2- Pulmonary Diseases Flashcards
What are 2 variations of lung diseases?
1.) Restrictive lung disease
2.) Obstructive lung disease
What type of lung disease are we describing when there’s difficulty in inflating the lungs + challenges with inhalation?
Restrictive lung disease
What type of lung disease are we describing when there’s difficulty deflating the lungs + challenges with exhalation?
Obstructive lung disease
What is COPD?
It is known as a chronic obstructive pulmonary disease. It is LONGTERM + PROGRESSIVE.
What two types of COPD exist?
1.) chronic bronchitis
2.) Emphysema
What type of COPD encompasses inflammation of the airways + excess mucous production?
Chronic bronchitis
What type of COPD encompasses damage to the alveoli + reduction in surface area for gas?
Emphysema
What are some risk factors associated to COPD?
1.) Smoking: accounts for 85-90% of COPD deaths
2.) Occupational exposure: biological dust, pesticides, gases etc.
3.) Environmental exposure: second hand smoke, pollution.
4.) Genetics
What is the main pathophysiology of COPD?
Irritation of the airways + lungs:
- inflammation
- increased mucous production
- scarring
What can inflammation cause in the airways & lungs?
- Reduction in the airway diameter
- Increased number of cells inflammatory cells
What can scarring cause in the airways & lungs?
- Further reduces surface area & airway diameter
- Less compliant
What are noticeable symptoms of COPD?
1.) Wheezing
2.) Dyspnea (shortness of breath)
3.) Persistent cough
4.) Accessory muscle use
What are some medical managements used for COPD?
- Smoking cessation
- Avoiding respiratory irritants
- Bronchodilators
- Anti-inflammatory drugs
- Supplemental oxygen
- Vaccinations
What are some dental managements used for COPD?
- Emergency Preparedness
- Risk assessment
- Stress/anxiety management
- Consideration of continuous pulse oximetry if available
- Smoking cessation counseling or referral
- Halitosis
- Caution with nitrous oxide sedation
What are some treatment planning considerations for patients with COPD?
1.) Placing them in a semi-supine or upright chair positioning
2.) Avoid aerosol-generating procedures
3.) Avoid use of rubber dam in severe cases
What is asthma?
It is the inflammation of the airways restricting airflow into & out of the lungs.
How is asthma caused?
Due to the hyperresponsive response to stimuli causing the restriction in asthma.
T or F, asthma is irreversible.
False, asthma is in fact reversible.
What are some risk factors associated with asthma?
- Family
- History of severe respiratory infection
- allergic conditions
- Occupational hazards
In severe asthma, what would occur to the smooth muscle of the airways?
Their would be:
- Constriction
- Thickening
- Hyperresponsiveness
In severe asthma, what would occur at the sub-epithelial layer?
Inflammation + fibrosis.
In severe asthma, what would occur to mucous secretion + mucus clearance?
There would be HYPERsecretion of mucus + impaired mucus clearance.
In severe asthma, what would occur in the eosinophil/neutrophil count in the airway of the lumen?
There would be an increase in eosinophils + neutrophils
What are the symptoms of asthma?
1.) Dyspnea
2.) Cough
3.) Wheezing
4.) Weakness
5.) Night cough
6.) Headache
7.) Tachycardia
8.) Allergy
9.) Shortness of breath
What are medical managements used for asthma?
1.) Limit exposure to triggers
2.) Monitor respiratory functioning
3.) Corticosteroids (if chronic)
4.) Bronchodilators (if acute)
What are some dental managements used for asthma?
1.) Inhaled medications
2.) Mouth breathing.
What are some problems associated with using inhaled medications as a form of dental management for asthma?
- Corticosteroids: risk of developing candidiasis or other infections
-Beta agonists: Reduces salivary flow + decreases plaque pH
What are some problems associated with mouth breathing in patients who have asthma?
- Halitosis (bad breath)
- Ortho considerations
- Caries risk
What are some treatment planning considerations for patients with asthma?
1.) Risk management
2.) Stress/anxiety management
3.) Having a rescue inhaler accessible
4.) Upright chair position for better tolerance
5.) Emergency preparedness
What is tuberculosis?
It is an infectious disease caused by Mycobacterium tuberculosis.
How is tuberculosis spread amongst individuals?
It is spread through inhalation of infected droplets.
Where does tuberculosis primarily impact in the body?
It primarily impacts the lungs (but can infect anywhere aswell)
What occurs to the bacteria in tuberculosis when it is ingested by the macrophages?
It begins to replicate itself.
What occurs to the walls of the lungs in tuberculosis?
It begins to destroy the walls of the alveoli causing cavitation & reactive fibrosis.
What differs between a latent TB infection & TB disease?
1.) It can live in the body but doesn’t grow
2.) Doesn’t make someone feel more sick
3.) It does NOT spread from person to person
4.) has the potential to advance to TB diseases.
What are some symptoms of tuberculosis?
1.) Severe prolonged cough
2.) Chest pain
3.) Night sweats
4.) Increased body temperatures
5.) Decreased appetite
6.) Weakness or fatigue
7.) Weight loss
8.) Intoxication
What would be the biggest result of latent TB infections?
It would appear asymptomatic.
What would be the medical management used if TB infections were latent?
It will not treatment unless they are at high risk for disease progression.
What would be the medical management used if TB infections were active?
2-7 months of isoniazid + rifampin + ethambutol + pyrazinamide
What would be the medical management used if TB infections were confirmed with multi-drug resistance?
8-20 months of pyrazinamide + a fluoroquinolone, injectable drug - (amikacin or kanamycin), ethionamide, & either cycloserine or para-aminosalicylic acid
What are dental managements used for patients with Tuberculosis?
1.) Medical hx check
2.) Medical consult
What dental managements would take place if the patient is treated for active tuberculosis?
- Chemotherapy for 2-3 week
- Confirmation that patient is non-infectious
- No complicating factors
What are some treatment planning considerations for patients with tuberculosis?
1.) Universal precautions
2.) Reduce risk of spread:
- airborne isolation rooms
- high volume evacuation
- aerosol-generating procedures
- UV irradiation
3.) Risk of bleeding while on chemotherapy
4.) Ability to tolerate care
