Background

            Asthma is one of the disorders that is perceived to be sudden and fatal hence having the ability of highlighting some of the risks of complications as well as the health outcomes that evolves whenever this condition is not managed as required. As a result of that, research indicates that severe asthma has the possibility of causing the collapse of lungs amongst pediatric patients who could have seemed to be healthy at first (Carlsen & Gerritsen, 2012). Despite that, there exist no single tests that have been proven to have to aid in determining its magnitude hence the need of identifying the symptoms and signs associated with it. Consequently, in the process of treating it, it is important to take into account the effect it has on the airway smooth muscle (ASM). Conditions associated with acute asthma have been found to be severe and sudden once they emerge and in case they are not managed quickly, they end up developing into chronic asthma (Chanez, 2012). 

Pathophysiological mechanisms of chronic asthma and acute asthma exacerbation

            Asthma is perceived to be one of the chronic diseases of the human airway that is ultimately characterized by recurring and variable symptoms, underlying inflammation, bronchial hyper-responsiveness, and airflow obstructions. Basically, it is the interactions of these asthmatic features that have the potential of determining the medical manifestations as well as the severity of this disorder and the response to therapeutics.  On the other hand, pathophysiological mechanisms that are used for the purpose of exacerbating chronic and acute asthma entail determining the manner in which tightness of the chest, coughing, wheezing, and shortness of breath induces episodes of airflow obstructions (Kian et al., 2019).

            Nonetheless, the need of understanding the mechanisms of asthma pathophysiology is the one that have been noted to have the potential of enabling people to understand the manner in which such conditions are diagnosed as well as treated. Both chronic and acute asthma have been acknowledged to have the ability of affecting bronchioles, bronchi, and the trachea as a whole. Inflammation of these parts always occurs regardless of the lack of the signs and the symptoms associated with asthma (Brasier, 2014). 

Changes in the arterial blood gas patterns during an exacerbation

            Nonetheless, during an exacerbation, the expansion and the increase in mucus secretion from the mucus secreting cells results to the blocking of the arterial airways with thick plugs of mucus. Extreme airway impairment can also result of the damaging of epithelial peeling hence making the airway to be hyper-responsiveness. The same changes result to the loss of vital enzymes that aid in breaking down some of the inflammatory disorders. Conversely, during an exacerbation, the oxygen supply decreases as a result of the dilation of the arterial airways (Carlsen & Gerritsen, 2012).

            As a result of the sharp contractions of the smooth muscles of the bronchial, it is possible of the bronchospasm to result to result to the narrowing of the airways. Similarly, edema resulting from microvascular leakage has also been noted to have the potential contributing to the narrowing of the breathing system. In return, the dilation and leaking of the airway capillaries will end up increasing secretions that impairs the clearance of mucus (Kian et al., 2019).  Consequently, as a result of the lack of proper clinical attention, it is possible for the patient to experience the remodeling of his or her airway hence inducing changes to tissues and the cells of the respiratory tract. In return, such changes have the ability of causing permanent fibrotic injury or damage. Moreover, due to the fact that this remodeling is ultimately irreversible, there is a progressive loss of the normal functioning of the lungs (Kimura & Ryo, 2015). 

How genetics impact the pathophysiology of both disorders

            Genetics is one of the factors to have been realized to impact the disorders’ pathophysiology in patient in question. According to research, the development of both disorders in the patient is a result of the inheritable components regarding its expression. Despite that genetics that is entailed in the eventual development of these disorders remain to be an incomplete and complex picture. Thus, the complexity of the involvement of the genes in medical asthma has been recognized to have a linkage to the patient’s phenotypic characteristics (Duke, 2007). Such a linkage is not also associated with pathophysiological process of the disease or their medical picture.

Diagnosis and treatment for the patient based on the selected factor

            The analysis or diagnosis of these disorders based on his genetics, will have to take into account the historical information provided by his family. The reason for that is because diagnosis based on genetics will have to go beyond chest tightness, dyspnea, wheezing, or coughing. Such a diagnosis will also not be based on the signs and symptoms that could have been perceived to worsen both conditions, especially at night. The treatment for these disorders will have to take into account both long-term and acute treatment. The reason for that is because the existence of diverse genetic variations is the one that has the ability of determining the patient’s responsiveness to therapy (Kimura & Ryo, 2015). Likewise, after obtaining the required patient and family genetic history, it will be the main basis of deciding the type of drugs to use to convert enzyme inhibitors or countering the effect of certain acute and chronic asthmatic agents.

Construct two mind maps—one for chronic asthma and one for acute asthma exacerbation

                                     Acute asthma exacerbation mind map

ACUTE ASTHMA EXACERBATION

Clinical presentation

pathophysiology

·         Swollen and sensitive airways ·         Muscle contraction ·         Inflamed airways ·         Narrowed bronchial tubes

Diagnosis

·         Physical examination ·         Imaging ·         Blood gases ·         Pulmonary function testing ·         Sputum testing

Treatment

·         Atrovent ·         Oxygen ·         Oral corticosteroids ·         Physical exercises

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                             Chronic asthma exacerbation mind map

CHRONIC ASTHMA EXACERBATION

Clinical presentation

pathophysiology

·         interlukins ·         increasing permeability of the vasculature ·         activation of the inflammatory mediator

Diagnosis

·         Genetic or family history

Treatment

·         Atrovent ·         Oxygen ·         Oral corticosteroids ·         Physical exercises

Anxiety Shortness of breath Wheezing Coughing Chest pressure Bronchospasm Blue finger tips or lips

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                                                           

                                               

 

 

                                                            References

Carlsen, K.-H., & Gerritsen, J. (2012). Paediatric Asthma: European Respiratory Monograph 56. Sheffield: European Respiratory Society.

Chanez, P. (2012). Asthma, An Issue of Clinics in Chest Medicine - E-Book. Saunders Press

Duke, P. (2007). Medmaps for pathophysiology. Lippincott Williams And Wilkin

In Brasier, A. R. (2014). Heterogeneity in asthma. New York : Springer Press

Kian, F.CElliot, I & Peter, G. G. (2019). Severe Asthma: Volume 84 of ERS Monograph. European Respiratory Society

Kimura, H., & Ryo, A. (2015). Pathophysiology and epidemiology of virus-induced asthma. S.L: Frontiers Media SA.