Bronchial Asthma

Bronchial asthma is a disease of the lung inflammation in the airways resulting in airway hiperrespon to various stimuli that can cause constriction of the airways that can arise thorough so shortness of breath that is reversible either spontaneously or with therapy.

Etiology

• Genetic factors
• Environmental factors
• Materials allergens
• Respiratory tract infections (especially viruses)
• Air pollution
• Food Factor

Trigger factors

• Allergens
• Physical
• Chemicals
• Infection
• Mechanical factors
• Psychological factors

Pathogenesis
The entry of allergens into the airway will cause a reaction between the allergen with immunoglobulin E. The release of materials from mastosit mediators, which cause the inflammation in the bronchial mucosa and submucosa causing bronchial smooth muscle contraction.

Pathology
Infiltration of inflammatory cells such as eosinophils, neutrophils, and other airway epithelial damage, resulting in expenditures as well as mediators and thickening of the mucosal and submucosal edema. There is hyperplasia of the glands Goblet cells. Happen "mucous plug" on-line the airways.

Clinical Symptoms
Complaints and symptoms depend on the severity at the time of the attack. In bronchial asthma attacks are mild and without complications, complaints and no typical symptoms.

Complaints:

• Breath sounds
• Crowded
• Cough

Physical examination
Abnormalities of the upper airway, bronchi, thoracic, and skins, can be rhinitis, sinusitis, bronchitis, asthma and alveoler broncho-lung hyperinflation.
General state:

• Composmentis
• Anxiety / anxiety / panic / sweating
• Blood pressure increases
• Pulse increased
• Pulsus paradoxus: decrease in systolic blood pressure over 10 mm Hg at the time of inspiration
• Respiratory frequency increased
• Cyanosis
• Auxiliary respiratory muscles hypertrophy

Lung:

• Obtained prolonged expiratory
• Wheezing

Laboratory:

• Increased blood Eosinophils> 250/mm3
• Analysis of blood gases in status asthmaticus

Radiology: there are no typical signs.
Pulmonary Physiology: decreased FEV1
Skin test: to indicate the presence of allergic
Bronchial provocation test: with inhaled histamine, acetylcholine, allergens.

Diagnosis

1. Anamnesa: complaints of shortness of breath by breath sounds ngiik frequent recurrence. The existence of hereditary factors and the presence of precipitating factors.
2. Physical examination: a thorough wheezing or prolonged expiratory phase.
3. Laboratory:

• Sputum: Charcot-Leyden crystals, Spiral Curschmann
• Blood: increased number of eosinophils.
• Physiology lung: airway obstruction (ratio of FEV1 / FVC <75% or PEF <150 liters / minute)
• bronchial provocation tests, skin sensitivity test.

Differential Diagnosis

• Upper airway obstruction (stridor)
• Laryngeal dysfunction
• Chronic obstructive pulmonary disease
• Congestive heart failure (asthma cardial)
• Pulmonary embolism
• Pulmonary infiltrates of eosinophils
• Cough caused by medications (beta blockers, ACE inhibitors).

Complications

• Respiratory infection
• Atelectasis
• Pneumothorax, Pneumomediastinum, Emphysema cutis
• Respiratory failure
• Arrhythmias (especially if previously existing cardiac abnormalities).

Management / Procedure of Bronchial asthma

Special Treatment of Bronchial Asthma


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