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(COMPLETE ANSWERS) SEMESTER 1 2026 - DUE 28 MAY
2026
ASTHMA
Correct Answer: Chronic disease due to bronchoconstriction and an excessive inflammatory
response in the bronchioles
Expert Rationale:
Asthma is a chronic inflammatory airway disorder characterized by reversible airflow
obstruction and bronchial hyper-responsiveness. The underlying mechanism involves immune-
mediated inflammation that leads to airway edema, mucus hypersecretion, and smooth muscle
constriction. These changes reduce airway diameter, particularly during exposure to triggers such
as allergens, exercise, cold air, or irritants, resulting in episodic respiratory symptoms.
What are 5 signs and symptoms of asthma?
Correct Answer: coughing, wheezing, shortness of breath, rapid breathing, chest tightness
Expert Rationale:
Asthma symptoms reflect intermittent airway narrowing and airflow limitation. Wheezing occurs
due to turbulent airflow through constricted bronchioles, while coughing is a protective reflex
aimed at clearing mucus and irritants. Shortness of breath and rapid breathing develop as the
body attempts to compensate for reduced oxygen exchange. Chest tightness results from
bronchial smooth muscle constriction and increased work of breathing. These symptoms often
worsen at night or early morning due to circadian variations in airway tone.
What is the pathophysiology of asthma (5)?
Correct Answer:
• airway inflammation, bronchial hyper-reactivity and smooth muscle spasm
• excess mucus production and accumulation
• hypertrophy of bronchial smooth muscle
• airflow obstruction
• decreased alveolar ventilation
,Expert Rationale:
Asthma pathophysiology is driven by chronic airway inflammation involving eosinophils, mast
cells, and T-lymphocytes. This inflammatory cascade increases bronchial hyper-responsiveness,
causing exaggerated smooth muscle contraction in response to stimuli. Mucus gland hyperplasia
leads to excessive secretion that can form plugs, further narrowing airways. Over time, repeated
inflammation causes structural remodeling, including smooth muscle hypertrophy and thickening
of airway walls. These changes result in airflow obstruction and impaired alveolar ventilation,
contributing to ventilation-perfusion mismatch and episodic hypoxemia.
What are bronchioles?
Correct Answer: smaller passageways that originate from the bronchi that become the alveoli
Expert Rationale:
Bronchioles are the smallest conducting airways in the respiratory system and serve as the
transition between larger bronchi and the alveolar ducts. They lack cartilage support, making
them highly susceptible to collapse during inflammation or obstruction. Their primary function is
to regulate airflow distribution into the alveoli where gas exchange occurs.
What are the 3 layers of the bronchioles?
Correct Answer: innermost layer, middle layer - lamina propria, outermost layer
Expert Rationale:
The bronchiolar wall is composed of three distinct layers that support airway structure and
function. The innermost epithelial layer regulates mucus production and barrier protection, the
lamina propria provides immune support and structural integrity, and the outer smooth muscle
layer controls airway caliber through constriction and dilation.
What is the lamina propria?
Correct Answer: the middle layer of the bronchioles
Expert Rationale:
The lamina propria is a connective tissue layer situated beneath the epithelial lining of the
bronchioles. It contains immune cells such as lymphocytes, macrophages, and mast cells, which
play a central role in airway immune defense and inflammatory responses, particularly in
asthma.
What is the structure of the lamina propria?
Correct Answer: embedded with connective tissue cells and immune cells
,Expert Rationale:
The lamina propria is composed of loose connective tissue rich in fibroblasts, collagen fibers,
blood vessels, and immune cells. This structure allows it to provide both mechanical support and
immunologic surveillance, enabling rapid response to inhaled pathogens or allergens.
What is the purpose of the lamina propria?
Correct Answer: white blood cells are present to help protect the airways
Expert Rationale:
The lamina propria serves as an immunological defense zone within the respiratory tract. It
contains resident immune cells that detect and respond to pathogens or irritants. In asthma, these
immune cells become hyperactive, releasing inflammatory mediators that contribute to airway
edema, mucus production, and bronchoconstriction.
How does the lamina propria affect the lungs in regards to asthma?
Correct Answer: the WBCs protective feature goes into overdrive causing an inflammatory
response that damages host tissue
Expert Rationale:
In asthma, immune cells within the lamina propria become overactivated, leading to chronic
inflammation of the airway walls. This results in the release of cytokines and mediators such as
histamine and leukotrienes, which promote bronchoconstriction, increased mucus secretion, and
vascular permeability. The ongoing inflammatory response damages airway tissue and
contributes to long-term airway remodeling.
What does the innermost layer of the bronchioles contain?
Correct Answer: columnar epithelial cells and mucus producing goblet cells
Expert Rationale:
The epithelial lining of the bronchioles consists of ciliated columnar cells and goblet cells.
Goblet cells secrete mucus that traps inhaled particles, while cilia help move mucus out of the
airways. In asthma, goblet cell hyperplasia leads to excessive mucus production, which can
obstruct airflow and worsen symptoms.
What does the outermost layer of the bronchioles contain?
Correct Answer: smooth muscle cells
Expert Rationale:
The outer layer of bronchioles contains smooth muscle fibers that regulate airway diameter.
Contraction of these muscles causes bronchoconstriction, while relaxation leads to
bronchodilation. In asthma, hyper-responsiveness of this smooth muscle leads to excessive
constriction in response to triggers.
, What does the outermost layer of the bronchioles do?
Correct Answer: control the airways ability to constrict and dilate
Expert Rationale:
The smooth muscle layer plays a critical role in regulating airflow resistance. It responds to
autonomic nervous system input and inflammatory mediators. In asthma, exaggerated
contraction reduces airway diameter, increasing resistance and making breathing difficult.
What is alveolar hyperinflation?
Correct Answer: When air is unable to move out of the alveoli like it should due to bronchial
walls collapsing around possible mucus plug thus trapping air inside
Expert Rationale:
Alveolar hyperinflation occurs when airflow out of the lungs is obstructed, commonly due to
mucus plugging and airway collapse during expiration. This leads to air trapping, increased lung
volumes, and overdistension of alveoli. Over time, this impairs gas exchange efficiency and
contributes to hypercapnia and respiratory fatigue.
How does hyperinflation occur?
Correct Answer: the ongoing inflammatory process of asthma produces mucus and pus plug
that the bronchial walls collapse around
Expert Rationale:
During asthma exacerbations, inflammation increases mucus production and airway edema.
During exhalation, narrowed and weakened airways collapse prematurely, trapping air distal to
the obstruction. This dynamic airway collapse leads to progressive air trapping and lung
hyperinflation.
What is the effect of alveolar hyperinflation?
Correct Answer: expanded thorax and hypercapnia (retention of CO2), respiratory acidosis
Expert Rationale:
Hyperinflation increases lung volumes and flattens the diaphragm, reducing its efficiency. This
leads to increased work of breathing and impaired ventilation. Inadequate CO₂ elimination
results in hypercapnia, which can progress to respiratory acidosis if compensatory mechanisms
fail. Chronic hyperinflation may also contribute to a barrel-shaped chest in severe cases.
What are two anticholinergic drugs used for asthma?
Correct Answer: tiotropium and ipratropium