup and view all the answers

What should be the primary focus of the initial assessment for asthma diagnosis?

Evaluating symptoms and lung function Signup and view all the answers

What is a significant indicator of asthma exacerbation in a patient?

PEF below 80% on any day Signup and view all the answers

What action is recommended for patients who use their rescue inhaler more than three times a week?

Consider increasing preventer therapy Signup and view all the answers

Which of the following would indicate an improvement in asthma control?

Experiencing daytime symptoms less than twice a week Signup and view all the answers

What is the function of the peak expiratory flow (PEF) diary in asthma management?

To identify lung function variability Signup and view all the answers

Which treatment step is indicated when a patient's asthma symptoms are not adequately controlled despite low-dose ICS?

Consider higher doses of preventers Signup and view all the answers

What type of asthma medication is primarily used as a rescue treatment?

Short-acting beta agonists Signup and view all the answers

Which of the following is NOT a recognized component of asthma severity classification?

Need for prolonged hospital stays Signup and view all the answers

Which asthma control level indicates that symptoms are present at least once per week?

Partly controlled Signup and view all the answers

What is the role of magnesium sulfate in asthma management during exacerbations?

To provide emergency bronchodilation Signup and view all the answers

Study Notes

Overview of Asthma

Affects all ages, most notably children; gender ratio shifts from M>F in childhood to F>M in adult onset.
Consists of three components: airway inflammation, hyperresponsiveness, and limitation (obstruction) which is often variable and reversible.

Inflammation in Asthma

Involved cells:
- Mast cells, basophils, eosinophils, macrophages.
- Epithelial cells, endothelial cells, smooth muscle cells, goblet cells, myofibroblasts.
Key mediators:
- Histamine, platelet-activating factor (PAF), prostaglandins (D2, D4, E4, C4), IL-5, IL-13, leukotrienes, IgE.

Airflow Limitation and Remodeling

Airflow restriction is generally reversible.
Causes of fixed airway narrowing:
- Bronchoconstriction from smooth muscle contraction.
- Edema due to increased blood vessel permeability.
- Increased secretions from goblet cells.
- Structural changes: fibrosis, smooth muscle hypertrophy/hyperplasia, goblet cell hyperplasia with cilia loss.

Hyperresponsiveness

Severity of asthma ranges from mild to severe.
Triggers include dust mites, cockroaches, pollution, respiratory infections, tobacco, NSAIDs/aspirin, beta blockers, exercise, GERD, and pet dander.

Risk Factors

Genetic predisposition: atopy and high IgE levels.
Environmental influences: pollution and allergens.
Infections: particularly viral and atypical bacterial.
Obesity, race, and gender also play roles.

Clinical Features

Symptoms often worsen at night and in the early morning: recurrent cough, wheezing, chest tightness, breathlessness.
Physical exam signs include tachycardia, tachypnea, pulsus paradoxus, prolonged expiration phase, and accessory muscle use.
Conditions indicating higher asthma probability: eczema and nasal polyps.

Differential Diagnosis (DDx)

Conditions to consider:
- Laryngospasm, cardiac asthma, COPD, upper airway obstruction, anemia, obesity, left ventricular (LV) dysfunction, bronchiectasis.

Laboratory Investigations

Lung function tests:
- Peak expiratory flow, spirometry with bronchodilator reversibility, bronchial challenge test.
Blood tests:
- Complete blood count (CBC), IgE levels, and radioallergosorbent testing (RAST).
Imaging:
- Chest radiograph for hyperinflation or pneumonia exclusion, CT scan for bronchiectasis.
Exhaled nitric oxide (FeNO) testing: indicates eosinophilic inflammation.

Management Goals

Control symptoms, maintain normal activity, ensure adequate pulmonary function, prevent exacerbations, minimize medication side effects, and prevent mortality.

Components of Severity

Symptoms categorized as intermittent, mild persistent, moderate persistent, or severe persistent.
Severity affects treatment approach and medication.

Asthma Control Levels

Classified as controlled, partly controlled, or uncontrolled based on daytime symptoms, activity limitations, nocturnal symptoms, need for rescue medication, and lung function measures.

Diagnosis and Evaluation

Assessment requires symptom evaluation, lung function measurement, inhaler technique checks, dose adjustments, and self-management plans.

Treatment Options

Regular preventer medications, short-acting beta agonists (SABAs) for relief, adjustment of treatment based on patient response.
Preferred treatments may include high-dose SABA/SAMA, and systemic steroids.
Intubation and mechanical ventilation may be necessary for impending respiratory failure.

Signs of Severity in Asthma Attacks

Mild: breathlessness while walking, sentences spoken, alert, normal respiratory rate.
Moderate: breathlessness at rest, phrases only, increased respiratory rate.
Severe: breathlessness limits conversation, agitated, >30/min respiratory rate, loud wheezing, unable to recline, possible bradycardia.

Respiratory Failure Indicators

Increasing obstruction may lead to serious conditions; respiratory arrest is a life-threatening event requiring immediate intervention.

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Description

Test your knowledge on common allergens and their relationship to respiratory infections. This quiz covers various pollutants including dust mites, cockroaches, and the impact of tobacco. Enhance your understanding of how different substances affect respiratory health.