BY KIMS AMALAPURAM STUDENT.

2. BRONCHIAL ASTHMA
 The term Asthma comes from the Greek verb aazein,
meaning to pant, to exhale with the open mouth,
sharp breath.
 Asthma is a disease of airways it is characterised by
increased responsiveness of tracheobronchial tree toa
variety of stimuli resulting in widespread narrowing of
the air passages which may be relieved spontaneously
or by therapy.
 Status asthmaticus.

3. EPIDEMIOLOGY
• All around the world 234 million people are suffering
from asthma.
• India has an estimated 15-20 million asthmatics.
• Majority 50%asthmatics are below are 10 years of age.
• Ratio between
male:female =2:1

4. TYPES OF ASTHMA
Based on the stimuli initiating bronchial asthma, are of 3 types
EXTRINSIC
INTRINSIC
MIXED

5. EXTRINSIC ASTHMA
 Atopic ,allergic.
 Most common type of asthma
 Usually begins in childhood or in early adult life.
 Most patients of this type have personal or family history of
preceding allergic diseases.
 Hypersensitivity to various extrinsic allergic substances or
ALLERGENS is usually present in these cases.
 OCCUPATIONAL ASTHMA
 It is a variant of extrinsic asthma
 Asthma is stimulated by fumes, gases and organic and
chemical dust.
 Allergic response is IgE mediated TYPE-1 hypersensitivity
reaction.

6. ALLERGENS

7. ACUTE IMMEDIATE RESPONSE
ALLERGEN
Stimulates the IgE sensitised mast cells
Mast cell degranulation occurs
Mediators like histamine
Leukotriene
prostaglandin,
PAF and chemotactic factor for
eosinophils and neutrophils.

8. Contd…..
Results in Bronchoconstriction
Oedema
Mucus hypersecretion and
Accumulation of eosinophils
and neutrophils.

9. PATHOPHYSIOLOGY

11. LATE PHASE REACTION
 It follows the acute immediate response and is responsible
for prolonged manifestations of asthma,
Mobilisation of blood leucocytes mainly Basophils along
with Eosinophils and Neutrophils
leads to further release of inflammatory mediators
which accentuates brochoconstriction , oedema,…..
• Inflammatory injury is caused by Neutrophils and MBP of
Eosinophils.

12. INTRINSIC ASTHMA
 Idiosyncratic,non-atopic.
 Seen in lateral adult life with negative personal or
family history of allergy , negative skin test ,normal
serum levels of IgE.
 Most of these patients develop acute typical symptom
complex of asthma after an upper respiratory tract
infection by virus.
 Commonly associated with nasal polyp,emphysema
and chronic bronchitis.
 10% patients become hypersensitive to drugs mostly to
small doses of aspirin- ASPIRIN SENSITIVE ASTHMA

13. MIXED TYPE OF ASTHMA
 Many patients do not clearly fit into either of the above
categories.
 They have mixed features of both.

14. SIGNS & SYMPTOMS
 Dyspnoea
 Wheezing
 Cough
 Limitation of activity

15. PRECIPITATING FACTORS

16. INVESTIGATIONS
 Eosinophilia
 Demonstration of CURSCHMANN’S SPIRALS and
CHARCOT-LAYDEN CRYSTALS in sputum.