LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Libro Blanco de las ACES Pediátricas 2024 116 ❚ 2. Understand that allergic factors predispose the majority of patients to asthma, but also not all asthmatic patients have allergy 3. Know that maternal smoking is associated with increased wheezing in infants 4. Recognize the socioeconomic and psychosocial factors that are associated with increased morbidity and mortality in patients with asthma 5. Recognize the factors in the medical history of a child with asthma that are associated with increased morbidity and mortality, (e.g., previous severe exacerbation with intubation or ICU admission; frequent hospitalizations or ED visits) 6. Know that environmental tobacco smoke exposure is an important contributing factor for triggering asthma symptoms 2. Etiology/genetics a. Know that asthma, allergic rhinitis, and eczema are embraced under the general term atopic hypersensitivity and that the genetics of atopic hypersensitivity is complex b. Know that asthma, occurring within or outside the context of atopy, is a complex genetic disorder with a heterogeneous phenotype, largely attributed to the interactions among many genes and between these genes and the environment 3. Pathophysiology a. Pathology 1. Recognize the histopathologic features of chronic asthma 2. Recognize the histopathologic features of status asthmaticus b. Pathogenic mechanisms and consequences 1. Know the noninfectious agents that exacerbate bronchial hyperresponsiveness and asthma symptoms 2. Know the infectious agents that exacerbate bronchial hyper- responsiveness and asthma symptoms 3. Understand that the degree of airway hyperreactivity to histamine or methacholine correlates with the number of mast cells, eosinophils, and desquamated epithelial cells detected on bronchoalveolar lavage 4. Understand the role of the parasympathetic nervous system in asthma 5. Understand the role of the sympathetic nervous system in asthma 6. Know that stimulation of the nonadrenergic, noncholinergic nervous system can lead to neurogenic inflammation in patients with asthma 7. Know the agents that are released from lung mast cells that may play a role in asthma 8. Understand the mechanism involved in the early phase of airflow reduction during an asthmatic response to an inhaled-allergen challenge 9. Understand the mechanism involved in the late phase of airflow reduction during an asthmatic response to an inhaled-allergen challenge 10. Know the role of leukotrienes in asthma 11. Know the role of cyclooxygenase products in asthma 12. Understand the role of bronchial epithelium in the pathogenesis of asthma 13. Understand the mechanisms that promote increased lung water and solute movement during status asthmaticus