Common Respiratory Conditions

Question 1

Define dyspnoea

Answer 1

difficulty breathing

Question 2

define ventilation

Answer 2

the amount of air entering or leaving the lungs

Question 3

define perfusion

Answer 3

the amount of blood perfusing a capillary bed

Question 4

define hyper or hypoventilation

Answer 4

hyper = excessive ventilation, hypo = decreased ventilation

Question 5

define trachypnoea

Answer 5

increased respiratory rate

Question 6

define bradypnoea

Answer 6

decreased respiratory rate

Question 7

define hypoxia

Answer 7

reduced oxygen in tissues

Question 8

define hypoxaemia

Answer 8

reduced levels of oxygen in the blood

Question 9

define hypercapina

Answer 9

increased carbon dioxide levels in the blood

Question 10

define cyanosis

Answer 10

blue discolouration of the skin

Question 11

define acidosis

Answer 11

blood Ph lower than 7.35

Question 12

define alkalosis

Answer 12

high blood Ph above 7.45

Question 13

define parenchyma

Answer 13

tissue in the lungs

Question 14

What is a restrictive respiratory disease?

Answer 14

restrictive is where there is a small volume of air flowing in, meaning the total lung capacity is low and there is a decreased lung compliance. There is restriction to airflow, which means it is harder to fill and inflate the lungs

Question 15

What is an obstructive respiratory disease?

Answer 15

Obstructive is where there is a small volume of air flowing out, meaning vital capacity is low and there is increased lung compliance. There is an obstruction to airflow, which means it is easier to fill and difficult to expel air.

Question 16

What is cystic fibrosis?

Answer 16

A monogenetic disorder, which has mutation in the CFTR gene. it is an obstructive disorder but has some restrictive elements.

Question 17

Which variant is cystic fibrosis?

Answer 17

The most common variant is delta F508 deletion mutation. The amino acid phenylaniline is deleted, and one AA deletion from a 1480 amino acid protein.

Question 18

What is CFTR?

Answer 18

A chloride ion transporter. Chloride ions are being pumped out from the epithelial cells onto the epithelial surface.

Question 19

What are the main cellular defects caused by CFTR variants?

Answer 19

Defects in protein production, defects in function of the pump, defects in regulation of the pump, defects in protein processing.

Question 20

Explain detlaF508 variant defective processing.

Answer 20

Defective protein folding, which means it doesn’t fold properly. It doesn’t reach the plasma membrane, which means they don’t pump the chloride ions onto the epithelial surface.

Question 21

What systems in the body does cystic fibrosis affect?

Answer 21

secondary biliary cirrhosis - blockage in tubules in the liver 
chronic pancreatis
abnormal sweat electrolytes 
obstruction of vas defernes 
meconium ileus - plugging of the valve in new borns
malabsorption 
lung abscess
chronic bronchitis 
bronchiectasis 
honeycomb lung

Question 22

what are the pathophysiological features in the lung due to cystic fibrosis?

Answer 22

dysregulated/reduced chloride secretion
increased sodium resorption into epithelial cells
water follows the sodium and is reabsorbed into the epithelium
mucus thickening
mucus adherent
Ph is lowered in bronchial epithelia
Ph is changed

Question 23

What are the pathophysiological features in respiratory system due to cystic fibrosis?

Answer 23

airway obstruction
chronic sinusitis 
hyperinflation of the lungs 
bronchiectasis 
peribranchial cuffing 
chronic pulmonary inflammation 
atelectasis 
lung abscess

Question 24

what is bronchiectasis?

Answer 24

the widening of airways, scarred and thickened airway wall, loss of smooth muscle in the airway, and loss of mucus production.

Question 25

What are the pathophysiological complication of cystic fibrosis in the lung?

Answer 25

chronic airway infection in occluded areas pneumothorax fragile, distended blood vessels - often bursting widespread tissue destruction pulmonary fibrosis (restrictive) and pulmonary hypertension ventilation - perfusion mismatching occurs chronic respiratory failure - hypercapnia, hypoxia or both

Question 26

What is COPD?

Answer 26

Chronic obstructive pulmonary disease, which causes airway obstruction, hyperinflation of the lungs, and causes the chest to be full of lungs tissue. It is a mix of emphysema and chronic bronchitis together

Question 27

What is emphysema?

Answer 27

it causes less alveoli, less surface area and less respiratory surface, vast pockets of alveoli, larger air spaces and less elastin in the tissues

Question 28

what is chronic bronchitis?

Answer 28

it causes thickened mucosa in the bronchiole walls, much more mucus being produced, and the loss of ciliated cells that keep everything clean

Question 29

How does COPD cause obstruction?

Answer 29

it causes blockage and plugging in the lumen, bronchoconstriction and inflammation in the walls, and parenchyma loss. It also causes an increased resistance of airflow and a reduction of expiratory flow rate

Question 30

What are the adult COPD risk factors?

Answer 30

tobacco smoking indoor air pollution outdoor air pollution occupational dusts and chemicals

Question 31

What are the child COPD risk factors?

Answer 31

Maternal/paternal asthma childhood asthma severe respiratory infections before age of 5 maternal smoking

Question 32

What is FEV and FVC, and their normal ranges?

Answer 32

FEV = forced expiratory volume in one second FVC = forced vital capacity Normal ranges = FEV - 4.0L and FVC - 5.0L so in one second, they've emptied 80% of their lungs.

Question 33

What are the etiologic factors of atshma?

Answer 33

``` Asthma is obstructive character of air breathed out - smoking, cold air, pollutants acid reflux post nasal drip stress and anxiety genetic linkage drug induced ```

Question 34

What is diffuse pulmonary fibrosis?

Answer 34

A restrictive respiratory disease, which raises the diaphragm, which makes it spacious and not as easy to inflate, which also makes it difficult to speak. It increases the interstitial space between the capillaries and alveoli which compromises the elasticity of the tissue

Question 35

What are the features of pulmonary fibrosis?

Answer 35

dyspnoea, dry cough, shallow breathing, reduced chest movements, clubbing of finger tips and nails

Question 36

Explain the interstitial lung disease pathology

Answer 36

reactive interstitial inflammation amputation of distal airway and ingrowth of bronchiolar epithelium causes dense fibrosis and collapsed distal airway can cause honeycomb lung

Question 37

Explain the role of the lung is acid base balance

Answer 37

The lungs keeps the homeostatic control working for the pH of blood. carbon dioxide production is respiring tissues is constant, lungs expel 240ml/min. the buffering system can donate or accept protons but elimination of excess is important

Question 38

what happens to the respiratory system as we age?

Answer 38

the respiratory surface area decreases, alveolar size increases, bronchiole diameter increases, elasticity of lung tissues decreases, dysregulation of fibroblast function and thoracic compliance decreases.

Question 39

Outline the effects of viral pneumonia and parenchyma on the lungs.

Answer 39

Viral pneumonia causes the lungs air sacs to become inflamed, and fill up with fluid or pus.