Podcast
Questions and Answers
What is a common respiratory virus that can exacerbate asthma due to damaged epithelium?
What is a common respiratory virus that can exacerbate asthma due to damaged epithelium?
What symptom is most commonly associated with asthma during the night?
What symptom is most commonly associated with asthma during the night?
Which class of medications is used specifically for quick relief of acute asthma symptoms?
Which class of medications is used specifically for quick relief of acute asthma symptoms?
Which characteristic of bronchial asthma indicates that airway obstruction can be reversed?
Which characteristic of bronchial asthma indicates that airway obstruction can be reversed?
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What diagnostic test is recommended for all asthma patients to identify allergic causes?
What diagnostic test is recommended for all asthma patients to identify allergic causes?
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Which inhaled steroid is the most widely used in the treatment of asthma?
Which inhaled steroid is the most widely used in the treatment of asthma?
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What primarily contributes to the hereditary predisposition to asthma?
What primarily contributes to the hereditary predisposition to asthma?
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Which of the following is an example of a class of medications used for long-term control of asthma?
Which of the following is an example of a class of medications used for long-term control of asthma?
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Which cell type's role is predominantly associated with the release of mediators that cause the asthmatic reaction?
Which cell type's role is predominantly associated with the release of mediators that cause the asthmatic reaction?
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In which demographic is asthma most prevalent according to the provided data?
In which demographic is asthma most prevalent according to the provided data?
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What should be avoided in patients with asthma due to potential exacerbation?
What should be avoided in patients with asthma due to potential exacerbation?
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Which asthma medication serves to prevent further exacerbations rather than treat acute symptoms?
Which asthma medication serves to prevent further exacerbations rather than treat acute symptoms?
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What defines intrinsic asthma?
What defines intrinsic asthma?
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What is a key characteristic of nocturnal asthma symptoms?
What is a key characteristic of nocturnal asthma symptoms?
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Which is a significant factor that exacerbates asthma symptoms apart from airway inflammation?
Which is a significant factor that exacerbates asthma symptoms apart from airway inflammation?
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Which of the following is NOT considered a common extrinsic factor to control in asthma management?
Which of the following is NOT considered a common extrinsic factor to control in asthma management?
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What inflammatory mediators are released primarily by eosinophils in asthmatics?
What inflammatory mediators are released primarily by eosinophils in asthmatics?
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What is the primary mechanism of airway hyperresponsiveness in asthma?
What is the primary mechanism of airway hyperresponsiveness in asthma?
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Which type of asthma is commonly associated with specific environmental allergens?
Which type of asthma is commonly associated with specific environmental allergens?
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What effect do corticosteroids have on eosinophils in asthmatics?
What effect do corticosteroids have on eosinophils in asthmatics?
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Study Notes
Bronchial Asthma
- Asthma is a chronic inflammatory airway disease with periodic attacks, marked by coughing, wheezing, and shortness of breath.
- Three characteristics of asthma are:
- Reversible airway obstruction, either spontaneously or with treatment
- Airway hyperresponsiveness to various stimuli
- Inflammation of the bronchi, causing epithelial damage, oedema, and mucus plugging
Prevalence
- Asthma prevalence has increased over the past 30 years.
- The increase is significant in children and young adults, with up to 15% of this population affected.
- Asthma is more common in developed countries and less prevalent in Far Eastern countries.
Classification
- Extrinsic asthma is caused by external factors, notably allergens, often affecting atopic individuals, especially children and young adults.
- Intrinsic or cryptogenic asthma is when no external cause is identifiable. This difference isn't crucial for diagnosis.
Etiology
- Atopy is a genetic predisposition to allergic diseases, including asthma, allergic rhinitis, and atopic dermatitis.
- Allergy is an exaggerated immune response to a foreign antigen, Regardless of mechanism.
Pathogenesis
- Asthma involves mediators and vascular leakage activated by various mechanisms, with exposure to allergens being a prominent one.
- Airway inflammation is key to asthma severity.
Pathophysiology
- Mast cells increase in asthmatic airways and release powerful mediators (histamine, prostaglandin D2, leukotrienes) that affect smooth muscle and blood vessels, driving the asthmatic response.
- Eosinophils are prevalent in the bronchial wall and secretions of those with asthma, and their numbers/activity are reduced by corticosteroids
- Macrophages and lymphocytes increase in airway and alveolar linings. Macrophages process allergens, and lymphocytes release mediators such as prostaglandins, thromboxanes, leukotrienes, and platelet-activating factor (PAF)
- The asthmatic airway's epithelium is often damaged making it more prone to infections, such as from rhinoviruses.
Symptoms
- Common symptoms include:
- Labored breathing
- Wheezing
- Frequent coughing
- Allergies
- Sleep problems
- Chest pain
- Feeling tired
- Episodes of shortness of breath (dyspnea)
- Nocturnal coughing, can be a presenting symptom.
Investigations
- There's no single definitive test, but investigations include:
- Lung function tests
- Blood and sputum tests to detect increased eosinophils
- Skin-prick tests to identify allergic causes
Treatment
- Control measures for extrinsic asthma include avoiding causative allergens (dust mites, pets, some foods) and avoiding smoking, salicylates, NSAIDs, and beta blockers.
- Medications are broadly classified as:
- Quick-relief medications for acute symptoms
- Long-term control medications to prevent future exacerbations
- Common treatment drugs include:
- Metered-dose inhalers with inhaled steroids
- Long-acting beta2-agonists
- Leukotriene modifiers
- Other bronchodilators, such as antimuscarinic agents and theophylline preparations.
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Description
This quiz covers the key aspects of bronchial asthma, including its characteristics, prevalence, and classification. Learn about the differences between extrinsic and intrinsic asthma, as well as the factors contributing to its increased prevalence, particularly in children and young adults. Test your knowledge on this chronic inflammatory airway disease.
