Describe the pathophysiological mechanisms of chronic asthma and acute asthma
exacerbation. Be sure to explain the changes in the arterial blood gas patterns during an
exacerbation.
Select one factor from genetics, gender, ethnicity, age, or behavior. Explain how the factor
you selected might impact the pathophysiology of both disorders. Describe how you would
diagnose and prescribe treatment for a patient based on the factor you selected.
Construct two mind maps-one for chronic asthma and one for acute asthma exacerbation.
Include the epidemiology, pathophysiology, and clinical presentation, as well as the
diagnosis and treatment you explained in your paper.
Pathophysiology Mechanisms of Chronic and Acute Asthma Exacerbation
Chronic and Acute Asthma are inflammatory conditions that are very common in
industrialized countries. As explained by Buhl & Farmer (2004), the issues that lead to these
conditions lead to the airways of the patient to narrow causing wheezing. This situation needs to
be controlled through medication and frequent treatment and medical checkups. The airways
themselves may keep changing leading to different levels of asthma. Acute and chronic asthma
can be reversed if the patient seeks medical attention as soon as possible. On the other hand, it
gets worse if the condition is delayed. As noted by Yamada (2003), the changes in the airways of
the patient include such complications as eosinophilis. Eosinophilis is a condition that affects the
immune system that when affected, combats many parasites that affects the chest of the patient
with time. These parasites also increase cases of allergy, eventually leading to asthma. They
generate themselves in the bone marrow of the patients, making it difficult to treat. Without
treatment, the parasites are likely to spread to the blood. Acute and chronic asthma are the main
killer diseases for children with a high hospital admission rates. Another change in the airways
include lamina reticularis thickening. In this case, the airways prolong increasing the number of
mucous glands. Other cells are T-lymphocytes, macrophages, neutrophils, cytokines,
PATHOPHYSIOLOGY MECHANISMS OF CHRONIC AND ACUTE ASTHMA EXACERBATION 2
chemokines, histamine, and leukotrienes. They are known to lead to the changes above named on
the blood gas patterns during exacerbation. This is the case both for acute and chronic asthma.
Children compared to adults are at a greater risk of suffering from Chronic and Acute
Asthma. This explains the reason why most patients of asthma are children. Chronic asthma kills
more children that acute asthma. The main reason is the poor immunity that children have
compared to adults. Exacerbation in acute asthma is referred to as asthma attack with patients
showing different symptoms. This implies that children are more susceptible to acute and chronic
asthma compared to adults. The cells of adults are stronger and more resistant compared to those
of adults. In the same point of view, Pathophysiology of acute and chronic asthma is also
different in children. In most cases, asthma can be stable in adults for some weeks, but for
children, a day is enough for them to die. After both conditions, the result is acute and chronic
asthma. Different people are affected in different ways all together. Several factors in the home
affect the exacerbation of asthma in children most especially. These are dust, cat and dog fur,
allergens and mold. Children will as well be affected by perfumes causing acute or chronic
asthma. These factors affect the respiratory tract hence making the diseases worse. Children will
therefore have a higher level of exacerbation in children than adults ( Knight-Madden, Forrester,
Lewis & Greenough (2005).
Diagnosing asthma is not something new in the field of medicine. Managing these
conditions however has been a challenge to most medical practitioners with more children and
adult patients dying from it every other day. Asthma is generally an inflammatory condition that
affects the airways, cells, and other elements that are easy to treat. This leads to wheezing,
breathlessness, tight chest and regular coughing. Most patients experience a lot of coughing
whenever it is cold, especially early in the morning and late in the evening. The diagnoses of
PATHOPHYSIOLOGY MECHANISMS OF CHRONIC AND ACUTE ASTHMA EXACERBATION 2
these conditions are easier to come up with most especially if the patient’s family has some
history of the disease. In this case, the patient is affected after much exercise, viral infections, air
pollution and allergies. To confirm the diagnosis, a process called spirometry is conducted as
explained by Zimmerman, Woodruff, Clark & Camargo (2000). The only difficult in this case of
spirometry is when the patient is a child of less than six years.
As explained by Wang & Petsonk (2004), spirometry is one of the known successful
steps towards diagnosing and managing acute and chronic asthma. It is the best and the only
mode that guarantees success. In this case, spirometry measures the FEV1 and if it shows an
improvement of twelve percent or more, medication and management starts right away. This
follows the application and use of bronchodilator. One of the best known bronchodilator is
salbutanol that doctors have used to support the diagnosis of these illnesses. People who face
simple asthma attacks are also advised to go through this process. It reduces chances of the
illness getting more serious. It is also an obvious way of reducing cases of deaths to a high
percentage both in children and in adults. Since there can be different types of asthma depending
on the degree of infection, single breath diffusing capacity goes a long way in helping diagnose
asthma. The patients should have medical attention as well as try to maintain a two to three year
intervals of checkups through Spirometry. It is worthy to mention that this process is performed
to patients with both acute and chronic asthma conditions.
PATHOPHYSIOLOGY MECHANISMS OF CHRONIC AND ACUTE ASTHMA EXACERBATION 2
Mind map for Acute Asthma
Oxygen administration
bronchodilators
corticosteriods
Over seven million children
diagnosed worldwide
Close to 34 million
Americans affected
Blacks have higher
mortality and morbidity
than whites
1:2 female to male ratio at
childhood
Epidemiology
Treatment
Hypoxemia &
respiratory alkalosis
Wheezing
Coughing
Dyspnea & chest
tightness
Hyperventilation
Exposure to Allergen
Bronchoconstricion
Airway obstruction &
increased mucous
secretion
Atopy takes place
Cross-link with mast cells
Acute Asthma
Pathophysiology Clinical
presentation
Diagnosis
PATHOPHYSIOLOGY MECHANISMS OF CHRONIC AND ACUTE ASTHMA EXACERBATION 2
Mind map for Chronic Asthma
Over 300 million people
affected worldwide
Common in countries that
are underdeveloped
Affects mostly the male
Anticholinergic
medications
Mast cell
stabilizers
Corticosteriods
Epidemiology
Treatment
Shortness of breath
Wheezing
Chronic cough
chest tightness
Increased mucus
Swelling and
inflammation
Muscle tightening
Pulmonary
function test
Pulse oximetry ABG’s Chest X-ray
Chronic
Asthma
Pathophysiology Clinical
presentation
PATHOPHYSIOLOGY MECHANISMS OF CHRONIC AND ACUTE ASTHMA EXACERBATION 2
References
Buhl, R., & Farmer, S. G. (2004). Current and future pharmacologic therapy of exacerbations in
chronic obstructive pulmonary disease and asthma. Proceedings of the American
Thoracic Society, 1(2), 136-142.
Knight-Madden, J. M., Forrester, T. S., Lewis, N. A., & Greenough, A. (2005). Asthma in
children with sickle cell disease and its association with acute chest syndrome. Thorax,
60(3), 206-210.
Wang, M. L., & Petsonk, E. L. (2004). Repeated measures of FEV1 over six to twelve months:
what change is abnormal?. Journal of occupational and environmental medicine, 46(6),
591-595.
Yamada, T. (2003). Significance of complications of allergic diseases in young patients with
interstitial cystitis. International Journal of Urology, 10(s1), S56-S58.
Zimmerman, J. L., Woodruff, P. G., Clark, S., & Camargo Jr, C. A. (2000). Relation between
phase of menstrual cycle and emergency department visits for acute asthma. American
journal of respiratory and critical care medicine, 162(2), 512-515.