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asthma vs pneumonia pathophysiology discussion essays

asthma vs pneumonia pathophysiology discussion essays

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Brian is a 7-year-old boy who presents to the primary care office with his mother. His mom has noticed that Brian has been coughing frequently and seems to have shortness of breath at times. She reports that Brian had a “cold” with a low grade fever and runny nose about 2 weeks ago and the symptoms seem to appear after the cold.

On physical examination, Brian appears in moderate respiratory distress, with suprasternal and intercostal retractions. His vital signs include a temperature of 100 A°F, a respiratory rate of 32 breaths per minute, heart rate of 120 beats per minute, and pulse oximetry of 95% on room air. Lung exam is notable for diffuse symmetrical expiratory wheezes. His nasal mucosa is erythematous with boggy turbinates and clear mucus. The remainder of the exam is unremarkable asthma vs pneumonia pathophysiology discussion essays.

1. Based on this case, discuss the differences in the pathophysiology  for asthma vs pneumonia.  Include your thougths as to the diagnosis for this case.

Post your initial response by Wednesday at midnight. Respond to one student by Sunday at midnight. Both responses must be a minimum of 150 words, scholarly written, APA formatted, and referenced. A minimum of 2 references are required (other than your text). Refer to grading rubric for online discussion.

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• • Fritzinger, Wk 5 DiscussionSubscribe
  • Cassie Fritzinger posted Feb 16, 2021 7:40 PM
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  • Brian should be evaluated with Pulmonary function tests (PFTs) to determine if his asthma has gotten worse secondary to his recent cold symptoms. According to Heuther, McCance, & Brascher (2020), the diagnosis for asthma requires these PFTs and are generally done after the age of five. Asthma is a chronic inflammatory disease of hyperreactive bronchials which obstructs the airways. This disease is usually present as a response to an allergen and is manageable with medication and treatments (Heuther, McCance, & Brascher, 2020). Conversely Pneumonia is an infection of the terminal airways secondary to an immune response to either a virus or bacterial.Brian’s physical exam presents with symptoms of bacterial pneumonia following his recent viral illness asthma vs pneumonia pathophysiology discussion essays. Mainly, fever, cough, respiratory distress, tachycardia (secondary to the fever/infection) and decreased pulse oximetry. One recommended treatment of pneumonia includes five days of amoxicillin (80mg/kg/day) for those children who present with retractions versus those without retractions being three days (Chang, Grimwood, 2020). Since pneumonia will affect future lung function it would be important to ensure complete pathogen clearance from the airways with the longer treatment course especially in Brian who has a known history of already compromised lung function with asthma. DynaMed (2018), recommends the treatment of children over the age of five to consider prescribing Amoxicillin or other macrolides. Amoxicillin is recommended at 90mg/kg/day divided in two doses with a maximum dose of 4 grams per day. Other treatments could include the use of clarithromycin, erythromycin, or doxycycline for any contraindications to amoxicillin (DynaMed, 2018).ReferencesDynaMed. (2018). Community-Acquired Pneumonia in Children. Retrieved February 16, 2020, from https://www.dynamed.com/condition/community-acquired-pneumonia-in-children.less3 UnreadUnread19 ViewsViews
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  • View profile card for Cassie Fritzinger
  • Last post February 23 at 12:09 AM by Cassie Fritzinger
  • Heuther, S. E., McCance, K. L., & Brashers, V. L. (2020). Understanding Pathophysiology (7th ed.). Elsevier.
  • Chang, A., Grimwood, K. (2020). Antibiotic for Childhood Pneumonia-Do We Really Know How Long to Treat? The New England Journal of Medicine, 383(1), 77-79. https://doi.10.1056/NEJMe2016328.
  • A viral pneumonia typically does not present with a fever and the white blood count does not increase during a viral pneumonia asthma vs pneumonia pathophysiology discussion essays. It would be important to evaluate and make sure that the child is up to date on his vaccines. Childhood vaccines (pneumococcal & H. influenzae) have greatly decreased the incidences of bacterial pneumonia from Streptococcus pneumoniae, and S. aureus (Heuther, McCance, & Brascher, 2020). Because bacterial pneumonia can develop following a viral infection such as the ‘common cold’ as Brian presents with a recent history, one could suspect that he aspirated on some bacteria from his own nasopharynx.  The viral infection of the cold he developed caused a change in his normal protective barriers in the epithelium, and reduced mucociliary clearance making him more susceptible to the bacterial which caused the pneumonia which would otherwise normally be cleared from his airways.
  • A frank comparisonSubscribe
  • Caroline Otto posted Feb 21, 2021 10:30 PM
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  • 	Pneumonia		Asthma
    	Acute		Chronic
    	Inflammation and Infection In the terminal airways and alveoli.		Inflammation Of the bronchials
    	CAP- Community Acquired Pneumonia (see below) HAP – Hospital Acquired Pneumonia – This is a nosocomial infection that occurs mostly commonly in those who are immunocompromised or who experience prolonged hospitalization for treatment of malignancy, trauma, surgery, or underlying chronic illness.		Bronchial hyperreactivity and reversible airflow obstruction usually in response to an allergen.
