أسئلة المحاضرة الرابعة باثولوجي RESP (قبل التعديل)

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Questions and Answers

What is a characteristic symptom of bronchial asthma?

  • Consistent cough without wheezing
  • Paroxysms of bronchospasm (correct)
  • Continuous chest pain
  • Severe headaches

Which type of asthma is associated with a family history of atopy?

  • Occupational asthma
  • Intrinsic asthma
  • Non-atopic asthma
  • Extrinsic (allergic) asthma (correct)

Which of the following factors can trigger bronchial asthma?

  • Excessive physical exercise
  • Low humidity levels
  • Consumption of fruits
  • Emotional stress (correct)

What causes airway hyper-responsiveness in asthma patients?

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

What is one of the primary mediators released during the early phase of an immune reaction?

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

Which immune response is primarily involved in the extrinsic (allergic) form of asthma?

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

Which cytokine is associated with the growth of mast cells?

<p>IL-4 (B), IL-13 (C)</p> Signup and view all the answers

What role do CD4+ T-lymphocytes play in asthma?

<p>They assist in the release of pro-inflammatory cytokines (A)</p> Signup and view all the answers

What characterizes late phase immune reactions following allergen exposure?

<p>Eosinophil infiltration (B)</p> Signup and view all the answers

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

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

What can happen between asthma attacks for most patients?

<p>Near-normal respiratory function (B)</p> Signup and view all the answers

What is a common consequence of chronic bronchial inflammation in asthma?

<p>Increased airflow obstruction (B)</p> Signup and view all the answers

What is a common characteristic of intrinsic asthma?

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

What physiological change is associated with mucus plugging in asthma?

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

Which of the following mediators would likely be released during the late phase of an immune response?

<p>Leukotrienes (A)</p> Signup and view all the answers

What is a characteristic of the airways in an asthmatic patient?

<p>Narrow lumen with mucus plug (A)</p> Signup and view all the answers

Which histological feature is primarily associated with bronchial asthma?

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

What type of hypersensitivity reaction is involved in asthma?

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

What is a common microscopic finding in the airway epithelium of patients with asthma?

<p>Patchy necrosis of epithelium (B)</p> Signup and view all the answers

Which inflammatory cells are typically found in the airways of asthma patients?

<p>Eosinophils and mast cells (D)</p> Signup and view all the answers

What potential complication may arise from bronchial obstruction due to mucous plugs in asthma?

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

Which microscopic feature is specifically associated with mucus accumulation in asthma?

<p>Curschmann’s spirals (A)</p> Signup and view all the answers

What is the role of mast cells in an asthma attack?

<p>Releasing histamine (D)</p> Signup and view all the answers

Which of the following is NOT associated with chronic inflammation in asthma patients?

<p>Acute bronchospasm (D)</p> Signup and view all the answers

Which inflammatory cell type is predominantly found in patients suffering from asthma?

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

Which pathological change in asthma can lead to severe complications such as lung collapse?

<p>Bronchial obstruction by mucus plugs (A)</p> Signup and view all the answers

What is one of the primary outcomes of the late phase immune response in asthma?

<p>Release of eosinophil chemotactic factors (A)</p> Signup and view all the answers

Which cells are primarily responsible for the increased inflammation seen in asthma during the late phase response?

<p>Neutrophils and eosinophils (B)</p> Signup and view all the answers

What characterizes the bronchoconstrictor response in asthma patients?

<p>An exaggerated response to triggering factors (A)</p> Signup and view all the answers

What describes the airway changes associated with bronchial asthma?

<p>Hyperinflation of the lung and mucus plugging (B)</p> Signup and view all the answers

Which cytokines are specifically associated with the activation of B-lymphocytes in asthma?

<p>IL-4, IL-5, and IL-13 (C)</p> Signup and view all the answers

Which of the following factors can increase airway hyperreactivity in asthmatic subjects?

<p>Stressed emotional states (A), Cold weather (C)</p> Signup and view all the answers

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

<p>Presence of family history of atopy (B)</p> Signup and view all the answers

What is the role of leukotrienes in the immune response of asthma?

<p>They produce bronchoconstriction and increase mucin secretion. (C)</p> Signup and view all the answers

What triggers the degranulation of mast cells during an asthma episode?

<p>The cross-linking of IgE on mast cells (D)</p> Signup and view all the answers

What role do CD4+ T-lymphocytes have in the development of asthma?

<p>Supporting the activation of B-lymphocytes in IgE production (D)</p> Signup and view all the answers

The development of asthma in children is often associated with which of the following characteristics?

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

What is a common physiological consequence of chronic bronchial inflammation in asthma?

<p>Airflow limitation due to bronchoconstriction (A)</p> Signup and view all the answers

In which type of asthma do respiratory tract infections serve as a common triggering factor?

