Questions and Answers
What is bronchial asthma?
A common and potentially serious chronic disease that causes respiratory symptoms and flare-ups.
What are the three main airway problems associated with asthma?
Genetics play a role in the development of asthma.
True
What is atopy?
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Which of the following are recognized causes of asthma? (Select all that apply)
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Name one common complication of bronchial asthma.
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Asthma is a chronic inflammatory lung disease involving recurrent breathing problems known as ______.
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List one type of medication used in the treatment of bronchial asthma.
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What is the primary mechanism of bronchoconstriction in asthma?
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Match the type of asthma with its characteristic:
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Study Notes
Bronchial Asthma Overview
- Bronchial asthma is a chronic inflammatory lung disease with significant respiratory symptoms, activity limitations, and potential for life-threatening flare-ups.
- Characterized by three primary airway issues: obstruction, inflammation, and hyperresponsiveness.
Definition and Etiology
- Asthma implies difficulty in breathing; main symptoms include dyspnea, cough, and wheezing.
- Risk factors include:
- Activity: Exercise-induced asthma.
- Diet: Allergens in eggs, fish, and milk.
- Drugs: Reactions to aspirin and penicillin.
- Family history: Correlation with urticaria and hay fever.
- Inhalants: Tobacco smoke, dust, pollen, and molds.
- Infections: Sources like tonsillitis and bronchitis.
- Hormonal influences: Variations during pregnancy, menstruation, and menopause.
Genetic and Environmental Factors
- Genetic predisposition; the risk increases significantly if one or both parents have asthma.
- Atopic conditions are essential in asthma development, with environmental allergens provoking IgE antibody overproduction.
- Obesity and stress also contribute to the exacerbation of asthma symptoms.
Types and Phenotypes of Asthma
- Atopic Asthma: Most common variant, linked to allergies and high levels of IgE.
- Allergic Bronchopulmonary Mycosis (ABPM): Hypersensitivity to molds, especially Aspergillus fumigatus.
- Aspirin-sensitive Asthma (ASA): Onset typically in adulthood; severe reactions after NSAID use.
Pathogenesis and Clinical Features
- Triggers lead to inflammatory cell activation (mast cells, eosinophils, etc.) releasing mediators like histamine, causing bronchoconstriction and airway hyperresponsiveness.
- Clinical signs include:
- General signs: Tachypnea, tachycardia, prolonged expiration.
- Local signs: Hyperinflation, use of accessory muscles, wheezing, diminished breath sounds.
Diagnostic Investigations
- Chest X-ray, sputum analysis, blood tests, allergy tests, ECG, pulmonary function tests (PFT), bronchial provocation tests, and exercise testing.
Complications of Asthma
- Severe complications can include status asthmaticus, COPD development, respiratory failure, cor pulmonale, pneumothorax, and allergic aspergillosis.
Acute Severe Asthma (Status Asthmaticus)
- A progressive, severe asthma attack persisting for more than 6 hours, requiring immediate intervention.
- Symptoms include tachypnea, cyanosis, and potential vascular collapse.
Management Strategies
- Therapeutic: Inhaled bronchodilators (short and long-acting), anti-inflammatory drugs (corticosteroids, leukotriene inhibitors), and antihistamines.
- Long-term management: Avoidance of triggers and adherence to inhaler therapy.
Stepwise Treatment Approach
- Step 1: Intermittent treatment with short-acting B2 agonists.
- Step 2: Adding inhaled corticosteroids for mild asthma.
- Step 3: Combination therapy for moderate cases.
- Step 4: Intensive management for severe asthma.
Emergency Care for Acute Exacerbation
- Indications for ICU transfer include PaCO2 > 40 mmHg or PEF < 25% of baseline.
- ICU treatment involves frequent nebulization of B2 agonists, intravenous hydration, and potential intubation if necessary.
Contact Information
- Ass. Prof. Ragia Sharshar, Faculty of Medicine, Tanta University.
- Email: [email protected]
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Description
This quiz covers key concepts and principles related to bronchial asthma as part of the Respiratory course in the Competency-based Medical Bachelor Program. Learn about the pathophysiology, diagnosis, and management of this common respiratory condition. Test your knowledge and prepare effectively for your upcoming assessments.