    Prevalence:	CAP or Community Acquired Pneumonia is the major cause of morbidity and mortality in children, in developing countries. Most caused by RSV – Virus. Risk factors for developing CAP are ages younger than 2 years old.		Common chronic disease in childhood. Affects 8.3% of US children between birth and 17 years of age. Prevalence is shown to be increasing.
    Population affected the most:	Children in developing countries.		Black and Puerto Rican children and those of low socioeconomic status.
    Originates from:	Overcrowded living conditions, winter season, recent antibiotic treatment, daycare attendance, and passive smoke exposure. Nutritional status, age, and underlying disease process influence morbidity and mortality rates related to CAP asthma vs pneumonia pathophysiology discussion essays.		Childhood asthma emerges from a complicated interaction between genetic and environmental factors. There are many genotypes associated with multiple phenotypes of asthma, including early onset mild allergic asthma, severe asthma and later onset asthma associated with obesity, atopic (allergic) or nonatropic asthma, as well as corticosteroid dependent asthma.
    Characterized by:	Viral	Bacterial	Allergen
    Causal Agents	RSV – Respiratory syncytial virus, influenza, adenovirus, others	Streptococcus pneumoniae, Staphylococcus Aureus Atypical bacterial: – Group A beta hemolytic streptococci Mycoplasma pneumoniae	Environmental Allergens- Air pollution, dust mites, molds, cockroach antigen, cat exposure, and tobacco smoke. Respiratory Tract Infections GERD – Gastroesophageal reflux Preterm births Childhood obesity
    Pathophysiology	2-3 times more likely to occur in children than in adults, and an incidence usually follows a seasonal pattern. RSV is the common culprit. There are others. Parainfluenza, influenza, human rhinovirus, human metapneumovirus, and adenoviruses.   There is initial destruction of the ciliated epithelium of the distal airway with sloughing of cellular material and initiation of an inflammatory response.   Bacterial coinfections are common.	Bacterial pneumonia usually begins with aspiration of one’s own nasopharyngeal bacteria. A preceding viral infection sometimes sets the stage for bacterial infection by causing epithelial damage, reduced mucociliary clearance in the trachea and major bronchi, as well as reduced immune response. Once in the alveolar region, bacteria encounter local host defenses such as antibodies, complement, and cytokines, which prepare the bacteria to be eaten by alveolar macrophages.   Alveolar macrophages recognize the bacterial with their surface receptors and phagocytose them. If this fails then the macrophages release numerous inflammatory cytokines and neutrophils will be recruited into the lung.   Then a intense cytokine-mediated inflammation will ensue Vascular engorgement, edema, and a fibrinopurulent exudate occur. The alveoli filling precludes gas exchange and if extensive can lead to respiratory failure.	Allergic asthma is initiated by type 1 hypersensitivity reaction primarily medicated by T-helper 2 (Th2) lymphocytes whose cytokines activate mast cells eosinophilia, leukocytosis, and enhanced B-cell IgE production. Inflammation, bronchospasm, and mucus production in the airways both lead to ventilation and perfusion mismatch with hypoxemia and to expiratory airway obstruction with air trapping and increased work of breathing in young children. Airway obstruction can be more severe because young children have a smaller diameter in their airways.
    Mode of Transmission	Direct contact Droplet transmission, or aerosol exposure.	Occurs person to person with often a 2–3-week incubation period asthma vs pneumonia pathophysiology discussion essays.	Inhalation, ingestion or contact with the allergen in question.
    Presenting Symptoms	Cough no fever. WBC normal Immunofluorescence tests may confirm diagnosis.	The viral illness is followed by fever with chills and rigors. Shortness of breath Productive cough Occasional blood streaked sputem. Auscultation reveals crackles or decreased breath sounds. Malaise, vomiting, abdominal pain, and chest pain, Absolute neutrophil counts and the percentage of bands (immature neutrophils) are usually elevated. Chest Xray will reveal dense pulmonary infiltrates.	Coughing, expiratory wheezing, and shortness of breath. Breath sounds may become faint when air movement is poor. Speaking is difficult. Elevated respiratory rate and heart rate. Nasal flaring. Use of accessory muscles with retractions in the substernal, subcostal, intercostal, suprasternal, or sternocleidomastoid areas.

