1. PATHOPHYSIOLOGY
   1. allergen exposure
      1. IgE production
      2. mast cell granulation
      3. release of inflammatory mediators
         1. capillary vasodilation
            1. airway obstruction
         2. mucosal edema
            1. activation of lung receptors triggering hyperventilation
         3. bronchoconstriction
            1. PaCo2 decrease, pH increase, respiratory alkalosis
         4. mucus secretion
            1. air trapping increases the pressure & decreases alveolar perfusion
         5. mucosal inflammation
         6. no change in Pa CO2
            1. PaCO2 increases, pH decreases
            2. respiratory acidosis
2. CLINICAL PRESENTATION
   1. cough and wheezing
   2. chest tightness
   3. dyspnea & shortness of breath
   4. respiratory distress
   5. tachypnea
   6. tripodding
3. DIAGNOSIS
   1. CXRay
   2. pulse oximetry
   3. arterial blood gases
   4. pulmonary function test
4. EPIDEMIOLOGY
   1. most asthma deaths occur in ages 45 years old
   2. 180,000 deaths annualy are attributed to asthma worldwide
   3. 11 million people have asthma with exacerbation each year in the U.S.
5. TREATMENT
   1. cortecosteroids
   2. antihistamines
   3. bronchodilators
   4. oxygen/ventilator