Podcast
Questions and Answers
What is a key characteristic of asthma?
What is a key characteristic of asthma?
Which of the following endotypes is NOT an identified type of asthma?
Which of the following endotypes is NOT an identified type of asthma?
What type of asthma is characterized by a lack of eosinophils or neutrophils?
What type of asthma is characterized by a lack of eosinophils or neutrophils?
Which method is primarily used to assess expiratory airflow obstruction in asthma?
Which method is primarily used to assess expiratory airflow obstruction in asthma?
Signup and view all the answers
What defines corticosteroid insensitivity in asthma patients?
What defines corticosteroid insensitivity in asthma patients?
Signup and view all the answers
Which phenotype of asthma is often associated with obesity?
Which phenotype of asthma is often associated with obesity?
Signup and view all the answers
What occurs during ongoing inflammation in asthma?
What occurs during ongoing inflammation in asthma?
Signup and view all the answers
In an obstructive pattern in spirometry, which of the following is typically seen?
In an obstructive pattern in spirometry, which of the following is typically seen?
Signup and view all the answers
Study Notes
Asthma
- Asthma is a chronic respiratory disease characterized by:
- Inflammation
- Reversible expiratory airflow obstruction
- Airway hyper-responsiveness
- Airway remodeling
Inflammation
- Persistent inflammation is the root cause of all asthma symptoms.
- Asthma is a heterogeneous disease, meaning it presents differently in different people.
- Different endotypes, phenotypes, and responses to treatment are seen.
Asthma Endotypes
- Endotypes describe the inflammatory processes driving the disease in different patient groups.
- Proposed endotypes for asthma include:
- Allergic eosinophilic asthma
- Non-allergic eosinophilic asthma
- Neutrophilic asthma
- Paucigranulocytic asthma
- Mixed granulocytic asthma
Asthma Phenotypes
- Phenotypes describe clinical manifestations seen in different patient groups.
- Five phenotypes have been proposed:
- Early symptom predominant
- Obese, non-eosinophilic
- Benign asthma
- Inflammation predominant
- Discordant inflammation
Response to Treatment
- Corticosteroid insensitivity: Failure to improve FEV1 by at least 15% from baseline after 10-14 days of oral prednisolone 40 mg daily treatment.
- Irresponsiveness to beta-2 agonists: Patients not responding to inhalers for unknown reasons.
Expiratory Airflow Obstruction
- Difficulty exhaling normally, due to ongoing inflammation causing mediator release, bronchoconstriction, increase in airway smooth muscle mass, and insufficient exhalation.
- Assessed by spirometry, measuring FEV1/FVC ratio (<70%), reduced FEV1 (defines severity), and normal or reduced FVC.
- Reversible in asthma (unlike COPD). Improved after bronchodilator administration (12% or 200ml increase in FEV1).
Clinical Presentation
- Symptoms include:
- Cough
- Wheezing (decreased breath sounds in severe cases)
- Chest tightness
- Shortness of breath
Treatment of Asthma
-
Conventional Therapy:
- Reliever Medications: Short-acting bronchodilators (beta-2 agonists) for airway dilation.
- Controller Medications: Anti-inflammatory agents (corticosteroids) and long-acting bronchodilators (beta-2 agonists) to reduce inflammation and manage symptoms.
Treatment for Acute Asthma (Exacerbation)
- Goal: Relieve symptoms and return patients to baseline lung function.
- Inhaled Bronchodilators: MDI or nebulizer-administered beta-2 agonists or anticholinergics. Heliox (helium and oxygen mixture) may be added for enhanced delivery to distal airways.
- Systemic Corticosteroids: Prednisone, prednisolone, or methylprednisolone (higher doses for severe cases). Dosage dependent on severity (40-60 mg once a day), duration of treatment (3-5 days for children, 5-7 days for adults).
- Subcutaneous Epinephrine: 1 mg/mL (1:1000) solution; may be preferred to epinephrine for children (although no longer widely used)
- Antibiotics: Only if a bacterial infection is suspected.
- Magnesium Sulfate : Airway smooth muscle relaxant; use controversial due to lack of confirmed safety and efficacy. Administered IV, bolus, or infusion.
PFT Revision
- Obstructive Disorders: Low FEV1/FVC ratio, low FEV1, normal TLC.
- Restrictive Disorders: Normal FEV1/FVC ratio, low TLC.
- Mixed Disorders: Low FEV1/FVC ratio, low TLC (but FVC may be low due to hyperinflation).
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Explore the complexities of asthma, a chronic respiratory disease characterized by inflammation and varying airflow obstructions. This quiz focuses on asthma's different endotypes and phenotypes, as well as their specific manifestations and underlying inflammatory processes. Test your knowledge on how asthma affects diverse patient groups and the proposed classifications related to this condition.