    “Asthma is one of the most common chronic syndromes worldwide and it encompasses a variety of signs and symptoms that usually do not include a high fever (Johnson et.al, 2019). Grandbastien, M., Piotin, A., Godet, J., Abessolo-Amougou, I., Ederlé, C., Enache, I., Fraisse, P., Tu Hoang, T. C., Kassegne, L., Labani, A., Leyendecker, P., Manien, L., Marcot, C., Pamart, G., Renaud-Picard, B., Riou, M., Doyen, V., Kessler, R., Fafi-Kremer, S., Metz-Favre, C., … de Blay, F. (2020). SARS-CoV-2 Pneumonia in Hospitalized Asthmatic Patients Did Not Induce Severe Exacerbation asthma vs pneumonia pathophysiology discussion essays. The journal of allergy and clinical immunology. In practice, 8(8), 2600–2607. https://doi.org/10.1016/j.jaip.2020.06.032Pelton, S. I., Shea, K. M., Bornheimer, R., Sato, R., & Weycker, D. (2019). Pneumonia in young adults with asthma: impact on subsequent asthma exacerbations. Journal of asthma and allergy, 12, 95–99. https://doi.org/10.2147/JAA.S200492more0 UnreadUnread

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  •  Johnson, J., Abraham, T., Sandhu, M., Jhaveri, D., Hostoffer, R., & Sher, T. (2019). Differential Diagnosis of Asthma. Allergy and Asthma: The Basics to Best Practices, 383–400. https://doi.org/10.1007/978-3-030-05147-1_17
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  • Viral infections however are known to exacerbate asthma in adults and children (Grandbastien et.al. 2020).
  • Dennies JonesSubscribe
  • Dennies Jones posted Feb 17, 2021 2:52 PM
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  •              Seven-year-old Brian is experiencing Pneumonia secondary to asthma. Brian presented with boggy turbinate, rhinorrhea, which could cause upper respiratory disease or allergic rhinitis, which explained that he has frequently been coughing and seems to have shortness of breath at times. According to Davis and Smallwood (2020), “Asthma is an obstructive airway disease that is the most common cause of acute hospital admission in children” (p. 1024).  Fadi et al. (2020) define pneumonia as “a common and severe lower respiratory tract infection, is recognized as “the forgotten killer of children” (2), killing 1.1–1.4 million children every year and accounting for 17–19% of all deaths among children under five years of age (3)” (p. 1042). The pathophysiology in asthma is a persistent inflammation of the airways. Airflow is limited because inflammation results in bronchoconstriction and edema of the airways (Harding et al., 2020).     Jain V, Vashisht R, Yilmaz G, et al. Pneumonia Pathology. [Updated 2020 Aug 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526116/ more2 UnreadUnread8 ViewsViews
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  • View profile card for Alfonsina Perez
  • Last post February 21 at 7:11 PM by Alfonsina Perez
  • Huether, Sue E., McCance, Kathryn L. Understanding Pathophysiology – E-Book (p. 1682). Elsevier Health Sciences. Kindle Edition.
  • Harding, Mariann M., Kwong, Jeffrey, Roberts, Dottie, Hagler, Debra, Reinisch, Courtney. Lewis’s Medical-Surgical Nursing E-Book (Kindle Locations 30216-30217). Elsevier Health Sciences. Kindle Edition.
  • Fadi, N., Ashour, A., & Muhammed, Y. (2020). Medical management of pneumonia in children aged under 5 years in Alexandria, Egypt: mothers’ perspective. Eastern Mediterranean Health Journal, 26(9), 1042–1050. https://doi-org.wilkes.idm.oclc.org/10.26719/emhj.20.013
  • Davis, M. D., & Smallwood, C. D. (2020). 2019 Year in Review: Asthma. Respiratory Care, 65(7), 1024–1029. https://doi-org.wilkes.idm.oclc.org/10.4187/respcare.07809

• •             Based on the diagnostic information above, most of the symptoms point to asthma, including the moderate respiratory distress, expiratory wheezes, suprasternal and intercoastal retractions, increased respiration rate (32 RR), and tachycardia (120 P). However, there is concern for some type of pneumonia, given his slightly elevated temperature of 100 degrees. Zambare and Thalkari (2019) note that fever is not a specific enough symptom for pneumonia, as it may also appear with other illness. However, as this is a low grade fever which has been developing over 2 – 3 weeks, this could be an atypical pneumonia. Getting a white blood cell count and chest x-rays would help in this diagnosis.
  • Asthma is a chronic inflammatory disease, where airway hyper-responsiveness causes difficulty breathing. It’s typically cause by an allergen. The airway epithelium is responsible for the inflammatory response.  T-helper 2 {Th2} lymphocytes play a role leading to B cell activation and subsequent IgE production, which react to the specific allergen. Th2 cells also recruit and help eosinophils and mast cells, induce goblet cell hyperplasia, and increase bronchial hyper reactivity. Eventually, inflammation, bronchospasm, and mucus production lead to hypoxemia and an obstructed airway, causing respiratory distress (Sullivan et al., 2016).
