Asthma Overview and Classification

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What characterizes asthma as a chronic disease of the airways?

Airway hyper-responsiveness

Inflammation

Permanent expiratory airflow obstruction

Both A and C (correct)

Which of the following describes a common clinical manifestation of asthma?

Normal expiratory airflow

Inability to inhale deeply

Persistent cough and wheezing (correct)

Excessive sputum production

What type of asthma endotype is characterized by the presence of eosinophils?

Paucigranulocytic asthma

Mixed granulocytic asthma

Allergic eosinophilic asthma (correct)

Non-allergic eosinophilic asthma (correct)

Which test is used to assess expiratory airflow obstruction in asthma?

Spirometry Signup and view all the answers

What indicates corticosteroid insensitivity in asthma patients?

Failure to improve FEV1 by at least 15% after treatment Signup and view all the answers

What is the typical FEV1/FVC ratio observed in obstructive lung diseases such as asthma?

Approximately 0.70 Signup and view all the answers

What does the presence of neutrophils in asthma indicate?

Infection or inflammation Signup and view all the answers

Which of the following is true regarding beta-2 agonist responsiveness in asthma?

Some patients show no response for unknown reasons Signup and view all the answers

Which of the following best describes bronchoconstriction in asthma?

Contraction of airway smooth muscle resulting in airflow limitation Signup and view all the answers

In asthma pathology, what does airway remodeling refer to?

Permanent structural changes in airways due to chronic inflammation Signup and view all the answers

What best defines the term 'endotype' in the context of asthma?

The inflammatory process that underlies asthma Signup and view all the answers

Which of the following statements about corticosteroid insensitivity in asthma is correct?

It shows no significant change in FEV1 after appropriate dosage. Signup and view all the answers

Which phenotype of asthma is primarily associated with the patient's clinical presentation rather than the inflammatory process?

Asthma with airway hyper-responsiveness Signup and view all the answers

What is the expected FEV1/FVC ratio in a patient exhibiting an obstructive pattern of asthma?

Less than 0.70 Signup and view all the answers

What is the primary implication of having both FEV1 and TLC values that are low?

It reflects a mixed and complex dysfunction in lung mechanics. Signup and view all the answers

What condition is characterized by an increase in airway smooth muscle mass due to ongoing inflammation in asthma?

Airway remodelling Signup and view all the answers

Which of the following describes a common misconception about asthma treatments?

All asthma patients will respond to corticosteroids. Signup and view all the answers

What aspect of asthma makes it classified as a heterogeneous disease?

The variation in inflammatory processes and responses to treatments. Signup and view all the answers

Study Notes

Asthma Overview

Asthma is a chronic airway disease characterized by:
- Inflammation
- Reversible expiratory airflow obstruction
- Airway hyper-responsiveness
- Airway remodeling

Asthma Endotypes

Endotypes describe the inflammatory process in patients
Five asthma endotypes have been proposed:
- Allergic eosinophilic asthma
- Non-allergic eosinophilic asthma
- Neutrophilic asthma
- Paucigranulocytic asthma
- Mixed granulocytic asthma

Asthma Phenotypes

Phenotypes describe the clinical manifestations of asthma
Five phenotypes have been proposed:
- Early symptom predominant
- Obese non-eosinophilic
- Benign asthma
- Early onset atopic
- Concordant symptoms

Response to Treatment

Corticosteroid insensitivity:
- Failure to improve FEV1 by at least 15% within 10-14 days of prednisolone 40mg daily.
Irresponsiveness to beta-2 agonists:
- Patients don't respond to inhalers for unknown reasons

Clinical Presentation

Cough
Wheezing (decreased breath sound in severe cases)
Chest tightness
Shortness of breath

Treatment for Asthma

Conventional therapy:
- Reliever medications: Short-acting bronchodilators (beta-2 agonists) to dilate airways
- Controller medications: Anti-inflammatory agents (corticosteroids) and long-acting bronchodilators (beta-2 agonists) to reduce inflammation and cause of all symptoms
Treatment for acute asthma exacerbation:
- Inhaled bronchodilators: Beta-2 agonists or anticholinergics; MDI or nebulizer; Heliox (helium and oxygen mixture) may be added
- Systemic corticosteroids: Prednisone, prednisolone, methylprednisolone, (IV/oral)
- Subcutaneous epinephrine: 1 mg/mL (1:1000) solution (but terbutaline may be preferred for children)
- Antibiotics: Indicated only when history, examination, or chest x-ray suggests underlying bacterial infection
- Magnesium sulfate: Airway smooth muscle relaxant used as a bronchodilator (controversial)

Expiratory Airflow Obstruction

Inability to exhale normally
Assessed by spirometry:
- Reduced FEV1/FVC ratio (<70%)
- Reduced FEV1 (defines severity)
- Normal or reduced FVC
Asthma is reversible (unlike COPD)
Following bronchodilator administration (12% or/and 200 ml increase in FEV1)

PFT Revision

Obstructive disorders: low FEV1/FVC, low FEV1, normal TLC
Restrictive disorders: Normal FEV1/FVC but low TLC
Mixed disorders: Low FEV1/FVC and low TLC

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Explore the complexities of asthma, a chronic respiratory condition characterized by inflammation and airway obstruction. This quiz delves into various asthma endotypes and phenotypes, alongside their clinical implications and treatment responses. Test your knowledge on this vital health topic.