<p>Intrinsic (non-allergic) asthma (B)</p> Signup and view all the answers

Which of the following accurately describes the physiologic effects of primary mediators released during the early phase of an immune reaction in asthma?

<p>Vasodilation, increased vascular permeability, and bronchoconstriction (B)</p> Signup and view all the answers

Which of the following is considered an intrinsic factor that may contribute to asthma?

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

What is the mechanism by which allergens cause airway hyperresponsiveness in asthma?

<p>Activation of type I hypersensitivity pathways (D)</p> Signup and view all the answers

Flashcards

Bronchial Asthma

A respiratory condition characterized by increased airway responsiveness, leading to bronchospasm and inflammation. This causes recurrent episodes of wheezing, breathlessness, and cough.

Bronchospasm

Sudden tightening and narrowing of the bronchial tubes.

Atopy

A predisposition to developing allergic diseases like asthma, with a family history of similar conditions.

Extrinsic (Allergic) Asthma

Asthma triggered by an allergic reaction to specific allergens, involving type I hypersensitivity.

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Intrinsic Asthma

Asthma with no clear identified trigger or allergic link.

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Airway Hyper-responsiveness

An exaggerated response of the airways to various stimuli.

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IgE

An antibody that plays a key role in allergic reactions.

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Triggers (Asthma)

Substances or factors that can initiate an asthma attack.

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IL-4,5,13 role in asthma

IL-4, IL-5, and IL-13 stimulate IgE production and mast cell growth, playing a key role in the allergic response in asthma.

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Early phase asthma response

The initial response to an allergen, occurring 30-60 minutes after exposure, involving the release of mediators like leukotrienes, histamine, and platelet-activating factor, leading to bronchoconstriction and inflammation.

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Late phase asthma response

The later inflammatory response to an allergen, occurring 4-8 hours after exposure, involving the release of secondary mediators and intensified inflammatory response from eosinophils and neutrophils, further damaging the airway.

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Extrinsic Asthma (Atopy)

Asthma driven by an allergic response and mediated by type I hypersensitivity to environmental antigens, often in childhood and with family history of allergy.

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Intrinsic Asthma (Non-Atopy)

Asthma not associated with a clear allergic response, often in adults, triggered by factors like respiratory infections, irritants or aspirin.

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Asthma lung changes

Asthma causes over-inflation of the lungs, mucus buildup in the airways, and narrowed airways due to bronchospasm.

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Asthma triggering factors

Asthma symptoms can be triggered by various factors like aspirin, infections, cold exposure, stress, exercise, and inhaled irritants.

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Asthma airway changes

Asthma leads to inflamed and swollen bronchial and bronchiole airways, which are often narrowed and plugged with mucus.

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Asthma's M/E (Microscopic Exam)

Asthma microscopic examination shows glandular hyperplasia, mucous plug in the lumen, and inflammation.

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Asthma Inflammation

Asthma involves chronic inflammation with an influx of inflammatory cells like eosinophils.

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Curschmann's Spirals

Whorled mucous plugs found in asthma.

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Charcot-Leyden Crystals

Eosinophil debris found in asthma.

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Type I Hypersensitivity (Asthma)

Allergens binding to IgE on mast cells trigger degranulation in asthma.

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What are Curschmann's Spirals?

Whorled mucous plugs found in the airways of asthmatic patients, caused by the accumulation of thick mucus and cellular debris.

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What are Charcot-Leyden crystals?

Crystals formed from the breakdown of eosinophil granules, commonly found in the sputum of asthmatic patients.

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What's the role of IgE in asthma?

Allergens bind to IgE antibodies on mast cells, triggering the release of inflammatory mediators like histamine, leading to bronchospasm and airway inflammation.

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Explain Type I Hypersensitivity in asthma.

An allergic reaction where allergens bind to IgE on mast cells, leading to degranulation and the release of histamine and other inflammatory mediators.

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Describe the role of eosinophils in asthma.

Eosinophils, a type of white blood cell, play a significant role in asthma inflammation. They release inflammatory mediators and contribute to airway remodeling.

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IL-4, IL-5, IL-13 in Asthma

These interleukins play a key role in the allergic response in asthma by stimulating the production of IgE antibodies and the growth of mast cells.

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Asthma Triggers (Extrinsic)

These factors include dust, pollen, and food. They trigger an allergic response in individuals with atopic asthma.

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Asthma Triggers (Intrinsic)

These factors involve triggers that are not related to allergies, including respiratory infections, aspirin, cold exposure, stress, exercise, and inhaled irritants.

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Asthma Airway Changes (Microscopic)

Asthma causes inflammation and swelling of the bronchial and bronchiole airways. These airways are often narrowed and plugged with mucus.

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Asthma Microscopic Examination

Microscopic examination of the airways of an asthma patient reveals glandular hyperplasia, mucous plugs in the lumen, and inflammation.