  • Module 5, Eleany YaseinSubscribe
  • Eleany Yasein posted Feb 17, 2021 1:33 PM
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  •            Pneumonia is a lower respiratory infection that has been linked with a high mortality, and morbidity rate in the world (Zaidi & Blakey, 2019). Pneumonia can be caused by bacterial, virus and fungal infections (Jain, Vashisht, Yilmaz, & Bhardwaj, 2020). Bacterial pneumonia is mainly caused by Streptacoccus pneumoniae. During this disease process, humoral and complement-mediated immunity is compromised. Cell-mediated immunity is also compromised. Moreover, there is buildup of secretions, reduced mucociliary clearance and the cough reflex is impaired. This leads virus, and bacteria to easily invade and cause infection. The immune response activates complement system to fight the pathogen in the alveoli, however the response fails and there will be buildup of inflammatory cells. This leads to inflammation of the alveoli/lung and the lining of capillaries becomes leaky, leading to congestion and pulmonary edema (Jain et al., 2020).            Based on Brain’s clinical presentations, he seems to be experiencing asthma. His symptoms appeared after he had cold. Some triggers of asthma include cold air, pollutes and exercise (Sinyor & Perez, 2020). Moreover, his symptoms including wheezing, shortness of breath, cough and tachycardia can indicate asthma (Sinyor & Perez, 2020).References  less1 UnreadUnread9 Views Views asthma vs pneumonia pathophysiology discussion essays
    

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  • View profile card for Melissa Morgan
  • Last post February 21 at 11:55 AM by Melissa Morgan
  • Zaidi, R. S., & Blakey, D. J. (2019, March 18). Why are people with asthma susceptible to pneumonia? A review of factors related to upper airway bacteria. Official Journal of the Asian Pacific Society of Respirology, 24(5), 423-430. https://doi-org.wilkes.idm.oclc.org/10.1111/resp.13528
  • Sinyor, B., & Perez, C. L. (2020, July 10). Pathophysiology of Asthma. Retrieved from StatPearls website: https://www.ncbi.nlm.nih.gov/books/NBK551579/
  • Jain, V., Vashisht, R., Yilmaz, G., & Bhardwaj, A. (2020, August 26). Pneumonia Pathology. Retrieved from StatPearls website: https://www.ncbi.nlm.nih.gov/books/NBK526116/
  •             Asthma is a chronic airway inflammation triggered by innate and adaptive response (Zaidi & Blakey, 2019). The lining of the epithelium in the airway is damaged. Moreover, there is thickening of the airway muscles. Metaplasia, hyperplasia and hypertrophy of smooth muscles cause airway remodeling. Activation of immune response cells such as histamine, leukotrienes and prostaglandins cause increased vascular permeability, mucus buildup and bronchial constrictions. Airway constriction can lead to increased work of breathing. The chronic inflammation can lead to bacterial and viral invasion. Having asthma puts people at risk for developing pneumonia (Zaidi & Blakey, 2019).
  • Asthma vs. PneumoniaSubscribe
  • Jazmin Jerez-Rivera posted Feb 17, 2021 11:02 AM
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  • While researching the pathophysiology of asthma Sinyor & Perez (2020)indicate there are two phases (early and late phase) of an asthma exacerbation. The early phase begins with IgE antibodies, which are triggered by the environment, bind to mast cells and degranulation occurs. The inflammatory cascade continues with the release of inflammatory mediators which cause “vasodilation, increased capillary permeability, mucosal edema, bronchospasm, and mucus secretion (Huether et. al. 2020, p. 681). This constricts the airway causing inflammation and decreased airflow to the lungs. The late phase is a continuation of chemotactic mediators causing tissue injury and accumulating mucus and cell debris to form mucus plugs further obstructing the airway (Sinyor & Perez, 2020)ReferencesJain, V., Vashisht, R., Yilmaz, G. & Bhardwaj, A. (2020) Pneumonia Pathology. StatPearls. StatPearls Publishing. Retrieved from https://europepmc.org/article/nbk/nbk526116#_article-27364_s4_less1 UnreadUnread7 Views Views asthma vs pneumonia pathophysiology discussion essays
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  • View profile card for Eleany Yasein
  • Last post February 20 at 3:09 PM by Eleany Yasein
  • Sinyor, B. & Perez, L. C. (2020). Pathophysiology of Asthma. StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK551579/
  • Huether, S. E., McCance, K. L., Brashers, V. L. (2020). Understanding Pathophysiology (7 Ed.).  Elsevier.
  • In contrast pneumonia is a lower respiratory tract infection that can be caused by various organisms including viruses, fungi, bacteria, and parasites. If a pathogen gets past the upper airway defense mechanism, then the adaptive immune response similar to asthma will occur causing inflammation in the lungs. According to Jain et. al. “the inflammatory reaction triggered by these very macrophages is what is responsible… for the clinical findings seen in pneumonia” (2020, p. 6). It causes damage to bronchial and alveolocapillary membranes allowing exudate and infectious debris to accumulate in the alveoli, making it difficult to breathe (Huether et. al., 2020).
