The forward effects in a patient with left ventricular heart failure include (Select all that apply)

Choice A reason: This is not the cause of airway obstruction in asthma. Collapse of the cartilaginous rings in the bronchi is a feature of tracheobronchomalacia, a condition in which the airways are weak and floppy.

Choice B reason: This is not the cause of airway obstruction in asthma. Type II alveolar cell injury and decreased surfactant are associated with acute respiratory distress syndrome (ARDS), a condition in which the alveoli are damaged and filled with fluid.

Choice C reason: This is not the cause of airway obstruction in asthma. Alveolar changes and pulmonary congestion are seen in chronic obstructive pulmonary disease (COPD), a condition in which the alveoli are enlarged and lose their elasticity.

Choice D reason: This is the correct cause of airway obstruction in asthma. Asthma is a chronic inflammatory disorder of the airways, characterized by mucus secretion, bronchoconstriction, and airway edema. These factors reduce the diameter of the airways and increase the resistance to airflow.

Choice A reason: The patient should not use the glucocorticoid as needed when symptoms flare. The glucocorticoid is a long-term controller medication that reduces inflammation and prevents exacerbations of COPD. It should be used regularly as prescribed, not as a rescue medication.

Choice B reason: The patient does not need to use the beta2-adrenergic agonist drug daily even when they don't have any symptoms. The beta2-adrenergic agonist is a short-acting bronchodilator that relaxes the smooth muscles of the airways and improves airflow. It should be used as needed for relief of acute symptoms, not as a maintenance medication.

Choice C reason: The beta2-adrenergic agonist does not suppress the synthesis of inflammatory mediators. The beta2-adrenergic agonist is a bronchodilator that acts on the beta2 receptors of the airways and causes relaxation of the smooth muscles. It does not have any anti-inflammatory effects.

Choice D reason: The glucocorticoid is used as prophylaxis to prevent exacerbations every day. This is the correct statement that indicates understanding of this medication regimen. The glucocorticoid is a long-term controller medication that reduces inflammation and prevents exacerbations of COPD. It should be used regularly as prescribed, along with the beta2-adrenergic agonist as needed for relief of acute symptoms.