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Name: Larry Ball
Bio 271- WA 2017SP
PATHOPHYSIOLOGY CASE STUDY - #5 Asthma
ETIOLOGY/CAUSE: The exact cause of asthma is unknown, but it is likely due to a combination of environmental and genetic factors. There has been an increase ion asthma in individuals who are frequently exposed to environmental allergens, such as cigarette smoke or dust mites. Other substances and irritants that can trigger asthma are airborne allergens, such as pollen, animal dander, mold, and cockroaches; respiratory infections, such as common cold, physical activity, cold air, stress, GERD, and some preservatives added to some types of foods and beverages.
SIGNS/SYMPTOMS: Clinical manifestations vary from person to person. They range from infrequent attacks, having symptoms only at certain times (such as when exercising) or having symptom s all the time. During remission, there may not be any signs or symptoms, but during an exacerbation, some or all of the following could be experienced: shortness of breath, chest pain/tightness, wheezing, excessive sputum production, coughing (particularly at night or early morning), anxiety, tachypnea, etc.
ORGAN(S)/ORGAN SYSTEM(S) INVOLVED: Immune system, respiratory system, integumentary system, cartilaginous bronchi, membranous bronchi, and gas-exchanging bronchi termed the respiratory bronchioles and alveolar ducts, terminal bronchioles, mucosa, basement membrane, a smooth muscle matrix extending to the alveolar entrances, connective tissue, mast cells, basophils, eosinophils, neutrophils, macrophages, stretch and irritant receptors, cholinergic motor nerves, etc.
PATHOPHYSIOLOGY/PATHOGENESIS: (DESCRIPTION OF EFFECTS ON CELLS-TISSUES-ORGANS): Upon exposer to a trigger, an IgE-mediated hypersensitivity reaction is immediate. IgE mast cells are stimulated to release chemical mediators which promote increased edema and subsequent bronchoconstriction in the airways. Additional products of inflammation also move into the area, as well as histamine and prostaglandins arriving a little while later. Approximately 6-24 hours after exposure, leukotrienes are released which further stimulate bronchospasm, swelling, and excessive mucus production in the airways. Chronic mucous plug formation consists of an exudate of serum proteins and cell debris that may take weeks to resolve. Airway remodeling is associated with structural changes due to long-standing inflammation and may profoundly affect the extent of reversibility of airway obstruction.
DIAGNOSTIC TESTS: Some diagnostic tests used to determine asthma are: patient history, physical exam, including evaluating signs and symptoms to determine triggers and decide the likelihood that the manifestations are actually asthma, lab studies/ABG, possible PFTs, with or without spirometry, peak flow, etc., imaging tests, allergy testing, methacholine challenge, etc.
TREATMENT: Treatment options for asthma are composed of four major components: 1) Monitoring lung functions, 2) controlling environmental triggers, 3) pharmacologic therapy, and 4) patient education to facilitate adherence to treatment plan. Also, an essential aspect of patient care should be a written action plan which outlines methods for avoiding triggers and describes what to when an asthma exacerbation occurs.
PROGNOSIS: In 2009 US asthma mortality rates were reported at one death per 100,000 persons, primarily related to ling function, but mortality has been also linked with asthma management failure, special in young persons. Other factors that impact mortality include age older than 40 years, cigarette smoking more than 20 pack-years, blood eosinophilia, forced expiratory volume in one second of 40-69% who develop asthma at an older age tend to develop long-term changes over time (i.e., airway remodeling). This can lead to chronic symptoms and significant irreversible components to their disease.
NATIONAL ASSOCIATION? IF YES-WEBSITE-ADDRESS ECT. Associations do exist for Asthma and Allergy Foundations but I was unable to find any specific "National Associations" for Asthma.
NEW RESEARCH/TREATMENT: (MAY OR MAY NOT FIND) http://www.cardiff.ac.uk/news/view/96649-researchers-hugely-exciting-asthma-discovery
INTERESTING FACTS: (MAY OR MAY NOT FIND) None Found
3 REFERENCES- MAY USE OUR TEXT, DISEASE'S NATIONAL ASSOCIATION WEBSITE, OTHER TEXT OR JOURNAL ARTICLE FROM MEDLINE ECT. DO NOT USE PERSONAL WEBSITES OF PERSONS WITH THE DISEASE.
Pathophysiology - A Clinical Approach 2nd Edition
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