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CHRONIC ASTHMA (EPIDEMIOLOGY (Risk is higher for males 10 and under vs…
CHRONIC ASTHMA
EPIDEMIOLOGY
Risk is higher for males 10 and under vs females
Risk is higher for females over 18 versus males
Nearly 10% of US population
Highest death rates for African Americans 15-24 years old
Most cases caused by atopy
Diverse microbial exposure in childhood decreases risk
obesity
multiple respiratory infections
Familial Link
DIAGNOSIS
history of wheezing, dyspnea, chronic cough an exercise intolerance
spirometry to test for dimnished expiratory volume
history of allergies
evidence of airflow obstruction that is at least partially reversible
elevated serum IgE
chest radiography
pulse oximetry
pulmonary function test
CLINICAL PRESENTATION
expiratory wheeze
chest pain with exertion
atopic dermatitis
cough/ nocturnal cough
allergic rhinitis
clubbing
conjunctival congestion and inflammation
TREATMENT
SABA inhaler
Stepwise Therapy
LABA
inhaled corticosteriods
SABA
oral corticosteriods
luekotriene inhibitors
mast cell stabilizers
monoclonal therapy
remove allergens from environment
precautions with exercise
PATHOPHYSIOLOGY
Structural changes of bronchi
thickening of smooth muscle
narrowed lumen
restricted airflow
Increase in mast cells
histamine release
bronchial hyperresponsiveness
increased
neutrophils,T-helper 2, and esinophils
T-helper 2 intiate IgE production
inflammation