Bronchial asthma
Definition: Chronic inflammation of the airways with airflow
obstruction and bronchospasm.
Symptoms and signs:
Wheezing.
Coughing.
Chest tightness.
Increase in breath rate.
Shortness and difficulty of Breath.
Increase in heart rate.
Cyanosis due to decrease O2 and increase CO2 in blood.
Symptoms worsen in: fatique.
Viral infection.
Dusty places.
Smokes.
Spring time.
Change in weather.
Menstrual cycle.
At night.
Causes:
1
a- Intrensic: runs in familes and usually disappear at adolcance.
b- Extrinsic: due to many causes as pollens,some fruits, dust
mites, smokes and some chemicals.
Investigation:
1- Sputum analysis: increase in number of Esinophils( white blood
cells).
2- Blood analysis: increase in number of Esinophils( white blood
cells) and decrease O2 and increase CO2 in blood.
3- X ray lung.
4- Lung function tests.
5- E C G.
6- Skin sensitivity tests to discover the cause.
Differential diagnosis:
Many.
Allergic rhinitis and sinusitis.
Obstruction of large airways as trachea or bronchus.
Obstruction of small airways as bronchouli.
Heart diseases.
Drug induced.
Diagnosis:
2
Done after good study for the signs, symptoms and differential
diagnosis.
Treatment:
1- Advice the patient to be out from the items can enhance the
asthma.
2- Do skin patch with items discriminated in producing asthma to
discover and desensitize against it.
3- Antibiotics if bacterial infection is present.
4- Bronchodilators: as Aminophillin as tablets, injections or
inhalers.
5- Glucocorticoids:
as Beclometasone to suppress the
inflammatory process.
6- Beta adrenoceptors agonists: as Salbutamol.
7-Mast cell stabilizers: as Na cromolyn.
Case no.1:
Patient 35 years complain from repeated cough and difficult in
breath. The doctor find that he have wheeze, increased breath rate,
increased heart rate and he is cyanosed.
1- What are the investigations you ask?
2- What are the differential diagnosis?
3- What is the diagnosis?
3
4- What are the treatment?
4