This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Asthma, Subject name: Medicine
All are true about aspirin sensitive asthma excpet - 
Select and explain. 
A. Nasal polyposis, B. Treatment with inhaled corticosteroids, C. Rhinosinusitis, D. Increased prostaglandins
D: Increased prostaglandins
Answer: D: Increased prostaglandins 
Explanation: Ans. is 'd' i.e., Increased prostaglandins o Aspirin-sensitive asthma is associated with severe rhinosinusitis and recurrent nasal polyposis.o The complex pathogenesis of aspirin-sensitive asthma involves chronic eosinophilic inflammatory changes, with evidence of increased mast cell activation.o Aspirin-sensitive asthma is an underdiagnosed condition affecting up to 20% of the adult asthmatic population.o It is associated with more severe asthma, requires increased use of inhaled and oral corticosteroids, more presentations to hospital and a risk of life - threatening reactions with aspirin,o The cyclo-oxygenase pathways play a major role in the respiratory reactions that develop after aspirin ingestion.Aspirin sensitive respiratory syndrome primarily affects adults and is characterized by:Perennial vasomotor rhinitis|Hyperplastic rhino-sinusitis with Nasal Polyps|Aspirin exposure|Block cycloxygenase without affecting lipoxygenase|Increased leukotriene|Progressive AsthmaOn exposure to even very small quantities of aspirin, affected individuals typically develop ocular and nasal congestion with acute, often severe, episodes of airway obstruction.