Positive and different diagnosis of professional asthma theoretical approach (chest x-ray presentations also if possible) Imagine three

different case presentations of professional asthma each in a different stage (different than the ones presented at practical lesson)
Asthma
The term asthma comes from Greek word for panting and means attacks of shortness of breath although in the past this term has been used for clinical picture of shortness of breath resulting from any cause today asthma is confined to a condition of abnormal responsiveness of the air passages to various stimuli causing widespread airway narrowing. The pathological changes involved in airway obstruction are found in the medium sized bronchi and in bronchioles as small as 1mm in diameter airway narrowing is caused by bronchospasm mucosal edema and hyper secretion of viscous mucus. Asthma can be divided in to three categories extrinsic or allergic, asthma, found in a minority of adult patients is clearly caused by a known allergen. This form generally begins in childhood in a member of a family with a history of atopic diseases including high fever eczema and dermatitis as well as asthma. Allergic asthma results from the sensitization of the person to an allergen usually a protein in the form of an inhaled pollen animal dander mold spores feather dust lint or less often to a food such as milk or chocolate exposure to the allergen even in minute quantities produces an asthmatic attack. Intrinsic or idiopathic, asthma on the other hand is characterized by the absence of clearly defined precipitating factors. Non specific factors such as the common cold exercise or emotional may trigger the asthmatic attack. The intrinsic type of asthma is more apt to develop after age 40 years with the onset of attacks after infections of the nasal sinuses or trachea bronchial tree. The attacks become more frequent over time and the condition merges in to chronic bronchitis and sometimes emphysema. Most patients develop mixed asthma which is composed of components of both extrinsic asthmas. Patients with intrinsic asthma often later develop the mixed type children who have the extrinsic type often have complete recovery at adolescence. C Clinical manifest as are easy to recognize. Dyspnea may begin suddenly patients feel as though they are suffocating and must stand or sit up and devote all their energy to breathing. On the basis of the anatomic changes previously described the appearance major difficulty is with expiration. The tracheobronchial tree widens and lengthens during inspiration, but forcing air out of the constricted edematous mucus-filled bronchioles which normally contract or a certain degree during expiration is

difficult. Air is trapped distal to the obstruction thus progressive hyper inflatation of the lungs occurs. Prolonged wheezing expirations are thus characteristic as the patient struggle to force the air out. An asthmatic attack usually lasts from a few minutes to several hours, followed by a cough that is productive of considerable whitish sputum. Asthma is a disease characterized by hypersensitivity of the tracheobronchial tree to various stimuli and is manifested by periodic, reversible airway narrowing resulting from bronchospasm.