  • Amandeep KaurSubscribe
  • Amandeep Kaur posted Feb 15, 2021 7:01 PM
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  • Asthma and Pneumonia are two respiratory illnesses commonly associated with one another due to similarities in signs and symptoms. However, the pathophysiology for each is different. Asthma is an obstructive lung disease that leads to airway inflammation, intermittent airflow obstruction, and bronchial hyperresponsive (Lynn & Kushto-Reese, 2015). The bronchial begin to have an exaggerated response to an external stimulus. This causes bronchospasm and a narrowing airway. Additionally, there will be an increase in mucus-producing cells that will secrete thick mucus and in turn block the airway. Eventually, asthma attacks will cause airway remodeling and changes to lung tissue. This can lead to permanent fibrotic damage and loss of lung function. Pneumonia is caused by a pathogen invading the lower respiratory tract (Ebeledike and Ahmad, 2020). These pathogens can be introduced by inhalation, aspiration, epithelium invasion, or hematogenous spread. This causes inflammation/injury and death of respiratory epithelium and alveoli. Inflammatory cells populate at the site of the infection and begin producing exudate. This further impairs oxygenation leading to shortness of breath. Based on Brian’s physical and symptom history he most likely has pneumonia. I have come to this conclusion based on the presentation of a fever two weeks prior and a current temperature. Asthma does not cause a fever, as it is not pathogen produced asthma vs pneumonia pathophysiology discussion essays. Inhaled corticosteroids can be used in the long-term treatment of asthma. Even so, these drugs can increase the likelihood of the individual developing pneumonia (Qian et al., 2017). Users need to be mindful of this as steroids cause a decrease in immunity, allowing pneumonia-causing pathogens to flourish.Ebeledike, C., Ahmad, T. (2020) Pediatric Pneumonia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.Qian, C. J., Coulombe, J., Suissa, S., & Ernst, P. (2017). Pneumonia risk in asthma patients using inhaled corticosteroids: a quasi-cohort study. British journal of clinical pharmacology, 83(9), 2077–2086. more1 UnreadUnread9 ViewsViews
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  • Last post February 20 at 7:40 AM by Candice Russell
  • Lynn, S. J., & Kushto-Reese, K. (2015). Understanding asthma pathophysiology, diagnosis, and management. American Nurse Today, 10(7), 49-51.
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  • 7 year old BrianSubscribe
  • Tallona Boddy posted Feb 15, 2021 6:41 PM
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  • Pneumonia is inflammation in one or both lungs that is caused by either a virus or a strain of bacteria.  Potential signs and symptoms of pneumonia for a 7 year old include, tachypnea, congestion, stomach pain and/or vomiting and fever (ADA, 2020). Stucky-Schrock, et al. (2012) discusses the importance of diagnosing pneumonia accurately and the difficulty that some providers may have with correctly diagnosing pneumonia.  Tachypnea is the most accurate indicator of pneumonia at this time, although providers do need to be aware that respirations can increase by 10 respirations per minute with each elevated degree celsius in febrile children (Stucky-Schrock, et al., 2012).  7 year old Brian is most likely suffering from asthma, the episode was most likely triggered by exposure to a virus or bacteria, as evidenced by his fever, and mom reporting a cold 2 weeks ago.  Brian is currently not experiencing tachypnea, congestion, stomach pain or vomiting, which is more indicative of pneumonia. Brian needs immediate emergent interventions due to his suprasternal and intercostal retractions, as this is a sign of a potential life threatening airway blockage (Medline Plus, 2021).ADA. (2 January, 2020). Pediatric pneumonia. https://ada.com/conditions/pediatric-pneumonia/Medline Plus. (2021, February 8). Intercostal retractions. https://medlineplus.gov/ency/article/003322.htmStucky-Schrock, K., Hayes, B.L., George, C.M.. (2012, October 1). Community acquired pneumonia in children. Am Fam Physician. 86(7), 661-667. https://www.aafp.org/afp/2012/1001/p661.htmlmore1 UnreadUnread7 ViewsViews
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  • Sharma, G.D. &  Gupta, P. (2019, January 8). Pediatric asthma clinical presentation. Medscape. https://emedicine.medscape.com/article/1000997-clinical#b3
  • Mayo Clinic. (n.d.). Childhood asthma. https://www.mayoclinic.org/diseases-conditions/childhood-asthma/symptoms-causes/syc-20351507
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  • Asthma is the inflammation of the airways when exposed to irritants such as allergens, the common cold or respiratory infections (Mayo Clinic, n.d.). Asthma can also be difficult to correctly diagnose.  Some common findings of pediatric asthma include, oxygen saturation above 95% (for a mild asthmatic episode), use of accessory muscles and expiratory wheezes.  Allergic rhinitis is also seen in asthmatics during an absence of an acute episode (Sharma & Gupta, 2019).
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  • Jennifer Bryant posted Feb 17, 2021 10:40 PM
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  • After reading about Asthma and pneumonia I believe he has pneumonia .Pneumonia can occur at any age, although it is more common in younger children. Different age groups tend to be infected by different pathogens, which affects diagnostic and therapeutic decisions (Waseem, 2020).
