Podcast
Questions and Answers
Which morphological feature is associated with bronchial asthma?
Which morphological feature is associated with bronchial asthma?
- Thinning of the epithelial lining
- Increased airway patency
- Decreased eosinophil count
- Sub-mucosal glandular hyperplasia (correct)
What is a notable histological finding in the mucus plugs present in bronchial asthma?
What is a notable histological finding in the mucus plugs present in bronchial asthma?
- Granulomatous inflammation
- Pleural effusion
- Curschmann’s spirals (correct)
- Alveolar wall thickening
What type of hypersensitivity reaction is primarily involved in asthma?
What type of hypersensitivity reaction is primarily involved in asthma?
- Type Ι hypersensitivity (correct)
- Type II hypersensitivity
- Type III hypersensitivity
- Type IV hypersensitivity
Which cell type is notably increased during the inflammatory response in asthma?
Which cell type is notably increased during the inflammatory response in asthma?
What potential complication may arise due to mucus plug obstruction in asthma?
What potential complication may arise due to mucus plug obstruction in asthma?
Which mediators are primarily released during the early phase of an immune reaction to an allergen?
Which mediators are primarily released during the early phase of an immune reaction to an allergen?
What effect do IL-4, IL-5, and IL-13 have on the immune system?
What effect do IL-4, IL-5, and IL-13 have on the immune system?
Which statement correctly describes a characteristic of intrinsic asthma?
Which statement correctly describes a characteristic of intrinsic asthma?
What is one of the physiological results of the mediators released during the late phase of an immune reaction?
What is one of the physiological results of the mediators released during the late phase of an immune reaction?
Which of the following factors is NOT a triggering agent for asthma?
Which of the following factors is NOT a triggering agent for asthma?
What is the primary phase of an asthma reaction that occurs 30-60 minutes after an allergen is inhaled called?
What is the primary phase of an asthma reaction that occurs 30-60 minutes after an allergen is inhaled called?
What pathological feature is commonly associated with asthma in the lungs?
What pathological feature is commonly associated with asthma in the lungs?
Which of the following describes the immune response in early phase asthma?
Which of the following describes the immune response in early phase asthma?
What characterizes the bronchospasm observed in bronchial asthma?
What characterizes the bronchospasm observed in bronchial asthma?
Which of the following is NOT a common triggering factor for bronchial asthma?
Which of the following is NOT a common triggering factor for bronchial asthma?
What is the primary distinction between atopic and non-atopic asthma?
What is the primary distinction between atopic and non-atopic asthma?
What cellular response is activated during the first exposure to an allergen in atopic asthma?
What cellular response is activated during the first exposure to an allergen in atopic asthma?
What does airway hyper-responsiveness in asthma primarily result from?
What does airway hyper-responsiveness in asthma primarily result from?
Which of the following cytokines is NOT released during the response of CD4+ T cells in atopic asthma?
Which of the following cytokines is NOT released during the response of CD4+ T cells in atopic asthma?
What occurs during the second exposure to the same antigen in atopic asthma?
What occurs during the second exposure to the same antigen in atopic asthma?
Which of the following statements about asthma symptoms is true?
Which of the following statements about asthma symptoms is true?
Which histological features are most associated with asthma pathology?
Which histological features are most associated with asthma pathology?
What pathological change is primarily associated with airway obstruction in asthma?
What pathological change is primarily associated with airway obstruction in asthma?
What is the role of eosinophils in the pathology of asthma?
What is the role of eosinophils in the pathology of asthma?
Which type of immune response is primarily involved in the pathology of asthma?
Which type of immune response is primarily involved in the pathology of asthma?
Which effect does inflammatory cell influx have during an asthma attack?
Which effect does inflammatory cell influx have during an asthma attack?
What is a key characteristic of bronchial asthma that contributes to its symptoms?
What is a key characteristic of bronchial asthma that contributes to its symptoms?
Which factor is primarily associated with non-atopic asthma?
Which factor is primarily associated with non-atopic asthma?
What are the primary mediators released during the early phase of an immune reaction to an allergen?
What are the primary mediators released during the early phase of an immune reaction to an allergen?
Which mechanism triggers bronchial inflammation in atopic asthma?
