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?

Eosinophils Signup and view all the answers

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

Massive lung collapse Signup and view all the answers

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

Platelet Activating Factor Signup and view all the answers

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

Stimulation of IgE production Signup and view all the answers

Which statement correctly describes a characteristic of intrinsic asthma?

Can occur at any age, mainly in late adults 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?

Increased vascular permeability Signup and view all the answers

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

High humidity 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?

Early phase Signup and view all the answers

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

Mucous plugging Signup and view all the answers

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

Immediate response with bronchoconstriction Signup and view all the answers

What characterizes the bronchospasm observed in bronchial asthma?

It is an increased responsiveness of the bronchial tree to various stimuli. Signup and view all the answers

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

Ingesting specific foods Signup and view all the answers

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

Atopic asthma has a family history of atopy, while non-atopic does not. Signup and view all the answers

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

Transformation of B-lymphocytes to produce IgE. Signup and view all the answers

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

Bronchial inflammation. Signup and view all the answers

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

IL-10 Signup and view all the answers

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

Degranulation of mast cells and release of chemical mediators. Signup and view all the answers

Which of the following statements about asthma symptoms is true?

Symptoms can include wheezing and breathlessness. Signup and view all the answers

Which histological features are most associated with asthma pathology?

Eosinophilia and mucous gland hyperplasia Signup and view all the answers

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

Mucous plugs with Curschmann's spirals Signup and view all the answers

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

Causing epithelial damage and inflammation Signup and view all the answers

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

Type I hypersensitivity Signup and view all the answers

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

Increased bronchial smooth muscle contraction Signup and view all the answers

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

Increased responsiveness of the bronchial tree Signup and view all the answers

Which factor is primarily associated with non-atopic asthma?

Lack of identifiable allergens Signup and view all the answers

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

Leucotriens, Histamine, and Platelet Activating Factor Signup and view all the answers

Which mechanism triggers bronchial inflammation in atopic asthma?

Cross-linking of IgE on mast cells Signup and view all the answers

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

Histamine Signup and view all the answers

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

Late phase Signup and view all the answers

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

They increase epithelial cell damage and produce further mediators. Signup and view all the answers

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

Exaggerated bronchoconstrictor response Signup and view all the answers

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

Normal serum IgE levels Signup and view all the answers

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

Strong emotional expressions Signup and view all the answers

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

Release of specific cytokines Signup and view all the answers

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

Promotion of eosinophil and neutrophil chemotaxis Signup and view all the answers

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

Consumption of dairy products Signup and view all the answers

What primarily differentiates atopic asthma from other forms?

Presence of airway hyper-responsiveness Signup and view all the answers

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

Narrowed lumen with increased mucus production Signup and view all the answers

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

Bronchial asthma Signup and view all the answers

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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