أسئلة الرابعة باثولوجي RESP (قبل التعديل)

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Questions and Answers

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?

  • Granulomatous inflammation
  • Pleural effusion
  • Curschmann’s spirals (correct)
  • Alveolar wall thickening

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?

<p>Eosinophils (C)</p> Signup and view all the answers

What potential complication may arise due to mucus plug obstruction in asthma?

<p>Massive lung collapse (A)</p> Signup and view all the answers

Which mediators are primarily released during the early phase of an immune reaction to an allergen?

<p>Platelet Activating Factor (B), Histamine (D)</p> Signup and view all the answers

What effect do IL-4, IL-5, and IL-13 have on the immune system?

<p>Stimulation of IgE production (D)</p> Signup and view all the answers

Which statement correctly describes a characteristic of intrinsic asthma?

<p>Can occur at any age, mainly in late adults (C)</p> Signup and view all the answers

What is one of the physiological results of the mediators released during the late phase of an immune reaction?

<p>Increased vascular permeability (C)</p> Signup and view all the answers

Which of the following factors is NOT a triggering agent for asthma?

<p>High humidity (C)</p> Signup and view all the answers

What is the primary phase of an asthma reaction that occurs 30-60 minutes after an allergen is inhaled called?

<p>Early phase (D)</p> Signup and view all the answers

What pathological feature is commonly associated with asthma in the lungs?

<p>Mucous plugging (C)</p> Signup and view all the answers

Which of the following describes the immune response in early phase asthma?

<p>Immediate response with bronchoconstriction (C)</p> Signup and view all the answers

What characterizes the bronchospasm observed in bronchial asthma?

<p>It is an increased responsiveness of the bronchial tree to various stimuli. (D)</p> Signup and view all the answers

Which of the following is NOT a common triggering factor for bronchial asthma?

<p>Ingesting specific foods (D)</p> Signup and view all the answers

What is the primary distinction between atopic and non-atopic asthma?

<p>Atopic asthma has a family history of atopy, while non-atopic does not. (C)</p> Signup and view all the answers

What cellular response is activated during the first exposure to an allergen in atopic asthma?

<p>Transformation of B-lymphocytes to produce IgE. (A)</p> Signup and view all the answers

What does airway hyper-responsiveness in asthma primarily result from?

<p>Bronchial inflammation. (C)</p> Signup and view all the answers

Which of the following cytokines is NOT released during the response of CD4+ T cells in atopic asthma?

<p>IL-10 (D)</p> Signup and view all the answers

What occurs during the second exposure to the same antigen in atopic asthma?

<p>Degranulation of mast cells and release of chemical mediators. (D)</p> Signup and view all the answers

Which of the following statements about asthma symptoms is true?

<p>Symptoms can include wheezing and breathlessness. (C)</p> Signup and view all the answers

Which histological features are most associated with asthma pathology?

<p>Eosinophilia and mucous gland hyperplasia (C)</p> Signup and view all the answers

What pathological change is primarily associated with airway obstruction in asthma?

<p>Mucous plugs with Curschmann's spirals (B)</p> Signup and view all the answers

What is the role of eosinophils in the pathology of asthma?

<p>Causing epithelial damage and inflammation (D)</p> Signup and view all the answers

Which type of immune response is primarily involved in the pathology of asthma?

<p>Type I hypersensitivity (C)</p> Signup and view all the answers

Which effect does inflammatory cell influx have during an asthma attack?

<p>Increased bronchial smooth muscle contraction (D)</p> Signup and view all the answers

What is a key characteristic of bronchial asthma that contributes to its symptoms?

<p>Increased responsiveness of the bronchial tree (D)</p> Signup and view all the answers

Which factor is primarily associated with non-atopic asthma?

<p>Lack of identifiable allergens (D)</p> Signup and view all the answers

What are the primary mediators released during the early phase of an immune reaction to an allergen?

<p>Leucotriens, Histamine, and Platelet Activating Factor (D)</p> Signup and view all the answers

Which mechanism triggers bronchial inflammation in atopic asthma?

<p>Cross-linking of IgE on mast cells (C)</p> Signup and view all the answers

What is one of the primary chemical mediators released during the inflammatory response in asthma?

<p>Histamine (C)</p> Signup and view all the answers

Which phase of the immune reaction develops 4-8 hours after exposure to an allergen?

<p>Late phase (C)</p> Signup and view all the answers

In what way do the mediators released during the late phase affect the site of the lesion?

<p>They increase epithelial cell damage and produce further mediators. (D)</p> Signup and view all the answers

Which of the following best describes airway hyper-responsiveness in asthma?

<p>Exaggerated bronchoconstrictor response (D)</p> Signup and view all the answers

Which of the following is a characteristic feature of intrinsic asthma?

<p>Normal serum IgE levels (A)</p> Signup and view all the answers

Which of the following is a common factor that can trigger asthma symptoms?

<p>Strong emotional expressions (D)</p> Signup and view all the answers

In asthma, which component is essential for the sensitization of T-helper cells?

<p>Release of specific cytokines (C)</p> Signup and view all the answers

What effect do IL-4 and IL-5 have during the late phase of an immune reaction?

<p>Promotion of eosinophil and neutrophil chemotaxis (D)</p> Signup and view all the answers

Which triggering factor is most likely NOT associated with airway hyperreactivity in asthma?

<p>Consumption of dairy products (C)</p> Signup and view all the answers

What primarily differentiates atopic asthma from other forms?

<p>Presence of airway hyper-responsiveness (C)</p> Signup and view all the answers

Which pathological change is commonly observed in bronchi and bronchioles associated with asthma?

