Jane, a 25 year old, was referred to the respiratory ward by her GP she had a five day history of increased

shortness of breath, a cough and an audible wheeze. Jane was diagnosed with asthma at the age of ten. There is a history of asthma in her mother s family. Jane s previous admission for e!acerbation of asthma was "arch 2##$ to another hospital. %n arrival Jane was immediately seen for aggressive treatment of e!acerbation of asthma. &ach lung has '''boncho(pulmonary segments )*#+ ,hat are the functions of the thoracic cavityprotect contents of the thoracic cavity and respiration ,hat are the atypical ribs*,2,*#(*2 .ifferentiate between e!trinsic and intrinsic bronchial asthma. e!trinsic intrinsic Type(/ )/g&(mediated+ hyper(sensitivity or 0ot allergic allergic reaction Triggered by environmental antigens )dust, Triggered by respiratory tract infections pollens, food, ..+ 1drugs )aspirin+. 2amily history of 3topy (0o family history ( 4egins in childhood. 5tate the type o hypersensitivity in this case. Type / )/g&+ 6ist the 7 pathologic reactions during as asthmatic episode. Patchy necrosis of epithelium 5ub(mucosal glandular hyperplasia 8ypertrophy of bronchial smooth muscle &osinophils, mast cells9 lymphocyte "ucous plugs, ,horled mucous plugs ):urschmann s spirals+ .ebris of eosinophils ):harcot(6eyden crystals Give 2 e!amples of selective (adrenergic agonists with their side effects. 5albutamol (Terbutaline and 4ambuterol. Tremors of s;eletal muscle, nervousness and wea;ness. Tachycardia secondary to hypotension produced by s;eletal vasodilatation. 8ypo;alemia Tolerance may occur with prolonged use. ,hat classification of drug would the leu;otriene inhibitors fall under antiinflammatory 6ist 7 muscles responsible for forced inspiration. sternocleiomastoid, serratus anterior 1 scalini muscle ,hat are the changes in pulmonary function test results with an asthmatic patient-

decreased 2<:,2&<t,2&<*=2<: ratio,<:,P&2>, decreased e!piatory flows and normal or increase volume unless severe conditions

6ist down the landmar; for sternal angle. 5econd rib 2ourth thoracic vertebrae )T?+ 4eginning and termination of the artic arch 4eginning of descending thoracic aorta Termination of the arch of azygous vein into the 5<: 4ifurcation of trachea 4ifurcation of pulmonary trun; ,hat are the blood supply of trachea /nferior thyroid arteries 4ronchial arteries ,hat are the chemicals factor affecting bronchial muscle tones 8istamine@@@constriction 5erotonin@@@constriction Platelet activating factor The partial pressure of %2 in arterial blood isA ):+ a+. Greater than in the tissue spaces b+. 6ess than in the venous blood c+. 6ess than in the tissues spaces d+. &Bual to that in the alveoli