Term
| What is the dominant event leading to CLINICAL symptoms of asthma? |
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Definition
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Term
| What is the strongest predisposing factor for asthma? |
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Definition
| Atopy - dermatitis or allergic rhinitis |
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Term
| What are 5 risk factors for asthma development? |
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Definition
- Parental history
- Atopy diagnosis
- Sensitization to foods
- Blood eosinophilia
- Wheezing apart from colds |
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Term
| What are clinical characteristics of asthma? |
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Definition
- Airway inflammation
- Bronchoconstriction
- Wheezing
- Coughing
- SoB |
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Term
| What are the roles of inflammatory cells in asthma? |
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Definition
• Mast cells – IgE dependent release of mediators – LT, histamine, PGs = bronchoconstriction
• Eosinophils – release proinflammatory mediators, infiltrate in late phase
• Epithelial cells – Release NO, contribute to airway remodeling |
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Term
| What are the roles of inflammatory mediators in asthma? |
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Definition
• Cytokines – Direct inflammatory response, determine asthma severity
• IgE – Common antigens bind to IgE – trigger mast cells
• Leukotrienes – bronchoconstrictors. Inhibit – improvement in lung function |
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Term
| What are the TH1 and TH2 phenotypes? |
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Definition
- TH1 - older siblings, day care, rural environment, infection exposure --> Protective immunity
- TH2 - antibiotic use, westernism, Urban environment, diet, Sensitization to dust --> allergic diseases |
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Term
| What are triggers for asthma? |
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Definition
• Indoor air pollutants – second hand smoke, combustion productions (CO, NO2), Mold/Mildew, volatiles. Dust mites – reduce humidity to 30-50%. Wash clothes in HOT water for smoke. Remove pets
• Outdoor air pollutants – Ozone, particulates (NO2, SO2)
• Other – Exercise, Cold, anxiety, NSAIDs (non-IgE) |
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Term
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Definition
Asthma is REVERSIBLE (unlike COPD), an airway obstruction and hyperresponsiveness
- Bronchoconstriction - causes symptoms. Tx first
- Inflammation - inflammatory response is always turned on, leading to chronic hyperresponsiveness. Tx long term |
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Term
| What are the phases of asthma? |
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Definition
- Early phase - mast cell degraulation releases inflammatory mediators --> inflammation and bronchospasms
- Late phase - infiltration by neutrophils and eosinophils, more release of mediators --> airway remodeling over time
**Exhaled NO measures inflammation |
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