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Flashcards in Respiratory System Deck (43)
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what host defences protect us from respiratory diseases

saliva, lymphoid tissue eg tonsils, alveolar macrophages


give an example of a disease causing sinusitis and how does it work

adenovirus, damages adhesions to cells, allows it to get through to mucosa and penetrate


give a virulence factor of streptococcus pyrogenes

exotoxins are haemolysis, break down blood cells, also protein m forming capsule


how does rheumatic fever result from strep pyrogenes

capsule is protective mechanism, form antibodies to this, but these are self reactive, attack sacrolemma of cardiac tissue, damages heart tissue


what is the difference between acute and chronic bronchitis

acute - happens over winter months due to virus
chronic - continuous cough for 3 months over 2 years


how does tb cause disease

has a thick capsule, macrophages engulf the bacteria, cannot lyse the capsule, so the bacteria continues to replicate inside the macrophages, giant cells form, if these liquify, the disease will spread in the body


what is pneumonia

inflammation of alveoli air sacs in lungs


how might pneumonia be acquired and what are pathogens are associated with disease

community - streptococcus pneumonia
hospital - staph aureus


what are 2 virulence factors of streptococcus pneumonia and how to they contribute to disease

pneumolysin - cleavage of proteins, allows adherence to alveoli cells, breaks down blood cells
capsulated - immune system can see bacteria but cannot get to it to attack it, chronic inflammatory disease


what are the treatments available for pneumonia

antibiotics - beta lactams, erythromycin
but resistance to these is increasing
so developing vaccine


how are drugs given by inhalation absorbed

powder which is topically by the airways, doesnt reach alveoli, is absorbed before then


how do bronchodilators aid respiratory disease

they act on beta 2 receptors as an agonist, opens up the airways, increase diameter, allows for better ventilation. or anticholinergic drugs block muscarinic nerve transmission to increase patency


how do anti-inflammatory's aid respiratory disease

break down mucous being secreted, this prevents a blockage in the airway


what triggers an asthma attack

mast cell degranulation


what is chromoglycate used for

mast cell stabiliser


what drugs impair respiratory function

opiods and benzodiazepines


what are the 2 types of inhalers

Metre dosed inhaler - puffer, powder in air is pressed out an inhaled, but can go at a high velocity so more absorbed in mouth than airways
breath activated device - blow into the inhaler, activates the powder, this is then inhaled, much slower velocity, more likely to be absorbed in airways


what can be given with a puffer to improve efficacy

spacer - slows down velocity and allows for a higher concentration of dose to be given


what are the 2 types of beta agonist inhalers

short acting - salbutamol, immediately opens airways, good in asthma attack, but only lasts up to 4 hours
long acting - salmeterol, takes 2 hours to start working but lasts 12-15 hours, may have affects on heart so must be used with steroid inhaler


what is an anticholinergic inhaler available

ipratropium - grey, improves bronchodilation


what steroid inhalers can be used

brown - beclomethasone, different shades of brown for different concentrations, indications of how severe asthma is
orange - fluticosone, pink - mometasone


what inhalers would give an indication that the asthma is not too bad

blue only or green and brown


what inhalers would indicate more severe asthma

orange or pink with green


why are compound preparations useful

patients tend to stop taking brown inhaler as dont feel it is doing anything, take green only, compromise heart. so these can be put together in one inhaler to ensure patient receives both drugs


what are symptoms of obstructive disease

cough - either dry or producing
wheezing or stridor, pain or dysponea - distress whilst breathing


what are signs of obstructive disease

respiratory rate - normally 12-15 breaths per minute, but will be much higher if breathing is insufficient
chest movement, vocal resonance - speaking heard whilst sounding chest


what investigations can be done into obstructive disease

peak expiratory flow rate - maximum flow
forced expiratory flow - in one second
chest x-ray


what is vq mismatch

blockage in ventilation so not all alveoli receiving oxygen, blockage in arteries so not all alveoli being perfused, the alveoli being perfused are not being ventilated - results in no oxygen delivery to blood


what is asthma

a reversible airflow obstruction


what causes asthma

hyper-reactivity to un-harmful substance, e.g. cold air or exercise. causes mast cell degranulation resulting in inflammatory mediators - causes inflammation, mucous production and constriction of airway smooth muscle.