<p>Narrowed lumen with increased mucus production (B)</p> Signup and view all the answers

What condition is typified by overinflation and mucus plugging in the lungs?

<p>Bronchial asthma (C)</p> Signup and view all the answers

Flashcards

Bronchial Asthma

A respiratory condition where the bronchial tubes become overly sensitive to stimuli, leading to bronchospasm (tightening of the airways).

Bronchospasm

A sudden tightening of the bronchial tubes, making breathing difficult.

Atopy

A tendency to develop allergic reactions.

Extrinsic Asthma

Allergic asthma triggered by an external allergen.

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Intrinsic Asthma

Asthma caused by non-allergic factors.

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Airway Hyper-responsiveness

An exaggerated response of the airways to certain stimuli.

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Type I Hypersensitivity

An allergic reaction involving IgE antibodies.

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Allergen

A substance that causes an allergic reaction.

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Lung Hyperinflation in Asthma

The lungs become overinflated due to airway obstruction caused by bronchospasm and mucous plugs. This trapping of air reduces lung elasticity and makes breathing difficult.

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Thick Bronchi with Mucous Plugs

In asthma, the bronchi become thickened due to inflammation and are often blocked by thick mucus plugs, further obstructing airflow.

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Curschmann's Spirals

These are tightly coiled, spiral-shaped mucous plugs found in the bronchi of asthmatic patients. They consist of mucus, epithelial cells, and inflammatory cells.

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Charcot-Leyden Crystals

These needle-shaped crystals are found in the sputum of asthmatic patients. They are formed from the breakdown of eosinophils, a type of white blood cell.

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Eosinophils in Asthma

Eosinophils are a type of white blood cell that are abundant in the airways of asthmatic patients. They release chemicals that contribute to inflammation and airway narrowing.

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IL-4, 5, and 13 effect

Stimulate IgE production and mast cell growth.

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Asthma early phase

Starts 30-60 minutes after allergen exposure, involves mediator release.

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Asthma late phase

Develops 4-8 hours after allergen exposure, involves secondary mediator release.

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Asthma mediators (early)

Histamine, leukotrienes, platelet-activating factor; causing bronchoconstriction, inflammation.

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Asthma mediators (late)

Eosinophil and neutrophil chemotactic factors, IL-4 & 5; increase mast cell activation and epithelial damage.

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Asthma lung effects

Overinflation, mucus plugging, and bronchospasm; leading to airway narrowing.

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Asthma triggering factors

Substances or situations that can trigger an asthma attack, such as dust mites, pollen, air pollution, and emotional stress.

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Atopic vs. Non-atopic Asthma

Atopic asthma is linked to allergies and family history, while non-atopic asthma is not, but both types involve airway hyper-responsiveness.

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IgE Production in Asthma

Allergens stimulate the production of IgE antibodies, which bind to mast cells and trigger the release of inflammatory mediators.

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Types of Asthma

Asthma can be classified based on the cause, including extrinsic (allergic) asthma and intrinsic (non-allergic) asthma.

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Early Phase Asthma

The initial reaction to an allergen, occurring 30-60 minutes after exposure. It involves the release of primary mediators like histamine, leukotrienes, and platelet-activating factor.

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Late Phase Asthma

Develops 4-8 hours after allergen exposure. Secondary mediators, such as eosinophil and neutrophil chemotactic factors, are released. This phase intensifies the initial response and causes damage to the airway.

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How do IL-4, 5, and 13 contribute to Asthma?

These interleukins stimulate the production of IgE, a key antibody in allergic reactions, and promote the growth of mast cells, the cells responsible for releasing inflammatory mediators.

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What are the main effects of early phase mediators?

They cause bronchoconstriction (airway narrowing), vasodilatation (blood vessel widening), increased vascular permeability (leaky blood vessels) and mucus secretion.

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What are the main effects of late phase mediators?

They bring in more inflammatory cells (eosinophils and neutrophils) and cause cell damage. These cells amplify the initial response, making asthma symptoms worse.

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What happens to the lungs in Asthma?

The lungs become overinflated, airways are blocked with thick mucus plugs, and bronchospasm occurs, all leading to airway narrowing.

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What happens to the bronchi and bronchioles in Asthma?

The lining of the airways (mucosa) becomes inflamed and swollen, and the airway walls thicken. Thick mucus plugs obstruct the airway lumen.

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What is the main inflammatory cell present in asthma?

Eosinophils are the predominant inflammatory cell type in the airways of asthma patients. They contribute to the inflammation and airway narrowing characteristic of the disease.

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What are Curschmann's spirals?

Curschmann's spirals are tightly coiled, spiral-shaped mucous plugs found in the bronchi of asthmatic patients. They are composed of mucus, epithelial cells, and inflammatory cells.

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What are Charcot-Leyden crystals?

Charcot-Leyden crystals are needle-shaped crystals found in the sputum of asthmatic patients. They are formed from the breakdown of eosinophils.

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What are the effects of IL-4, 5, and 13 in asthma?

Interleukins (IL-4, 5, and 13) play a role in asthma by stimulating IgE production and mast cell growth, contributing to the inflammatory response and allergy development.

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What lung changes happen in asthma?

The lungs in asthma undergo hyperinflation, mucus plugging, and bronchospasm. These changes, caused by airway obstruction, lead to impaired airflow and difficulty breathing.

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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

  • 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.

  • In extrinsic allergic asthma, hypersensitivity to triggers is explained by Type 1 hypersensitivity.

  • 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.

  • Second exposure to the same antigen causes cross-linking of IgE on mast cells/basophils, triggering their degranulation and releasing chemical mediators.

  • 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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