NURS 165 Study Guide - Final Guide: Mucous Gland, Major Basic Protein, Palpitations
Asthma Patho Study Guide
• Obstructive vs. Restrictive Lung Diseases
o Obstructive: increased resistance to airflow
o Restrictive: decreased expansion of lungs
• Asthma is a chronic OBSTRUCTIVE lung disease
o Airway inflammation
o May be reversible – test by administering bronchodilator med
o Airways can become reactive and have hypersensitivity (allergic)
reactions
▪ Can lead to remodeling, like in heart
o Bronchial contractions → asthma attack. Manifested by:
▪ Wheezing
▪ Dyspnea (labored breathing)
▪ Cough
• Pathogenesis
o Mix of genetic and environmental factors
o Often beings in childhood
o Damage to lower airways (like in lungs) due to
▪ Tobacco smoke
▪ Working in a factory, etc.
o Recurrent asthma attacks lead to higher presence of inflammatory
cells and airway remodeling → causes more asthma attacks (like a
catch 22)
• Pediatric Asthma
o Most chronic childhood disease (9.8% of children)
o Children’s airways normally narrower than adult’s → they have
proportionally greater inflammation
o 80% is before age 6, may or may not persist to adulthood
o 16% of blacks, 9% Hispanics, 8% whites
o 13% poor kids, 8% not poor kids
• Adult Asthma
o 8% of US population
o Most cases develop before age 25, but can occur through lifespan
o Many adult causes are not atopic
▪ Atopy is higher sensitivity to common allergens (allergic
reactions)
▪ Asthma can develop from things like viral infections
• Types of Asthma
o Atopic asthma
▪ Most common – allergic asthma
▪ May have same symptoms as non-allergic asthma
▪ May develop subsequent allergies due to high hypersensitivity
of lungs
o Non-atopic asthma
find more resources at oneclass.com
find more resources at oneclass.com
▪ Also called non-allergic asthma
▪ Person can have both types!!
▪ Symptoms may be triggered by
• Cold air
• Viral/bacterial infection
• Exercise
• Related conditions (like gastric reflux)
• Common Asthma Triggers
o Pollen
o Mold
o Dust mites
o Pet dander
o Upper respiratory infections
o Cigarette smoke
o Pollution
o Perfume/other strong scents
o Insect waste
o Food allergies
o Cold if it’s severe
o Exercise
o Stress
• Atopic Asthma
o Symptoms of asthma are triggered by exposure to an allergen to
which person is sensitized
o Allergic response mediated through IgE antibodies
▪ T-cell, antigen-presenting cell, B-Cell also involved
o Consist of early and late phases
o Key Cellular Components
▪ T-helper Cells
▪ B lymphocytes (class switch from IgG to IgE with T-cell help)
▪ Mast cells and basophils
• Release histamine → inflammation
▪ Eosinophils
• Associate w/ atopy, key bad guys in late response
• When sensitized, de-granulate and release cytotoxic
components in allergic reaction
▪ Macrophages and neutrophils
o Key Mediators
▪ Initial pathogenesis
• Allergen – causes cytokine/IgE release
▪ Early phase (consists of bronchoconstriction, mucosal
thickening, and secretions)
• Acetylcholine (parasympathetic bronchoconstrictor)
• Histamine (causes bronchoconstriction, inc. mucus
viscosity)
find more resources at oneclass.com
find more resources at oneclass.com
• Leukotrienes (pro-bronchoconstriction)
• Lipoxins
o These are actually anti-inflammatory, but less
are present in asthmatics!
▪ Late phase
• Eosinophil chemotactic factor
o Attracts more eosinophils to inflammation site
• Eosinophil major basic protein
o Released onto tissues → cause more damage
• You have lots of eosinophils if you’re asthmatic!
▪ Initial Response:
• Antigen processed by APC → presented to naïve T-cell
→ become antigen specific T-cell
▪ Then, after that:
• Activation of TH2 cells, Class-switching of B-cells from
IgG to IgE → )gE binds to mast cell receptors primed
→ subsequent exposure causes IgE receptor cross-link,
degranulation of mast cells, and histamine/leukotriene
release
▪ STUDY PICS ON SLIDES 15-20!!!
find more resources at oneclass.com
find more resources at oneclass.com
