These symptoms were found in Selena

Running head: MENTAL HEALTH
Mental health
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Answer 5:
Acute asthmatic attacks result in symptoms of severe wheezing, rapid breathing, chest
tightness, anxiety, sweating, persistent coughing and difficulty in talking. Similar symptom was
found in Selena too, a 19 year old female patients who was admitted to the emergency
department because of shortness of breath, wheezing and chest tightness. The patient verbally
complained that her chest feels tight and she cannot catch her breath. Although she had a history
of asthma since the age of 4 years, however the specific clinical symptoms that indicated that she
had suffered from an asthmatic attack were shortness of breath, coughing, wheezing and chest
tightness. All these symptoms were found in Selena at the time of hospital admission. The study
by supports too that asthma exacerbation result in progressive loss of lung function and this
occurs because of allergy sensitization, bacterial infections, exposure to environment allergens
and tobacco smoking. In case of Selena, the main trigger or risk factors for the asthmatic attack
included allergy to cats and ragweed and the recent exposure to pet cats while Selena visited her
friends (Castillo et al., 2017). Sanya et al. (2014) supported too that attacks of wheezing and
shortness of breath during asthma exacerbation occur after exposure to household. Asthmatic
attacks may be fatal and it is often driven by respiratory viral infection. There is a need to be
continuously monitor such patients and implement appropriate pharmacological interventions to
control symptoms and reduce the onset of symptoms in the future too.
Answer 6:
The chest x-ray report of Selena reported hyperinflated lungs. Hyperinflation is a
condition that leads to trapping of the air in the lungs and overinflation of the lungs. It is most
commonly seen in patients with Chronic Obstructive Pulmonary Disease (COPD) such as

2MENTAL HEALTH
asthma. It is a condition that occurs because of small airway dysfunction and it leads to dyspnea
in patient (van der Meer et al., 2017). In healthy individuals, the lung returns to basal level of
inflation during relaxed tidal breathing which is known as functional residual capacity (FRC).
However, during exercise, both tidal volume and respiratory rate increases to meet the
respiratory needs. Hence, stable lung function is maintained by using expiratory muscles to
increase alveolar pressure and increase expiratory flow. Hyperinflation occurs when high volume
of air remains in the lungs after the end of expiration. Static and dynamic effects of breathing
contribute to such effect in patients like Selena. In asthma patient with COPD, the lung recoil
pressure decreases by reducing the elastic load. This pathophysiological changes result in
decrease of elastic recoil pressure to zero at normal FRC thus resulting in static hyperinflation. In
some patients, dynamic hyperinflation may occur which involves increase in respiratory rate and
volume to accommodate increased respiratory demands. Patients with asthma suffer from
combined effects of reduced lung elastic recoil pressure and high airway resistance resulting in
higher respiratory rate and expiratory flow (Gagnon et al., 2014). Thus, hyperinflation is seen in
asthma patient as an effort to increase expiratory flow.

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References:
Castillo, J. R., Peters, S. P., & Busse, W. W. (2017). Asthma exacerbations: pathogenesis,
prevention, and treatment. The Journal of Allergy and Clinical Immunology: In
Practice, 5(4), 918-927.
Gagnon, P., Guenette, J. A., Langer, D., Laviolette, L., Mainguy, V., Maltais, F., ... & Saey, D.
(2014). Pathogenesis of hyperinflation in chronic obstructive pulmonary
disease. International journal of chronic obstructive pulmonary disease, 9, 187.
Sanya, R. E., Kirenga, B. J., Worodria, W., & Okot-Nwang, M. (2014). Risk factors for asthma
exacerbation in patients presenting to an emergency unit of a national referral hospital in
Kampala, Uganda. African health sciences, 14(3), 707-715.
van der Meer, A. N. A., Hoekstra-Kuik, A., ten Brinke, A., & Bel, E. H. D. (2017). Dynamic
hyperinflation: an important target for treatment in asthma.
https://www.researchgate.net/publication/321928498_Dynamic_hyperinflation_an_impor
tant_target_for_treatment_in_asthma