  • Asthma is a chronic inflammatory disease characterized by bronchial hyperactivity and reversible air flow obstruction usually in response to allergen (Huether, McCance & Brashers, 2020).The main difference is that asthma is a chronic, noninfectious condition, whereas pneumonia is a lung infection asthma vs pneumonia pathophysiology discussion essays. Asthma causes inflammation and narrowing of the airways. It mainly affects the bronchioles, which are the tiny branches of the airways in the lungs. Asthma is not a curable disease, though a person can manage its symptoms with the right medications. Asthma triggers can lessen over time and as a person learns to manage their illness.
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  • Candice Russell posted Feb 15, 2021 4:21 AM
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  • Pneumonia and asthma are common diseases of the lung and are commonly seen amongst the pediatric population. The similarities in the symptoms of these diseases can make it difficult to diagnose. Asthma is a chronic condition, which can cause inflammation and narrowing of the airways, it also affects the bronchi. Although incurable, asthma can be treated. Pneumonia is a lung infection, which can occur in both lungs. Inflammation of the air sacs can occur, along with fluid-filled lungs. Pneumonia is both treatable and curable. Although the symptomology of these two diseases is similar, they are two very different diseases and require different treatment.Jain (2018) described asthma as “a complex disease of the airways, where interactions of immune and structural cells result in disease outcomes with airway remodeling and airway hyper-responsiveness” (p. 1). The activation Th2 immune response has a significant role in the pathophysiology of asthma. Structural cell involvement has been explored in the pathophysiology of asthma. Jain (2018) states “Remodeling of lung architecture in response to Th2 environment increases the thickness of sub-epithelial basement membrane in lung bronchus due to the proliferation of ASMCs (airway smooth muscle cells) and fibroblasts” (p. 4)Pneumonia is said to be “an umbrella term of a group of syndromes caused by a variety of organisms resulting in varied manifestations and sequelae” (Mackenzie, 2016, as cited by Jain et al., 2020, para. 1) Zambare and Thalkari (2019) described pneumonia as an “infection in one or both lungs. It is caused by bacteria, viruses, or fungi” (p. 1). Zambare and Thalkari further break down pneumonia into categories determined by how it is acquired, clinically, the area of lung infected, and others. Other refers to aspiration pneumonia, chemical pneumonia, immunocompromised people pneumonia, severe acute respiratory syndrome (SARS), and necrotizing pneumonia. The many forms of pneumonia are caused by different organisms, which lead to infection. “Commonly the upper respiratory tract infection or infection to the other organs of the body may lead to the infection of lower respiratory tract” (Zambare and Thalkari, 2019, p. 4). Zambare and Thalkari, (2019) describe the pathogenesis of pneumonia by referencing the invading bacteria or viruses, “proliferate and infect the parenchyma of the lungs leading death of lung parenchyma via apoptosis, this leads to the activation of immune system” (p. 5). Fluid accumulation in the alveoli takes place due to vasodilation, caused by inflammatory mediators asthma vs pneumonia pathophysiology discussion essays.Shared symptoms of asthma and pneumonia are shortness of breath, difficulty breathing cough, fatigue, overproduction of mucus, increased pulse rate and increased respiratory rate. Along with the symptoms mentioned above, symptoms of asthma also include wheezing or whistling sound when breathing out, chest congestion or tightness. Common signs and symptoms of childhood asthma include, trouble sleeping do due to difficulty breathing, coughing that is exacerbated by cold/flu, delayed recovery from respiratory infections, and fatigue. Pneumonia signs and symptoms include fever and crackling sound, heard while breathing, chills, headache stuffy nose, nausea, vomiting, diarrhea, chest and belly pain, loss of appetite. Children also experience decreased activity levels.His mother reports Brain had a cold, low-grade fever, and runny nose 2 weeks ago, symptoms appeared after the cold. During Brian’s physical exam, moderate respiratory distress was noted, with suprasternal and intercostal retractions. Diffuse symmetrical expiratory wheezes were found during lung exam. A refresher of pediatric vital signs, many sources had different vital sign ranges. Brian appears to have a slightly elevated temp, normal high heart rate, and an elevated respiratory rate. Brian appears to be suffering from asthma, based on his presentation, findings of his physical assessment, and information received by his mother.                                                                                                 Reference:  So, J. Y., Mamary, A. J., & Shenoy, K. (2018). Asthma: Diagnosis and treatment. European Medical Journal, 3(4), 111-121. https://www.emjreviews.com/respiratory/article/asthma-diagnosis-and-treatment/Zambare, K. K., & Thalkari, A. B. (2019). Overview on Pathophysiology of Pneumonia. Asian Journal of Pharmaceutical Research, 9(3), 1-9. https://wilkes.idm.oclc.org/login?url=https://www-proquest-com.wilkes.idm.oclc.org/scholarly-journals/overview-on-pathophysiology-pneumonia/docview/2305722840/se-2?accountid=62703less1 UnreadUnread10 ViewsViews
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• Jain, V., Vashisht, R., Yilmaz, G., & Bhardwaj, A. (2020). Pneumonia pathology – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK526116/
• Jain, V. (2018). Role of polyamines in asthma pathophysiology. Medical Sciences (Basel), 6(1), 4. https://doi.org/10.3390/medsci6010004
• Brian, a 7-year-old boy, is experiencing frequent coughing and shortness of breath asthma vs pneumonia pathophysiology discussion essays.
