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• 1 Asthma

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• What is status asthmaticus

  Severe form of asthma that does not respond to bronchodilator or corticoid therapy and can persist for several days or even weeks.
  The lungs cannot ventilate properly. Organ malfunction occurs due to depleted supplies of O2. Lack of CO2 removal means that acidosis can occur. Air cannot move into or out of the lung so severe breathlessness occurs. Ventilation and multiple medications are needed.

• What causes epithelial desquamatation?

  Major basic protein secreted by the eosinophils

• What do IL-2, IL-4, IL-5 and IL-13 do in relation to asthma?

  IL-2: differentiation and clonal expansion of TH2 cells
  IL-4: Production of IgE
  IL-5: recruitment of eosinophils
  IL-13: recruitment of eosinphils, release of mucus from submucosal glands and production of IgE.

• Which leukotrienes are released during an asthma attack?

  LTC4, LTD4 and LTDE- cause constriction of bronchial smooth muscle cells, increase vascular permeability and increase bronchial secretions.

• What is the role of gender re asthma?

  Prevalence of asthma is greater in boys before puberty. Reverses after puberty.

• What is the layman's definition of asthma?

  Asthma is a condition in where the airways narrow reversibly in response to certain stimuli that would otherwise be harmful.
  Usually first appears during childhood and may continue into adulthood.

• Which receptors are present on bronchial smooth muscle cells? What happens to them during an asthma attack?

  Cholinergic- bind to acetylcholine cause constriction.
  Adrenergic- bind to adrenaline/noradrenaline and cause relaxaion
  Peptidergic- bind to neurokinins and cause constriction.
  In asthma, it is the inappropriate activation of the cholinergic and the peptidergic receptors that cause constriction.  
  Certain cells can release substances that will bind to these receptors and will result in muscle contraction.

• What are the typical symptoms of asthma?

  Wheezing, coughing, airway obstruction, chest tightness, dyspnea, excessive mucus production

• What is the pathophysiology of bronchial hyperresponsiveness?

  The release of certain cytotoxic chemicals can damage the epithelial cell wall lining and contribute to hyperresponsiveness.
  Inappropriate activation of local axons and the vagus nerve can cause constriction of the smooth muscles.
  Responsible for coughing.
  The nerve endings become more sensitive in response to inflammation.

• What happens during an asthma attack?

  Asthma attacks can manifest suddenly or gradually.
  Shortness of breath, fatigue and chest tightness are usually the first signs.
  Bronchoconstriction and inflammation occurs. Inflammation leads to the secretion of mucus. Epithelial cells may be shed and fall into the mucus plug forming the whirls. All of this obstructs the airways.
  Pulse fastens, sweating and anxiety occurs. Confusion, lethargy and cynosis can occur.
  Wheezing develops during expiration, but may eventually stop as the individual struggles to pass air into and out of the lung.
  In severe cases, the alveoli can rupture - pneumothorax may develop.