Respiratory Disorders: Bronchial Asthma
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Questions and Answers

What is the primary function of histamine released during mast cell degranulation?

  • To inhibit inflammatory responses
  • To induce smooth muscle constriction and bronchospasm (correct)
  • To induce bronchial relaxation
  • To stimulate mucus secretion
  • What is the source of mediators such as PAFs, prostaglandins, thromboxane, and leukotrienes?

  • Neutrophils (correct)
  • Eosinophils
  • Mast cells
  • Alveolar macrophages
  • What is the function of the 5-lipoxygenase pathway of arachidonic acid metabolism?

  • Production of prostaglandins
  • Production of thromboxane
  • Production of leukotrienes (correct)
  • Production of cytokines
  • What is the primary definition of asthma according to the National Asthma Education and Prevention Program?

    <p>A chronic inflammatory disorder of the airways</p> Signup and view all the answers

    What is the effect of epithelial shedding on airway responsiveness?

    <p>Heightened airway responsiveness</p> Signup and view all the answers

    What are the three most common signs and symptoms of bronchial asthma?

    <p>Cough, dyspnea, wheezing, and chest tightness</p> Signup and view all the answers

    What is the result of the exudative inflammatory process and sloughing of epithelial cells into the airway lumen?

    <p>Impaired mucociliary transport</p> Signup and view all the answers

    What is the primary cause of airflow limitation in asthma?

    <p>All of the above</p> Signup and view all the answers

    What is the characteristic of expectorated mucus from patients with asthma?

    <p>High viscosity</p> Signup and view all the answers

    What type of nerves are involved in maintaining the normal resting tone of airway smooth muscle?

    <p>Parasympathetic nerves</p> Signup and view all the answers

    Which type of receptors in airway smooth muscle produce bronchodilation?

    <p>β2-adrenergic receptors</p> Signup and view all the answers

    What is the primary characteristic of bronchial asthma?

    <p>Chronic airway inflammation</p> Signup and view all the answers

    What is the effect of vagal stimulation on small bronchi?

    <p>Bronchoconstriction</p> Signup and view all the answers

    What is the primary pathogenic mechanism of asthma?

    <p>Bronchial linings overreact to various triggers</p> Signup and view all the answers

    What is the primary function of the non-adrenergic, non-cholinergic nervous system in the trachea and bronchi in asthma?

    <p>To amplify inflammation</p> Signup and view all the answers

    What is the classification of asthma with symptoms occurring more than 2 times a week?

    <p>Mild Persistent</p> Signup and view all the answers

    What is the range of severity of chronic asthma?

    <p>Mild intermittent symptoms to severe disabling disease</p> Signup and view all the answers

    What is the primary response to allergen interaction with mast cell-fixed IgE?

    <p>Release of several spasmogens</p> Signup and view all the answers

    What is the primary etiology of asthma?

    <p>Complex interaction of genetic and environmental factors</p> Signup and view all the answers

    When are the symptoms of asthma most likely to occur?

    <p>At night or early in the morning</p> Signup and view all the answers

    What is the result of the late phase response in asthma?

    <p>Progressing inflammatory reaction</p> Signup and view all the answers

    What is the primary outcome of activation and degranulation of mast cells and basophils?

    <p>Recruitment of inflammatory cells</p> Signup and view all the answers

    What is the primary consequence of inhaled allergens in asthma?

    <p>Activation of airway mast cells and macrophages</p> Signup and view all the answers

    Which type of T-helper cells are involved in allergic inflammation in asthma?

    <p>Type 2 T-helper cells</p> Signup and view all the answers

    What is the primary function of eosinophils in asthma?

    <p>Release of inflammatory mediators</p> Signup and view all the answers

    What is the impact of asthma on lung function in adults?

    <p>Progressive loss of lung function</p> Signup and view all the answers

    What is the primary characteristic of the late-phase inflammatory reaction in asthma?

    <p>Recruitment and activation of eosinophils</p> Signup and view all the answers

    What is the result of an imbalance between TH1 and TH2 cells in asthma?

    <p>Allergic asthmatic inflammation</p> Signup and view all the answers

    What is the primary consequence of plasma protein leakage in asthma?

    <p>Thickening of the airway wall</p> Signup and view all the answers

    What is the risk associated with asthma?

    <p>Life-threatening acute exacerbations and asthma-related death</p> Signup and view all the answers

    What is the hallmark of airway inflammation in asthma?