• Jain et al. (2020) stated “there is an intricate balance between the organisms residing in the lower respiratory tract and the local systemic defense mechanisms (both innate and acquired) which when disturbed gives rise to inflammation of the lung parenchyma, i.e., pneumonia” (para. 12). Jain et al. (2020) list the defense mechanisms that are compromised in the pathogenesis of pneumonia, systematic defense mechanisms, mucociliary clearance, impaired cough reflex, and accumulation of secretions.  Macrophages protect the lungs from foreign pathogens, “ironically, the inflammatory reaction triggered by these macrophages is what is responsible for the histopathological and clinical findings seen in pneumonia” (Jain et al., 2020, para. 13). Neutrophils flock to the site of infection, activation of cellular and humoral defense mechanisms take place, complement, and form antibodies against these organisms. Jaine et al. (2020) state “this in turn, causes inflammation of lung parenchyma and makes the lining capillaries, “leaky”, which leads to exudative congestion and underlines the pathogenesis of pneumonia” (para. 13).
• Jain (2018) further states “Airway remodeling has been thought to contribute to airway hyper-responsiveness by increasing the stiffness of airways” (p. 4). The first line of defense between the lungs and the external environment is airway epithelium. In asthma, airway epithelium exposure to environmental insults, allergens, and antigens causes stress to epithelial cells. Alarmins, cytokines released by stressed epithelial cells, “govern the immune responses and other key features of asthma, such as airway hyper-responsiveness and airway remodeling” (Jain, 2018, p. 4). Mucous metaplasia takes place, along with epithelial-to-mesenchymal transition. “Taken together, in asthma, immune and structural cells interact with each other, resulting in disease pathophysiology” (Jain, 2018, p. 4).
• Asthma is a heterogenous obstructive lung disease, affecting millions of people worldwide. So et al. (2018) described asthma as having a “complex pathophysiology and phenotype” (p. 111).  So et al. (2018) states “the classic pathway of asthma involves the release of thymic stromal lymphopoietin by epithelial cells and when an allergen or infectious agent centers the airway” (pg. 115). The activation of Th2 cells produces cytokines, which then lead to “IgE formation and eosinophil activation responsible for airway hyper-responsiveness” (So et al., 2018, p. 115). Attachment of IgE to “high-affinity” IgE receptors, causes the activation of mast cells, which leads to the release of histamine, leukotrienes, and prostaglandins involved in bronchoconstriction. (So et al., 2018)
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• Hilary Szpara posted Feb 17, 2021 8:38 PM
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• Symptoms of asthma and symptoms of pneumonia in children can be very similar and make it hard to determine diagnoses based on symptoms alone asthma vs pneumonia pathophysiology discussion essays. Symptoms of pneumonia in children can include cough, rapid breathing, increased work of breathing, grunting, chest retractions, nasal flaring, chest pain, shortness of breath and symptoms may vary based on severity of disease (Shah et al., 2017). Asthma symptoms in children may also vary depending on severity of the case. Severe asthma signs and symptoms may include chest tightness, productive or non-productive cough, sensation of air hunger, insomnia, severe fatigue, use of accessory muscles of respiration, tachypnea, tachycardia, diaphoresis, and wheezing (Fergeson et al., 2016). The similarities between the signs and symptoms may make it hard to differentiate between the diagnoses without adequate testing. Based on Brian’s symptoms, I would think that he has asthma. The main factors which lead me to believe this are the expiratory wheezes, suprasternal and intercostal retractions, and his low-grade fever. I think that his temperature would have been higher if he had pneumonia and wheezing is much more common in asthma than in pneumonia.            Pneumonia occurs when the balance between the microorganisms in the lower respiratory tract and the local and systemic defense mechanisms becomes disrupted. When this happens, inflammation of the lung parenchyma occurs (Jain et al., 2020). The macrophages in the lungs and protect the lungs from pathogens, trigger the inflammatory reaction responsible for the clinical findings of pneumonia (Jain et al., 2020). When the macrophages engulf foreign pathogens in the lungs, it triggers molecules like IL-8 and IL-1, which in turn bring inflammatory cells like neutrophils to the site. The macrophages also present these pathogens to T cells which trigger a host of defense mechanisms and activate complement. This then causes inflammation of lung parenchyma and leads to capillaries producing exudate and congestion in the lungs (Jain et al., 2020).    less0 UnreadUnread