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Asthma Triggers

Substances or factors that can initiate an asthma attack, such as dust mites, pollen, air pollution, tobacco smoke, and respiratory infections.

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Atopic vs. Non-Atopic Asthma

Atopic asthma has a family history of allergies and is triggered by allergens, while non-atopic asthma doesn't have a clear allergic link.

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Asthma and IgE

In atopic asthma, IgE antibodies bind to mast cells, and when exposed to allergens, they release inflammatory chemicals that trigger bronchospasm.

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Asthma's Early Phase Response

The immediate response to an allergen, occurring within 30-60 minutes, causing bronchospasm and inflammation.

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Asthma's Late Phase Response

The delayed inflammatory response to an allergen, occurring 4-8 hours after exposure, intensifying inflammation and airway damage.

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Bronchospasm in Asthma

The sudden tightening and narrowing of the bronchial tubes caused by muscle contractions, making it difficult to breathe.

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Asthma's Microscopic Changes

Under the microscope, asthma lungs show glandular hyperplasia, mucus plugs in the airways, and chronic inflammation.

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Charcot-Leyden Crystals in Asthma

Crystallized eosinophil debris found in asthma, indicating the presence of these inflammatory cells.

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Study Notes

Bronchial Asthma

  • Bronchial asthma is a condition characterized by increased responsiveness of the bronchial tree to various stimuli, resulting in paroxysms of bronchospasm.
  • This bronchospasm can be reversible in the early stages but may progress to chronic bronchial inflammation and airflow limitation due to bronchoconstriction and mucus plugs.
  • Recurrent episodes of wheezing, breathlessness, and coughing are characteristic, occasionally with periods of symptom-free intervals.

Clinical Presentation of Bronchial Asthma

  • Recurrent episodes of wheezing, breathlessness, and cough, that show partial or full reversibility with treatment or spontaneously.
  • Asymptomatic periods between acute episodes are common.

Triggering Factors of Bronchial Asthma

  • Environmental: Domestic dust mites, air pollution, tobacco smoke, occupational irritants, cockroach allergens, animal fur, pollen, respiratory viral infections.
  • Other: Chemical irritants, strong emotional expressions, and certain drugs (e.g., aspirin, beta-blockers).

Pathogenesis of Bronchial Asthma

  • Atopic: Involves a family history of atopy (allergic conditions). Characterized by exaggerated bronchoconstrictor responses to triggering factors, particularly allergens.
  • Non-atopic: Lacking a family history of atopy and hypersensitivity to certain factors like aspirin or viruses.
  • Early Phase (30-60 minutes): Release of primary mediators like leukotrienes, histamine, platelet-activating factor causing bronchoconstriction, vasodilation, and increased vascular permeability.
  • Late Phase (4-8 hours): Secondary mediators like eosinophil and neutrophil chemotactic factors, IL-4, and 5 are involved, leading to further inflammation, edema, mucous plugs, and damage to the epithelial lining.

Pathophysiology of Extrinsic Asthma

  • Initial exposure to an allergen leads to sensitization of TH2 cells, which release cytokines like IL-4, 5, and 13. These cytokines stimulate IgE production and mast cell growth.
  • Secondary exposure to the same allergen leads to cross-linking of IgE on mast cell surface.
  • This triggers degranulation and release of chemical mediators, causing an inflammatory response. This results in bronchoconstriction and other symptoms.

Pathophysiology of Intrisic Asthma

  • The exact cause is often less clear than with allergic asthma.
  • Non-atopic factors such as viral infections and irritants can trigger an inflammatory response, leading to airway hyperresponsiveness.

Pathological Findings (Microscopic & Macroscopic)

  • Lung: Over-inflation, mucous plugging, and bronchospasm are observed.
  • Bronchi and Bronchioles: Mucosa is hyperemic, edematous, with thick-walled, narrow lumens often plugged by mucus.
  • Other Features: Patchy necrosis of epithelium, submucosal glandular hyperplasia, hypertrophy of bronchial smooth muscle, eosinophils, mast cells, lymphocytes, mucous plugs (Curschmann spirals), debris of eosinophils (Charcot-Leyden crystals) are present in the deeper tissues.

Complications of Bronchial Asthma

  • Bronchopneumonia: Inflammation in the bronchi and surrounding lung tissue.
  • Emphysema: Over-inflation and damage to lung alveoli.
  • Status Asthmaticus: A severe, potentially life-threatening, acute episode of asthma that does not respond to usual treatments.
  • Massive Lung Collapse: Blockage in the airways by mucus plugs can lead to partial or complete lung filling.

Summary

  • Bronchial asthma is characterized by chronic airway inflammation, hyperresponsiveness, and reversible bronchospasm.
  • There are distinct types (intrinsic and extrinsic).
  • Allergens and non-allergic triggers are involved which initiate a cascade of events leading to symptoms.
  • Complications can range from pneumonia to life-threatening conditions.

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