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Flashcards in 22 When airways go wrong Deck (57):
1

Types of respiratory diseases:

-Obstructive
-restrictive
-Infection and inflammation

2

What happens in obstructive diseases?

-Airway resistance is increased
-due to narrowing of the airways
-outflow pressure is reduced
-due to loss of elastic recoil?

3

What is airway resistance

the ease with which air can flow into and out of the lungs

4

What is outflow pressure?

The rate at which we can exhale

5

What effects do restrictive diseases have?

Reduced compliance
- loss of elasticity
-reduced vital capacity

6

What is compliance

The extent to which our lungs increase in volume in response to a given pressure change

7

How do we measure airway resistance?

Using FEV1 (the forced expiratory volume in the 1st second) - taken as a percentage of the total vital capacity

8

What is a normal FEV1

80% of vital capacity

9

What do we use FEV1 for?

-measuring airway resistance
-diagnosing airway resistance
-monitoring it

10

Name the obstructive pulmonary diseases:

-Bronchitis (acute and chronic)
-emphysaema
-asthma

11

what happens in chronic obstructive pulmonary disease:

-covers emphysaema and chronic bronchitis
-narrowing of the airways --> increased airway resistance
-mucus build up
-loss of elastic recoil --> reduced outflow pressure and gas exchange
-over inflation of the chest coz of increased residual volume

12

What kind of respiratory tract diseases can you get?

upper and lower
-upper is more common and easier to treat
-lower is more severe so more intense treatment

13

How many people die annually from COPD?

3 million
-3rd leading cause of death in the world

14

Acute Bronchitis:

-your standard phlegmy cough
-caused by bacteria or virus
-lasts for days or weeks

15

Chronic bronchitis: what happens

-irritants cause inflammation of the bronchi
-bronchi narrow
-over production of mucus
-airways become plugged
-airways become more prone to infection causing inflammation

16

Chronic bronchitis: causes

80% smoking, sometimes environmental irritants

17

Chronic bronchitis: treatments

-stop smoking
-bronchodilators (can be preventative) open up airways to aid airflow
-antibiotics to treat underlying infection

18

Chronic bronchitis: symptoms

-shortness of breath
-airway obstruction
-wheezing due to turbulent airflow
-chest pain - over exertion of muscles in breathing (not quiet breathing anymore, accessory muscles used)
-productive cough - can look for bacteria present in mucus of cough

19

Chronic bronchitis: lasts for

3 consecutive months in 2 years

20

Emphysaema: causes

smoking or an alpha1 trypsin deficiency (2% of COPD patients)
20% of smokers will develop emphyseama

21

Emphysaema: treatments

-stop smoking
-alpha1 antitrypsin supplements
-O2 supplement
-lung transplant

22

Emphysaema: what happens

-irritants in smoke cause neutrophils and macrophages to release elastase
-elastase breaks down alveolar walls reducing surface area
-significantly high compliance
-increased residual volume and FRC because damaged alveoli retain air
-chronically over inflated lung
-reduced vital capacity
-inefficient gas exchange
-Hyperventilation because of excess CO2 in lungs (to get rid)
(-alpha1 antitrypsin inhibits elastase action)

23

Emphysaema: symptoms

-hyperventilation
-inflated chest
-shortness of breath
-muscle wastage due to inefficient gas exchange and hyperventilation

24

what does high compliance indicate?

loss of elastic recoil

25

Asthma: Symptoms

-bronchoconstriction
-over production of mucus
-oedema (collection of mucus in cavities)
both cause increased airway resistance

26

Asthma: Treatments

Bronchodilators:
-relievers
-act immediately e.g. salbutamol
-preventors
-take two weeks to effect
-contain steroids
-dull down mast cell response
Anti-inflammatories:
Given in an asthma attack to re-inflate the airways

27

Asthma: Mechanisms

-mast cells stimulated by allergen
-release histamine and other cytokines
-bronchoconstriction
-mucus production
-oedema
-smooth muscle contraction narrowing airways

28

Asthma: Causes

-hypersensitive reaction to allergens
-exercise and cold air
-genetics
-stress
-air pollution

29

Name the restrictive diseases:

-fibrosis
-respiratory distress syndrome (IRDS, ARDS, SARS)

30

Acute Fibrosis: causes

-severe trauma or infection

31

Chronic fibrosis: causes

-industrial or environmental pollutants
-prescription drug taken over a long period of time
-disease process

32

Acute fibrosis causes

protein exudation - causes fluid build up (oedema) in the alveoli

33

Chronic fibrosis causes:

inflammatory processes which cause fibrosis

34

What is fibrosis

-replacement of lung tissue with connective tissue (collagen) and fibrotic tissue
-reduces gas exchange
-reduces compliance, makes lungs stiffer

35

Fibrosis: treatments

There are no treatments

36

Fibrosis: causes

-environmental or industrial pollutant inhalation
-cigarette smoke
-auto immune disease

37

Upper respiratory infections effect the

nasal cavity, pharynx and larynx

38

Lower respiratory tract infections include

-tuberculosis pneumonia and chronic bronchitis

39

Lower respiratory tract infections effect the

lungs, trachea and bronchi

40

how often does an adult get a upper respiratory tract infection?

2-4 times a year

41

How long does a normal cough last

15-18 days

42

How long does a productive cough last?

13-17 days

43

More women than men get productive coughs. T or F?

T

44

More men than women get productive coughs. T or F?

F

45

Pneumonia caused by:

bacteria
-usually streptococcus
-can be staphylococcus aureus or klebsiella
-effects the alveoli and bronchioles but can effect the lung

46

What happens in pneumonia?

Protein exudate fluid fills the alveoli, inhibiting gas exchange and this causes them to become airless and firm (consolidation)

47

consolidation

Protein exudate fluid fills the alveoli, inhibiting gas exchange and this causes them to become airless and firm

48

two types on pneumonia?

-bronchopneumonia
-alveoli in some of the bronchioles are affected
-lobar pneumonia
-alveoli in a certain lobe all become fluid filled

49

Tuberculosis stats:
new cases 2012:
active chronic cases 2012:
deaths:

8.8 million new
8 million active
1.2-1.5 millon deaths

50

TB is caused by

mycobacterium inhaled, extremely infectious, shows up red in sputum

51

How many phases are there in TB? Name them.

2
Latent
Active

52

Describe the Latent phase of TB

-mycobacterium innitiate response which causes the formulation of a granuloma in lung tissue
-isolated (only effect this lung tissue)
-not infectious

53

Describe the active phase of TB

-only occurs in 10% of people
-spreads to the bronchioles and into the circulation
-breaks down lymphnodes in order to enter the lymph
-spreads systematically

54

How does TB spread around the body

-Initially it replicates on the macrophages
-thought to spread due to inefficient immune response
-spreads to bronchioles
-moves to lymph and collagen gets deposited around the bacterium destroying lymph nodes and alveoli
-moves into the lymph and spreads systematically

55

Treatments for TB

Very difficult to treat due to antibiotic resistance

56

What percentage of people move from the latent phase to the active phase of TB?

10%

57

Why does Tb transition phases?

Due to an inefficient immune response