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• Shah, S. N., Bachur, R. G., Simel, D. L., Neuman, M. I. (2017). Childhood pneumonia. JAMA, 318(5), 490. https://doi.org/10.1001/jama.2017.9039
• Quirt, J., Hildebrand, K. J., Mazza, J., Noya, F., Kim, H. (2018). Asthma. Allergy, Asthma and Clinical Immunology, 14(Suppl 2). https://doi.org/10.1186/s13223-018-0279-0
• Jain, V., Vashisht, R., Yilmaz, G., Bhardwaj, A. (2020). Pneumonia pathology. StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK526116/
• Fergeson, J. E., Patel, S. S., Lockey, R. F. (2017). Acute asthma, prognosis, and treatment. Journal of Allergy and Clinical Immunology, 139(2), 438-447. http://dx.doi.org/10.1016/j.jaci.2016.06.054
• Asthma is related to T helper cell type-2 (Th2) immune responses and the triggers of asthma may be either allergic, such as dust mites or pollen, or non-allergic, such as tobacco smoke or exercise (Quirt et al., 2018). When these Th2 cells levels are elevated in the airways, cytokines, such as interleukin (IL)-4, IL-5, IL-9, and IL-13 promote inflammation of eosinophils and immunoglobulin E (IgE) production (Quirt et al., 2018) asthma vs pneumonia pathophysiology discussion essays. The cytokines and other mediators that are released during early phases of an immune response to a particular trigger continue to propagate the inflammatory response, which leads to airway inflammation and bronchial hyperreactivity (Quirt et al., 2018). There also is evidence which suggests that there may be a genetic component to the development of asthma. Chromosomal regions that are associated with susceptibility of asthma have been identified and are areas related to production of IgE antibodies, expression of airway hyper-responsiveness, and production of inflammatory mediators (Quirt et al., 2018).
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• Alfonsina Perez posted Feb 17, 2021 3:58 PM
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•             During this week’s discussion we are introduced to 7-year-old Brian, a boy who comes to the primary care office accompanied by his mother. The child’s mother reports a cough and shortness of breath which appeared after a “cold” and low-grade fever two weeks ago. Harris et al., (2019) defined asthma as a respiratory condition characterized by wheezing, shortness of breath, chest tightness and cough. Other characteristics of asthma also include chronic airway inflammation and physical limitations (Huether et al., 2020). At the cellular level, when a person with asthma is exposed to an antigen, an innate and adaptive immune response is initiated. Many cells are involved in this immune response and some include dendritic cells, T-helper 2, lymphocytes, mast cells and neutrophils (Huether et al., 2020). All of these cells and the resulting reaction lead to the persistent bronchial inflammation and hypersensitivity of the airways as it is found in patients with asthma (Huether et al., 2020).The clinical presentation of Brian would suggest an asthma exacerbation as indicated by expiratory wheezing, suprasternal and intercoastal retractions, cough and shortness of breath. Usually, pneumonia presents with crackles in the lungs. The slight elevated temperature could be indicative of any respiratory infection which may be exacerbating the patient’s asthma.  ReferencesGoodman, D., Crocker, M. E., Pervaiz, F., McCollum, E. D., Steenland, K., Simkovich, S. M.,Miele, C. H., Hammitt, L. L., Herrera, P., Zar, H. J., Campbell, H., Lanata, C. F.,McCracken, J. P., Thompson, L. M., Rosa, G., Kirby, M. A., Garg, S., Thangavel, G.,Thanasekaraan, V., Balakrishnan, K., … HAPIN Investigators (2019). Challenges in thediagnosis of pediatric pneumonia in intervention field trials: recommendations from apneumonia field trial working group. The Lancet. Respiratory medicine, 7(12), 1068–1083. https://doi.org/10.1016/S2213-2600(19)30249-8                
• Pathophysiology 7^th ed.  Elsevier Mosby.
• Huether, S. E., McCance, K. L. & Brashers, V. L. (2020). Understanding 
• CD011651. https://doi.org/10.1002/14651858.CD011651.pub2
• mixed methods systematic review. The Cochrane database of systematic reviews, 1(1),
• School-based self-management interventions for asthma in children and adolescents: a
• Harris, K., Kneale, D., Lasserson, T. J., McDonald, V. M., Grigg, J., & Thomas, J. (2019) asthma vs pneumonia pathophysiology discussion essays.
• Pneumonia’s signs and symptoms in children include cough, fever, poor feeding, tachypnea and lower chest wall indrawing (Goodman et al., 2019). Another clinical presentation of pneumonia are inspiratory crackles heard upon auscultation (Goodman et al., 2019). Huether et al., (2020) defined pneumonia as an infection and inflammation of the airways and alveoli. Pneumonia can be caused by both virus and bacteria, with the most common virus being RSV and most common bacteria Streptococcus aureus (Goodman et al., 2019). In viral pneumonia, the inflammatory response is accompanied by destruction and sloughing of epithelium cells (Goodman et al., 2019) asthma vs pneumonia pathophysiology discussion essays.