Which mechanism triggers bronchial inflammation in atopic asthma?
What is one of the primary chemical mediators released during the inflammatory response in asthma?
What is one of the primary chemical mediators released during the inflammatory response in asthma?
Which phase of the immune reaction develops 4-8 hours after exposure to an allergen?
Which phase of the immune reaction develops 4-8 hours after exposure to an allergen?
In what way do the mediators released during the late phase affect the site of the lesion?
In what way do the mediators released during the late phase affect the site of the lesion?
Which of the following best describes airway hyper-responsiveness in asthma?
Which of the following best describes airway hyper-responsiveness in asthma?
Which of the following is a characteristic feature of intrinsic asthma?
Which of the following is a characteristic feature of intrinsic asthma?
Which of the following is a common factor that can trigger asthma symptoms?
Which of the following is a common factor that can trigger asthma symptoms?
In asthma, which component is essential for the sensitization of T-helper cells?
In asthma, which component is essential for the sensitization of T-helper cells?
What effect do IL-4 and IL-5 have during the late phase of an immune reaction?
What effect do IL-4 and IL-5 have during the late phase of an immune reaction?
Which triggering factor is most likely NOT associated with airway hyperreactivity in asthma?
Which triggering factor is most likely NOT associated with airway hyperreactivity in asthma?
What primarily differentiates atopic asthma from other forms?
What primarily differentiates atopic asthma from other forms?
Which pathological change is commonly observed in bronchi and bronchioles associated with asthma?
Which pathological change is commonly observed in bronchi and bronchioles associated with asthma?
What condition is typified by overinflation and mucus plugging in the lungs?
What condition is typified by overinflation and mucus plugging in the lungs?
Flashcards
Bronchial Asthma
Bronchial Asthma
A respiratory condition where the bronchial tubes become overly sensitive to stimuli, leading to bronchospasm (tightening of the airways).
Bronchospasm
Bronchospasm
A sudden tightening of the bronchial tubes, making breathing difficult.
Atopy
Atopy
A tendency to develop allergic reactions.
Extrinsic Asthma
Extrinsic Asthma
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Intrinsic Asthma
Intrinsic Asthma
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Airway Hyper-responsiveness
Airway Hyper-responsiveness
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Type I Hypersensitivity
Type I Hypersensitivity
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Allergen
Allergen
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Lung Hyperinflation in Asthma
Lung Hyperinflation in Asthma
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Thick Bronchi with Mucous Plugs
Thick Bronchi with Mucous Plugs
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Curschmann's Spirals
Curschmann's Spirals
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Charcot-Leyden Crystals
Charcot-Leyden Crystals
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Eosinophils in Asthma
Eosinophils in Asthma
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IL-4, 5, and 13 effect
IL-4, 5, and 13 effect
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Asthma early phase
Asthma early phase
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Asthma late phase
Asthma late phase
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Asthma mediators (early)
Asthma mediators (early)
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Asthma mediators (late)
Asthma mediators (late)
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Asthma lung effects
Asthma lung effects
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Asthma triggering factors
Asthma triggering factors
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Atopic vs. Non-atopic Asthma
Atopic vs. Non-atopic Asthma
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IgE Production in Asthma
IgE Production in Asthma
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Types of Asthma
Types of Asthma
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Early Phase Asthma
Early Phase Asthma
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Late Phase Asthma
Late Phase Asthma
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How do IL-4, 5, and 13 contribute to Asthma?
How do IL-4, 5, and 13 contribute to Asthma?
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What are the main effects of early phase mediators?
What are the main effects of early phase mediators?
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What are the main effects of late phase mediators?
What are the main effects of late phase mediators?
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What happens to the lungs in Asthma?
What happens to the lungs in Asthma?
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What happens to the bronchi and bronchioles in Asthma?
What happens to the bronchi and bronchioles in Asthma?
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What is the main inflammatory cell present in asthma?
What is the main inflammatory cell present in asthma?
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What are Curschmann's spirals?
What are Curschmann's spirals?
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What are Charcot-Leyden crystals?
What are Charcot-Leyden crystals?
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What are the effects of IL-4, 5, and 13 in asthma?
