asthma

Question 1

What is the basic pathophysiology of asthma?

Answer 1

Chronic airway inflammation causing bronchial hyperresponsiveness, reversible airflow obstruction, and mucus overproduction.

Question 2

What cells are involved in asthma inflammation?

Answer 2

Mast cells, eosinophils, T-helper 2 lymphocytes, and macrophages.

Question 2

What mediators cause bronchoconstriction in asthma?

Answer 2

Histamine, leukotrienes, prostaglandins, and cytokines.

Question 2

Why is asthma obstruction reversible?

Answer 2

Because airway narrowing is due to bronchospasm and inflammation, not fixed structural destruction like in COPD.

Question 3

List risk factors for asthma.

Answer 3

Family history, atopy, allergic rhinitis, eczema, smoking exposure, air pollution, obesity.

Question 4

Common triggers of asthma exacerbation?

Answer 4

Dust, pollen, cold air, exercise, viral infections, smoke, stress.

Question 5

Mechanism of salbutamol?

Adverse effects of SABA?

Answer 5

Stimulates β2 receptors → ↑ cAMP → bronchial smooth muscle relaxation

Tremor, tachycardia, palpitations, hypokalemia.

Question 6

Counseling for SABA?

Answer 6

Use as needed for symptoms, carry inhaler at all times, if using >2 times weekly, asthma is not controlled.

Question 7

Mechanism of ICS?
Adverse effects of ICS?

Answer 7

Reduces airway inflammation by suppressing cytokine production.

Oral candidiasis, dysphonia, throat irritation.

Question 8

Important caution with LABA?

Answer 8

Must not be used alone; always combine with inhaled corticosteroid.

Question 9

Why not LABA monotherapy?

Answer 9

Back: Increases risk of severe asthma exacerbation and death.

Question 10

Counseling for ICS?

Answer 10

Use daily even if asymptomatic, rinse mouth after use to prevent oral thrush.

Question 11

Mechanism of montelukast?

Important adverse effect of montelukast?

Answer 11

Blocks leukotriene receptors → reduces bronchoconstriction and inflammation.

AE>Neuropsychiatric effects such as mood changes and nightmares.

Question 12

Mechanism of ipratropium?

Adverse effects of anticholinergics?

Answer 12

Blocks muscarinic receptors → reduces bronchoconstriction.

Dry mouth, blurred vision if sprayed into eyes

Question 13

When are systemic steroids used in asthma?

Major adverse effects of long-term systemic steroids?

Answer 13

Acute exacerbations to reduce airway inflammation.

Hyperglycemia, hypertension, osteoporosis, HPA suppression.

Question 14

What indicates poorly controlled asthma?

Answer 14

Frequent SABA use, night awakenings, limitation of activity, repeated exacerbations.

Question 15

Step-up therapy if asthma uncontrolled on low-dose ICS?

Answer 15

Add LABA or increase ICS dose.

Question 16

First-line maintenance therapy for persistent asthma?

Answer 16

Inhaled corticosteroids.