Vestil, Niña Christene BSPH3 Clinical 2 01-23-2024

ON RESPIRATORY DISEASES:

 Allergic Rhinitis
 Asthma
 COPD

RESEARCH ON THE FF:

1. Explaining the pathophysiology of the disorder

 Allergic Rhinitis

Allergic rhinitis is a condition that is characterized by inflammation of the nasal mucosa due to an allergic reaction.
The pathophysiology of allergic rhinitis is complex and involves an early- and late-phase allergic response. The
process is triggered by exposure to allergens such as pollen, mites, and/or animal dander that are recognized by
antigen-specific immunoglobulin E (IgE) receptors on mast cells in the nasal mucosa. This leads to the release of
inflammatory mediators such as histamine, leukotrienes, and cytokines, which cause the characteristic symptoms
of allergic rhinitis, including sneezing, itching, rhinorrhea, and nasal congestion.

 Asthma

Asthma is a chronic inflammatory disorder of the airways that causes recurrent episodes of wheezing,
breathlessness, coughing, and chest tightness. It is usually mediated by immunoglobulin E (IgE) and triggered by
allergens such as pollen, dust mites, and animal dander. The pathophysiology of asthma involves chronic
inflammation of the airways, which leads to an increase in airway hyperresponsiveness and recurrent episodes of
bronchoconstriction. This inflammation is caused by the release of inflammatory mediators such as leukotrienes,
histamine, and prostaglandins, which are produced by mast cells and eosinophils in response to allergen exposure.
The resulting bronchoconstriction leads to the characteristic symptoms of asthma, including wheezing,
breathlessness, coughing, and chest tightness.

 COPD

Chronic obstructive pulmonary disease (COPD) is a life-threatening condition that affects the lungs and the ability
to breathe. The pathophysiology of COPD involves chronic inflammation of the airways, which leads to an increase
in airway hyperresponsiveness and recurrent episodes of bronchoconstriction. This inflammation is caused by the
release of inflammatory mediators such as leukotrienes, histamine, and prostaglandins, which are produced by
mast cells and eosinophils in response to allergen exposure. The resulting bronchoconstriction leads to the
characteristic symptoms of COPD, including coughing, shortness of breath, and other symptoms. The damage done
by COPD can’t be undone, but there are some preventive measures you can take to lower your risk of developing
COPD.

2. Identifying factors that may induce or potentiate the disorder

 Allergic Rhinitis

Allergic rhinitis can be triggered by a variety of allergens, including pollen, dust mites, animal dander, and mold.
The condition can also be seasonal or perennial, depending on the allergen and the time of year. Nonallergic
rhinitis, on the other hand, is not triggered by a specific allergen but rather by one or more non-allergy inducing
triggers such as foreign material in the nose, infections, certain medications, certain foods and odors, smoke,
Vestil, Niña Christene BSPH3 Clinical 2 01-23-2024

fumes, and other air pollutants, weather changes, hormonal changes, and stress. Structural problems in the nasal
cavity such as polyp formation or a deviated nasal septum with narrowed nasal passages can also cause nonallergic
rhinitis.

 Asthma

Asthma can be triggered by a variety of factors, including indoor and outdoor allergens such as dust mites, mold,
pollen, and pet dander. Other triggers include respiratory infections such as colds, influenza, and COVID-19.
Physical activity, especially in cold air, can also trigger asthma. Emotional stress, such as intense anger, crying, or
laughing, can also trigger asthma. Certain medications, such as aspirin and beta-blockers, can also trigger asthma in
some people. Smoking and exposure to secondhand smoke can also increase the risk of developing asthma.

 COPD

Chronic obstructive pulmonary disease (COPD) is primarily caused by long-term, cumulative exposure to airway
irritants such as cigarette smoke, pollution, and occupational exposure to chemicals and substances such as coal
mine dust, cotton dust, silica, and grain dust. Other factors that can contribute to the development of COPD
include genetic predisposition, respiratory infections, and individual or parental respiratory disease history.

3. Describing the clinical presentation of the disorder, including diagnostic and laboratory tests

 Allergic Rhinitis

The diagnosis of allergic rhinitis is usually clinical and is made if someone experiences one or more of the following
symptoms in response to allergen exposure: rhinorrhea, sneezing, itching of nose/palate/eyes, or nasal congestion.
Cough is also a common symptom. The diagnosis is confirmed with a demonstration of specific IgE reactive to
environmental allergens. Skin-prick testing and in vitro-specific IgE determination are some of the diagnostic tests
that can be used to confirm the diagnosis of allergic rhinitis.

Common diagnostic tests include:

 Skin Prick Testing (SPT): A small amount of allergen is applied to the skin using a tiny needle, and the skin's
reaction is observed. Positive reactions, indicated by a wheal and flare response, help identify specific
allergens.
 Blood Tests (IgE Specific Antibodies): Measurement of specific immunoglobulin E (IgE) antibodies in the
blood can identify allergens. The most common blood test for allergic rhinitis is the radioallergosorbent
test (RAST).

 Asthma

 Wheezing: High-pitched whistling sounds during expiration, resulting from narrowed airways.
 Shortness of Breath: Difficulty breathing, with a sensation of breathlessness or tightness in the chest.
 Coughing: Persistent cough, often worse at night or in the early morning.
 Chest Tightness: Discomfort or pressure in the chest due to airway constriction

Diagnostic and laboratory test:

1. Spirometry: This lung function test measures the amount (volume) and speed (flow) of air that can be
inhaled and exhaled. The results help determine the presence and degree of airflow limitation, a
characteristic feature of asthma. The test often includes assessing the forced expiratory volume in one
second (FEV1) and the forced vital capacity (FVC).
Vestil, Niña Christene BSPH3 Clinical 2 01-23-2024

2. Peak Expiratory Flow (PEF) Measurement: This simple test involves using a peak flow meter to measure
the maximum speed of air breathed out of the lungs. Regular monitoring of PEF can help assess the
variability in airflow and provide an objective measure of asthma control.
3. Bronchoprovocation Tests: In cases where spirometry results are inconclusive, bronchoprovocation tests
may be performed to induce bronchoconstriction and assess airway responsiveness. Methacholine or
histamine challenges are common methods.
4. Fractional Exhaled Nitric Oxide (FeNO) Test: Elevated levels of nitric oxide in exhaled breath can indicate
airway inflammation, providing an additional marker for asthma.
5. Allergy Testing: Identifying specific allergens through skin prick tests or blood tests (specific IgE
antibodies) can help in managing allergic asthma triggers.

 COPD

The clinical presentation of COPD includes a range of symptoms related to airflow obstruction and inflammation of
the airways. Common symptoms include chronic cough, sputum production, dyspnea (shortness of breath), and
wheezing. As the disease progresses, individuals may experience exacerbations, marked by a sudden worsening of
symptoms.

Diagnostic tests may include:

1. Chest X-ray: To rule out other potential causes of respiratory symptoms and to assess for signs of
emphysema or chronic bronchitis.
2. Arterial Blood Gas (ABG) Analysis: Measures oxygen and carbon dioxide levels in the blood, providing
information about respiratory function and the severity of hypoxemia and hypercapnia.
3. Complete Blood Count (CBC): To assess for signs of polycythemia, which can occur in response to chronic
hypoxemia.

NOTE: A CASE STUDY WILL BE POSTED IN THIS LESSON