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Figure A
5%
5/111
Figure B
3%
3/111
Figure C
11%
12/111
Figure D
72%
80/111
Figure E
6/111
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This patient presents with atopic (extrinsic) asthma in which a sputum culture will demonstrate excess eosinophils (Figure D). Asthma is an inflammatory airway disease that causes reversible airway obstruction and bronchospasm. It is commonly treated with beta-agonists, corticosteroids, and anticholinergics. Atopic (extrinsic) asthma is a type of asthma which is characterized by paroxysmal breathlessness and wheezing in young patients. It is not related to aspirin ingestion, pulmonary infections, inhalation of irritants, exercise, or stress. A sputum sample will demonstrate excess eosinophils. IL-5 is involved in the activation of the eosinophils and plays a key role in the pathophysiology of this condition. Pollart et al. review the management of acute asthma exacerbations. They state that in the ambulatory and emergency department settings, the goals of treatment are correction of severe hypoxemia, rapid reversal of airflow obstruction, and reduction of the risk of relapse. Multiple doses of inhaled anticholinergic medication combined with beta-2 agonists improve lung function and decrease hospitalization in school-age children with severe asthma exacerbations. Courtney et al. review the treatment guidelines for childhood asthma, especially focusing on prevention and chronic management. They state chronic care focuses on controlling asthma by treating the underlying airway inflammation. Inhaled corticosteroids are the agent of choice in preventive care, but leukotriene inhibitors and nedocromil (mast cell stabilizer) also can be used as prophylactic therapy. Long-acting beta2 agonists may be added to one of the anti-inflammatory medications to improve control of asthma symptoms. Figures are explained in incorrect answer choice explanations below. Incorrect Answers: These incorrect answers would not be increased in the sputum of atopic asthma. Answer 1: Figure A represents a mast cell. Answer 2: Figure B represents a lymphocyte. Answer 3: Figure C represents a basophil. Answer 5: Figure E represents a neutrophil.
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