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Pathophysiology

- The underlying pathophysiology of asthma is reversible and diffuse airway inflammation that leads to airway narrowing and obstruction.

- The inflammation is mediated by various cells and molecules such as mast cells, eosinophils, basophils, neutrophils, lymphocytes, macrophages, cytokines, chemokines, leukotrienes, prostaglandins, histamine, and nitric oxide.

- The inflammation results in two main processes:

  • Bronchoconstriction
  • airway remodeling

- Bronchoconstriction is the acute contraction of the smooth muscle in the bronchial walls that reduces the diameter of the airways and increases the resistance to airflow.

- Bronchoconstriction can be triggered by exposure to allergens, irritants, cold air, exercise, or emotional stress.

- Bronchoconstriction can be reversed by bronchodilators such as beta2-agonists that relax the smooth muscle.

- Airway remodeling is the chronic structural change in the airways that occurs due to prolonged inflammation and tissue damage.

- Airway remodeling can include subepithelial fibrosis, increased smooth muscle mass, mucus hypersecretion, goblet cell hyperplasia, epithelial cell shedding, angiogenesis, and edema. Airway remodeling can lead to irreversible airflow limitation and reduced responsiveness to bronchodilators.

Questions on Pathophysiology

Correct Answer is B

Explanation

Incorrect. Asthma is not an autoimmune disorder and does not primarily affect the joints.

Correct Answer is C

Explanation

Incorrect. Asthma is a chronic condition, and while symptoms may improve with treatment, it does not typically resolve on its own within a few days.

Correct Answer is C

Explanation

Incorrect. Asthma is not a bacterial infection but a chronic respiratory condition.

Correct Answer is D

Explanation

Correct. Asthma is a common chronic respiratory condition characterized by airway inflammation and narrowing.

Correct Answer is D

Explanation

Correct Answer: D) "Asthma is a chronic respiratory condition that involves the narrowing of the airways."Rationale:

Correct Answer is C

Explanation

Incorrect. Asthma primarily involves airway inflammation and narrowing, not a lack of oxygen in the bloodstream.

Correct Answer is B

Explanation

Incorrect. Mast cells do not produce antibodies to protect against asthma attacks.

Correct Answer is C

Explanation

Incorrect. Asthma does affect the structure of the airways, primarily through inflammation and airway remodeling in the long term.

Correct Answer is D

Explanation

Correct. Eosinophils are white blood cells that contribute to inflammation and airway damage in asthma by releasing inflammatory substances.

Correct Answer is B

Explanation

Incorrect. Bronchial smooth muscle does not release antibodies to protect against asthma attacks.

Correct Answer is C

Explanation

Incorrect. While emotional stress and anxiety can exacerbate asthma symptoms, they are not the sole triggers of the condition.

Correct Answer is B

Explanation

Incorrect. Avoiding all exercise is not necessary for asthma prevention and can lead to other health problems. Properly managed exercise can be beneficial for individuals with asthma.

Correct Answer is D

Explanation

Correct. Respiratory infections, especially during early childhood, can be a risk factor for the development of asthma.

Correct Answer is B

Explanation

Incorrect. Allergies are one of several potential factors that can contribute to asthma, but they are not the sole cause.

Correct Answer is C

Explanation

Incorrect. Having a diet low in processed foods may be associated with better overall health but is not a direct risk factor for asthma.

Correct Answer is B

Explanation

Incorrect. Difficulty speaking in full sentences is a more advanced symptom that may occur during an asthma attack.

Correct Answer is D

Explanation

Correct. Frequent coughing and the production of thick mucus can be indicative of asthma, especially during exacerbations.

Correct Answer is C

Explanation

Incorrect. Mild chest tightness after exposure to allergens is a common symptom of asthma but may not necessarily indicate a severe attack.

Incorrect. Improved lung function and increased energy at night are not characteristic of asthma; in fact, asthma symptoms often worsen at night.

Incorrect. Infrequent nighttime awakenings due to asthma may be a sign of well-controlled asthma but do not necessarily signal an exacerbation.

Correct. Spirometry is a common lung function test used to assess airflow and determine the presence and severity of asthma.

Incorrect. Checking for specific antibodies related to asthma is not a primary diagnostic test for asthma; it is more commonly associated with allergies.

Incorrect. Evaluating bone density and fracture risk is not related to peak flow monitoring.

Incorrect. ESR is a nonspecific test used to detect inflammation in the body but is not specific to asthma diagnosis.

Correct. A skin prick test, also known as a skin allergy test or scratch test, involves applying small amounts of allergens to the skin and monitoring for allergic reactions, helping identify specific allergens triggering asthma symptoms.

Incorrect. While asthma action plans may mention triggers, their primary function is to guide actions during asthma attacks.

Incorrect. ICS are not used to treat acute allergic reactions; they are aimed at preventing asthma symptoms over time.

Incorrect. Peak flow measurements are a valuable tool in asthma management and are related to monitoring and controlling asthma symptoms.

Incorrect. Bronchodilators are not used to treat allergic reactions; they are used to relieve acute bronchoconstriction associated with asthma.

Correct. Outdoor allergens like pollen can trigger asthma symptoms in many individuals, so avoiding exposure is an important part of asthma management.

Incorrect. Pet fur and dander can be potent asthma triggers, and regular cleaning and reducing exposure to these allergens are essential for asthma management.

Correct. The correct technique involves standing with feet together and exhaling gently but forcefully into the peak flow meter.

Correct. A spacer device helps ensure that more of the medication reaches the lungs by slowing down and dispersing the spray from the inhaler, making it easier to inhale effectively.

Incorrect. There is no specific benefit to using a rescue inhaler before bedtime unless asthma symptoms are present at that time.

Incorrect. Spacers are designed to make inhalers easier to use correctly, not more challenging.
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