Week 10 Flashcards
(14 cards)
part 1
Pneumonia, Asthma, Bronchiectasis
what are the 5 main symptoms of a respiratory disease
Five main symptoms of respiratory disease
1. Dyspnoea
2. Cough
3. Sputum and haemoptysis
4. Wheeze
5. Chest pain
After screening for the above symptoms ensure you identify:
1. Duration
2. Severity
3. Pattern
4. Associated factors (such as triggers etc)
what is Bronchiectasis
Dilation and destruction of bronchi because of recurrent inflammation and infection
Bronchiectasis is a long-term condition where the airways of the lungs become widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection (British Lung Foundation)
what are the Bronchiectasis symptoms
Triad of symptoms-
Chronic cough
Excess purulent sputum production
Repeated infections
Patients also c/o dyspnoea
what are the causes of Bronchiectasis
Smoking
Severe lung infection e.g Pneumonia or Tuberculosis
Childhood diseases i.e measles, whooping cough
Immunodeficiency
Inhaled foreign bodies
Gastric reflux
Inflammatory bowel disease e.g Crohns, ulcerative disease
Arthritis
Severe allergic response to fungus or moulds
Can be genetic or acquired
Congenital-primary ciliary dyskinesia or cystic fibrosis
Approx. half of people diagnosed with Bronchiectasis have no known cause-idiopathic Bronchiectasis
what is consider to be normal sputum
What’s normal? – Mucoid (whitish, light straw colour)
Sputum Assessment steps:
Colour
Consistency – thick, viscous sputum harder to clear. (Remember the wallpaper paste analogy!)
Smell can also be a factor. Purulent sputum is foul smelling
When?
Is the cough productive?
Is it easy for the patient to bring out sputum
Is there a specific time of day or activity that increases/decreases sputum?
How much?
what is asthma
Chronic inflammatory airway disease characterised by intermittent airway obstruction and hyper-reactivity.
Often reversible either spontaneously or with treatment
Asthma commonly begins in childhood but can begin at any age
Often predisposition if parents or close relatives are asthmatic
Increase responsiveness of smooth mm in the bronchial wall to stimuli that are otherwise innocuous = hyper reactivity
Hypertrophy of the mucus glands = mucus production increases
Kills 1600 people in the U.K every year
Hyperactive airways respond to various stimuli by widespread inflammation
the muscles around your airways tighten, making your airways narrower
The airway lining also becomes inflamed causing a build-up of sputum.
Airways become even narrower.
With narrow airways, it’s harder to get air in and out of your lungs
what triggers asthma
Environmental factors- allergens e.g dust mites, furred animals, pollens, moulds,
chemical irritants - cigarette smoke, air pollution, inhaled chemicals
Also exercise, cold air, URTI?LRTI, some foods or drinks (SULPHITES)
what are the symptoms of asthma
Coughing
Dyspnoea
Wheeze
Chest tightness
Symptoms of asthma explained:
Episodes of wheezy difficulty in breathing
Narrowing of the air passages in the lungs and hence increased resistance to airflow.
The narrowing is due to different combinations of:
(a) contraction of muscles around the air passages
(b) swelling of the airway lining due to airway inflammation
(c) excessive mucus in the airways
Rapid and considerable changes in airway obstruction (peak flow variation >= 20%)
Frequent nocturnal episodes and low morning peak flow values
Significant reversibility with drugs i.e steroid and beta2 agonists
Symptom-free periods
Frequent occurrence of allergy
Inflammation of the air passages, characterised by eosinophils in the airway wall
Bronchial hyper-responsiveness to non-specific stimuli such as cold air or histamine
what is Eosinophils
Type of white blood cell
They accumulate wherever allergic reactions (like those in asthma) take place.
Their natural role is to defend us against invaders.
In fact allergies such as asthma are probably a malfunction of our protective mechanism against invaders
what are the physiological consequences of asthma
Reduced expiratory volume (FEV1) -> hyperinflation of lungs
Reduced air exchange during breathing
Increased levels of CO2 in the lungs
Hyperinflation disrupts perfusion:ventilation ratios
Increased CO2 in blood (PCO2 – hypercapnia)
Decreased O2 in blood (PO2 – hypoxia)
what are some statistics associated with asthma
5.4 million people in the UK are currently receiving treatment for asthma:
1.1 million children (1 in 11) and 4.3 million adults (1 in 12).
UK still has some of the highest rates in Europe and on average 3 people a day die from asthma.
In 2016 (the most recent data available) 1,410 people died from asthma.
The NHS spends around 1 billion a year treating and caring for people with asthma
One in 11 children in the UK has asthma.
On average there are three children with asthma in every classroom in the UK.
The UK has among the highest prevalence rates of asthma symptoms in children worldwide.
Asthma attacks hospitalise someone every 8 minutes
185 people are admitted to hospital because of asthma attacks every day in the UK
A child is admitted to hospital every 20 minutes because of an asthma attack.
what is Pneumonia
Pneumonia is swelling (inflammation) of the tissue in one or both lungs. It’s usually caused by a bacterial infection.
alveoli become inflamed and fill up with fluid or pus
Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia
Pneumonia is an infection that inflames the air sacs in one or both lungs.
The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing.
A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia
High morbidity and mortality
In UK pneumonia counts for approx,. 83,000 hospital admissions per year (2013)
5th leading cause of death
what are the types of Pneumonia
- Community acquired pneumonia (CAP
- Hospital acquired pneumonia (HAP)
- Aspiration pneumonia
- Immunocompromised patients
- Pneumonia is usually the result of a pneumococcal infection, caused by bacteria called Streptococcus pneumoniae.
- Many different types of bacteria, including Haemophilus influenzae and Staphylococcus aureus, can also cause pneumonia, as well as viruses and, more rarely, fungi.
