08/02/2020
Today,let's talk about CHRONIC CONDITION/DISEASE .
A chronic condition/disease is a human health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. There are a number of chronic diseases to include but a few; Asthma,Arthritis,Hypertension,Diabetes,Cancer,Chronic Obstructive Pulmonary Disease(COPD),Heart disease,Stroke e.t.c.
ASTHMA.
This is a chronic inflammatory disorder of the airway characterised by airway hyper-responsiveness leading to a triad of events that is;
1.Broncho constriction
2.Oedema of airway
3. Excessive secretions
These events lead to airway obstruction which is reversible either spontaneously or with treatment. It's a life threatening episode of airway obstruction and is considered a medical emergency.
FACTORS PREDISPOSING TO ASTHMA.
These can be divided majorly into;
1.Host factors
- Genetic predisposition
-Obesity
2. Environmental factors
-Allergens
-infections
-Diet
-To***co smoking
- Occupational sensitization e.g lime
-Air pollution
MECHANISM OF ASTHMA.
Involves inflammatory cells such as mast-cells,esinophills and F cells e.t.c and multiple chemical mediators e.g chemokine,cytokine e.t.c.
Airway inflammation in Asthma is persistent although symptoms are episodic. Relationship between the severity of asthma and the intensity of inflammation is not clearly established.
Inflammatory changes occur in both upper and lower airway but physiological effects are most pronounced in medium sized bronchi and bronchitis.
The pattern of inflammation in the airway appears to be similar in all clinical forms of Asthma regardless of aetiology,dyspnoea (shortness of breath),dry cough,use of accessory respiratory muscle,fast or labored breathing and extreme wheezing.
HOW TO DIAGNOSE;
-History taking on episodic cough,breathlessness and chest tightness
-Physical examination through auscultation to listen for wheezing
-Exercise induced constriction of the bronchi (typically develops within 5-10mins of exercise )
-Skin tests with Allergens
-Lung function tests e.g Peak expiratory flow
TREATMENT OF ASTHMA.
1)Relief control.
Interventions may include;-
-Medications to dilate the airway (bronchudilators e.g Salbutamol)
-Intravenus medication e.g magnesium sulphate.
-Positive pressure therapy including mechanical ventilation incase of status Asthmaticus
Treatment Guidelines.
-Identify and avoid provoking factors
- Check inhaler techniques
-Allay any fears and anxiety
-Design for self management plan
-Check and ensure compliance
Differential Diagnosis.
-Aspiration Syndrome
-Bronchiectasis
-Bronchiolitis
-Chronic obstructive pulmonary disease(COPD)
-Cystic Fibrosis
-Foreign bodies of the airway
-Gastroesophageal Reflux Disease
- Heart failure
