NR 507 PULMONARY QUESTIONS AND ANSWERS WITH SOLUTIONS 2024

NR 507 PULMONARY QUESTIONS AND
ANSWERS WITH SOLUTIONS 2024
AnticholinergicYdrugsYforYasthmaY-YANSWERYFast-actingYtreatmentYforYasthma

-TiopropiumYandYIprapropium

-
blockYacetylcholineYbindingY(rememberYthisYisYNTYtransmitterYreleasedYinYtheYparasympatheticYstimulation
YwhichYcausesYconstrictionYofYtheYbronchiYbyYblockingYit,YweYdecreaseYtheYparasympatheticYresponseYthere

foreYpreventingYconstriction.



-AtroventY&YSpirivaYbothYpreventYtheYmuscleY

bandsYaroundYtheYairwaysYfromYtighteningY

thusYreduceYinYexacerbation.



AsthmaY-
YANSWERYAYchronicYallergicYdisorderYcharacterizedYbyYepisodesYofYsevereYbreathingYdifficulty,Ycoughing,Ya

ndYwheezing.Y



-
CharacterizedYby:Y1.YAirwayYinflammationY2.YBronchialYhyperactivityY3.YIntermittent,YreversibleYairflowYobs
truction.



causesYofYasthmaY-YANSWERYcomplexYinteractionYofYgeneticYandYenvironmentalYfactors

ResultsYin:Y

1.YExcessYmucusYproduction/accumulation
Y



2.YHypertrophyYofYsmoothYmuscleY
Y



3.YAirflowYobstructionY
Y



4.YDecreasedYalveolarYventilation.
Y




extrinsicYasthmaY-YANSWERYtriggeredYbyYaYchronicYallergicYreactionY

egY-Ymold,Ypollen,YdustYmites,YpetYdander
Y



-elevatedYIgEYlevelYisYdiagnostic
Y

, -moreYcommon,YespeciallyYinY
Y



childrenY(males:femalesY=Y2:1)
Y




S/S

Coughing,Ywheezing,YSOB,Ytachypnea,YchestYtightness.



IntrinsicYasthmaY-YANSWERY-triggeredYbyYaYvarietyYofYnon-allergicY

factors
Y



egY-Ychemicals,Yair-borneYirritants,Y
Y



infectionsY(esp.Yviral),Y
Y



exercise,Ystress,Yanxiety,YGERD,Y
Y



obesityY
Y



-noYinitialYelevationYinYIgEYlevel
Y



-typicallyYseenYinYadultsY(<40Yy/o)Y(slightlyYmoreYcommonYinYfemales)



pathoYofYasthmaY-YANSWERY1.AllergenYentersYbodyY



2.YAgYbinds,YmastYcellsY(whichYhaveYIgE)YdegranulateY(histamine,Yprostaglandins,Yleukotrienes,Yinterleukin)
Y




3.YLeadsYtoYsmoothYmuscleYconstrictionY>YmucusYsecretionY>YvasodilationY>edemaY>YmoreYWBCYtoYsiteY(to
oYmany)YdendriticYcells,YTYHY2YcellsY(TYhelperY2)Y>YStimulateYB-
cellsY>YMoreYIgEY>YEosinophilsYandYneutrophilsYtoYsiteY>InflammationY>YLeadsYtoYdamageYofYtissueY>YwhichY
canYfurtherYleadYtoYpermanentYairwayYremodelingY(resultingYinYextrinsicYasthma).



AlveolarYHyperinflationYinYAsthmaY-
YANSWERYPlugsYofYmucusYandYpus,YcausedYbyYtheYprocessYexplainedYabove,YfromYtheYinflammatoryYproces

sYcanYblockYalveolarYpassageways,YleadingYtoYair-
trappingYinsideYtheYalveoli,YcausingYhyperinflation.Y>YThisYcanYalsoYoccurYwithYbronchitis.



shortYactingYbetaY2YagonistsY-YANSWERYFast-actingYtreatmentYforYasthma