A 25-year-old previously well woman presents to your office with complaints of episodic shortness of

A 25-year-old previously well woman presents to your office
with complaints of episodic shortness of breath and chest tightness. She has
had the symptoms on and off for about 2 years but states that they have
worsened lately, occurring two or three times a month. She notes that the
symptoms are worse during the spring months. She has no exercise-induced or
nocturnal symptoms. The family history is notable for a father with asthma. She
is single and works as an administrative assistant in a high-tech firm. She
lives with a roommate, who moved in approximately 2 months ago. The roommate
has a
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A 25-year-old previously well woman presents to your office
with complaints of episodic shortness of breath and chest tightness. She has
had the symptoms on and off for about 2 years but states that they have
worsened lately, occurring two or three times a month. She notes that the
symptoms are worse during the spring months. She has no exercise-induced or
nocturnal symptoms. The family history is notable for a father with asthma. She
is single and works as an administrative assistant in a high-tech firm. She
lives with a roommate, who moved in approximately 2 months ago. The roommate
has a cat. The patient smokes occasionally when out with friends and drinks
socially, but has no history of illicit drug use. Examination is notable for
mild end-expiratory wheezing. The history and physical examination are
consistent with a diagnosis of asthma. Pulmonary function tests are ordered to
confirm the diagnosis.

Questions

A. What are the three categories of provocative agents that
can trigger asthma? What are some possible triggers in this patient?

B. Describe the early events responsible for the
pathogenesis of asthma. How does this result in chronic airway inflammation and
airway hyperresponsiveness?

C. What pathogenetic mechanisms are responsible for this
patient’s symptoms of wheezing, shortness of breath, and chest tightness?

D. What might you expect the results of her pulmonary
function tests to be? Why?

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