    <p>Eosinophilic infiltration of the airways</p> Signup and view all the answers

    What is the primary presentation of chronic asthma?

    <p>Daily coughing, shortness of breath, and wheezing</p> Signup and view all the answers

    What is the primary cause of airway narrowing in asthma?

    <p>Contraction of airway smooth muscle</p> Signup and view all the answers

    What is the typical duration of the late-phase response in asthma?

    <p>24-48 hours</p> Signup and view all the answers

    What is the primary diagnostic test for asthma in patients older than 5 years old?

    <p>Spirometry</p> Signup and view all the answers

    What is the characteristic of airway hyperresponsiveness in asthma?

    <p>Exaggerated narrowing of the airways in response to a trigger</p> Signup and view all the answers

    What is the primary characteristic of acute asthma?

    <p>Rapid onset of symptoms within 3-6 hours</p> Signup and view all the answers

    What is the primary component of airway remodeling in asthma?

    <p>Airway smooth muscle hypertrophy</p> Signup and view all the answers

    Study Notes

    Respiratory Disorders

    • Disease or trauma can interfere with the respiratory system's vital work, affecting the conducting airways, lungs, breathing mechanics, and neurochemical control of ventilation.

    Asthma Definition and Pathogenesis

    • Asthma is a chronic inflammatory disorder of the airways, characterized by recurrent episodes of wheezing, breathlessness, chest tightness, and coughing.
    • In susceptible individuals, inflammation causes airflow obstruction that is often reversible either spontaneously or with treatment.
    • The inflammation also causes an increase in bronchial hyperresponsiveness (BHR) to a variety of stimuli.

    Pathogenesis of Bronchial Asthma

    • Bronchial linings overreact to various triggers, causing smooth-muscle spasms that severely constrict the airways.
    • Mucosal edema and thickened secretions further block the airways.
    • Asthma is a complex disorder characterized by chronic airway inflammation, airflow limitation, and symptoms such as wheezing, breathlessness, chest tightness, and coughing.

    Etiology of Asthma

    • Asthma results from a complex interaction of genetic and environmental factors.
    • The severity of chronic disease ranges from mild intermittent symptoms to a severe disabling disease.

    Pathophysiology of Asthma

    • The major characteristics of asthma include a variable degree of airflow obstruction, bronchospasm, edema, and hypersecretion, as well as airway inflammation.
    • Inhaled allergens cause an early-phase allergic reaction, which activates airway mast cells and macrophages, releasing pro-inflammatory mediators that induce contraction of airway smooth muscle, mucus secretion, vasodilation, and exudation of plasma in the airways.

    Late-Phase Inflammatory Reaction

    • The late-phase inflammatory reaction occurs 6 to 9 hours after allergen provocation and involves recruitment and activation of eosinophils, T lymphocytes, basophils, neutrophils, and macrophages.
    • Eosinophils migrate to the airways and release inflammatory mediators, cytotoxic mediators, and cytokines.

    T-Lymphocyte Activation

    • T-lymphocyte activation leads to the release of cytokines from type 2 T-helper (TH2) cells that mediate allergic inflammation.
    • Conversely, type 1 T-helper (TH1) cells produce cytokines that are essential for cellular defense mechanisms.

    Mast Cell Degranulation

    • Mast cell degranulation in response to allergens results in the release of mediators such as histamine, eosinophil chemotactic factor, and leukotrienes.
    • Histamine is capable of inducing smooth muscle constriction and bronchospasm and may play a role in mucosal edema and mucus secretion.

    Airway Hyperresponsiveness

    • Airway hyperresponsiveness is an exaggerated ability of the airways to narrow in response to a variety of stimuli.

    Classification of Asthma

    • Asthma can be classified as mild intermittent, mild persistent, moderate persistent, or severe persistent based on symptoms and lung function.

    Clinical Presentation and Diagnosis

    • Diagnosis is based on a detailed medical history, physical examination of the upper respiratory tract (URT) and skin, and spirometry for pulmonary function tests.
    • Severity ranges from normal pulmonary function with symptoms only during acute exacerbations to significantly decreased pulmonary function with continuous symptoms.

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    Description

    This quiz covers the etiology and pathogenesis of bronchial asthma, a respiratory disorder that affects the conducting airways, lungs, and breathing mechanics. It also explores the neurochemical control of ventilation and its relation to asthma.

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