What are the effects of IL-4, 5, and 13 in asthma?
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What lung changes happen in asthma?
What lung changes happen in asthma?
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Study Notes
Bronchial Asthma
- Bronchial asthma is a respiratory condition characterized by increased responsiveness of the bronchial tree to various stimuli, resulting in paroxysms of bronchospasm.
- Reversible bronchospasm can progress to chronic bronchial inflammation, limiting airflow due to bronchoconstriction, mucus plugs, and obstructive lung disease.
- Recurrent episodes of wheezing, breathlessness, and cough are common symptoms, often partially reversible with treatment.
- Between attacks, individuals may be virtually asymptomatic.
Triggering Factors
- Environmental allergens: Domestic dust mites, air pollution, tobacco smoke, occupational irritants, cockroaches, and animal fur.
- Infectious agents: Respiratory viral infections.
- Chemical irritants: Strong chemical irritants.
- Stress: Strong emotional expressions.
- Medications: Aspirin, beta-blockers.
- Food allergies: Certain foods can trigger allergic responses.
- Pollen: Pollen is a common trigger for allergic reactions.
Clinical Picture
- Recurrent episodes of wheezing, breathlessness, and coughing.
- Coughing, usually associated with chest tightness.
- Reversibility of symptoms, with or without medication.
- Asymptomatic periods between episodes.
Pathogenesis of Bronchial Asthma
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Extrinsic (atopic) asthma: This type is associated with a family history of allergies, and involves an exaggerated bronchoconstrictor response (airway hyperresponsiveness) to triggers like pollen or dust mites. The response comes from the immune system's reaction to these allergens.
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In extrinsic allergic asthma, hypersensitivity to triggers is explained by Type 1 hypersensitivity.
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First exposure to the antigen causes stimulation of B-lymphocytes, which transform into IgE-producing plasma cells. This is helped by CD4+ T-lymphocytes. The IgE binds to mast cells and basophils.
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Second exposure to the same antigen causes cross-linking of IgE on mast cells/basophils, triggering their degranulation and releasing chemical mediators.
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Intrinsic (non-atopic) asthma: This type isn't associated with a family history of allergies, and the exact cause is less clear. It can be triggered by factors such as infections, stress, or certain medications (like aspirin).
Pathogenesis of Extrinsic Asthma
- Early phase: Immediate reactions (30-60 minutes after exposure) in which primary mediators (leukotrienes, histamine, platelet-activating factor) are released, causing bronchoconstriction, vasodilation, increased vascular permeability, and mucus secretion.
- Late phase: Delayed reactions (4-8 hours after exposure) producing secondary mediators (eosinophil and neutrophil chemotactic factors, IL-4, IL-5; platelets activating factor) further exacerbating inflammation, attracting eosinophils and neutrophils, and intensely affecting the initial response leading to tissue damage.
Pathogenesis of Non-atopic Asthma
- Different triggering factors compared to atopic asthma.
- Important factors include; infections (especially viral), cold exposure, psychological stress, exercise, and certain irritants like ozone and sulfur dioxide.
- This type of asthma is often triggered by non-allergic factors, and its pathogenesis is less well understood.
Pathology of Bronchial Asthma
- Lung: Overinflation, mucus plugging, and bronchospasm
- Bronchi and bronchioles: Hyperemia, edema of the mucosa, and mucus plugs in the lumen narrowing airways.
- M/E: Patchy necrosis of epithelium, submucosal glandular hyperplasia, hypertrophy of bronchial smooth muscle, eosinophils, mast cells, lymphocytes; mucus plugs (Curschmann’s spirals), and debris of eosinophils (Charcot-Leyden crystals).
Complications
- Bronchopneumonia
- Emphysema
- Massive lung collapse due to mucus plugs
- Death (in severe cases, known as status asthmaticus).
Summary of Asthma
- Type I hypersensitivity: Allergens bind to IgE on mast cells, triggering degranulation and release of mediators (histamine, etc.).
- Inflammation: Characterized by muscle spasm, inflammatory cell infiltration (especially eosinophils), and mucosal inflammation/edema.
- Chronic inflammatory response: The inflammatory process tends to become chronic and persistent in asthma.
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