Alice is rushed to the emergency department during an acute, severe prolonged asthma attack and is unresponsive to usual treatment. The condition is referred to as which of the following?
A. Status asthmaticus
B. Reactive airway disease
C. Intrinsic asthma
D. Extrinsic asthma
Correct Answer: A. Status asthmaticus
Status asthmaticus is an acute, prolonged, severe asthma attack that is unresponsive to usual treatment. Typically, the child requires hospitalization. One of the most common causes of emergency room visits in the United States is status asthmaticus, an acute, emergent episode of bronchial asthma that is poorly responsive to standard therapeutic measures.
Option B: Reactive airway disease is another general term for asthma. In children, the diagnosis of RAD (reactive airway disease) or recurrent WARIs (wheezing-associated respiratory infections) often precede a formal diagnosis of asthma.
Option C: Intrinsic is a term used to denote internal precipitating factors, such as viruses. In intrinsic asthma, IgE is usually only involved locally, within the airway passages. The airways become more and more narrow, resulting in an asthma attack. Unlike extrinsic asthma, which is triggered by commonly known allergens, intrinsic asthma may be triggered by a wide range of non-allergy-related factors.
Option D: Extrinsic is a term used to denote external precipitating factors, such as allergens. Extrinsic asthma is more common than intrinsic asthma. In extrinsic asthma, symptoms are triggered by an allergen (such as dust mites, pet dander, pollen, or mold). The immune system overreacts, producing too much of a substance (called IgE) throughout the body. It’s the IgE that triggers an extrinsic asthma attack.