Question

Ruta is a 36 years old female with a weight of 60kg. She was admitted to the hospital on 15/04/2020. She was just getting home from her gardening and she just felt uneasy to breathe. She has been noticing for a while that she is having trouble in breathing and her chest tightens. She is also having coughing with mucus. She said because of shortness of breath (SOB), sometimes she is not able to speak in full sentence. She also stays awake occasionally in the night because of SOB and wheezing. Her past medical histories were hypercholesterolemia and asthma. She has no known drug and food allergy. She is working occasionally now and is living alone. She is a smoker and drinks occasionally. She has no known family history. The Emergency Department (ED) doctor has diagnosed her with Exacerbation of Asthma.

She is on salbutamol 200mcg as required.

Question 1. Two major pathological changes that occur in the lungs during an asthma attack are:

• Bronchial smooth muscle contraction

• Increased mucus production

Explain how these pathological changes arise in your person/client (Ruta) (ie. the pathophysiology). Hint: your answer should include discussion of the immune cell mediated. response.

Answer 1

Pathophysiology of Bronchial Asthma   

• Exposure to Specific Antigen
• Activated Mast cells, T cells, eosinophils release histamine, Leukotrines, Cytokynins & Prostaglandins
• Bronchospasm & Edema of Bronchial Muscles
• Increased Bronchial secretion
• Airway inflammation & Obstruction
• Hyperinflation Of lungs & airtrapping
• Ventilation Perfusion Mismatch
• Hypoxemia ( That is a clinical features Of Bronchial Asthma )

During initial 10-30 min of exposure to specific antigen , Activated mast cells,T cells , eosinophills secrete chemical substance like Histamine, Leukotrine, cytokynines, Prostaglandins ..This leads to Bronchoconstriction, Mucosal edema & airway Inflammation.