22. when things go wrong

Question 1

types of respiratory disease (3)

Answer 1

obstruction
restriction
infection and inflammation

Question 2

obstructive respiratory disease

Answer 2

impede the rate of flow into and out of the lungs
increased airway resistance=narrowing of airways
decreased outflow pressure=elastic recoil of lungs lost

Question 3

restrictive respiratory disease

Answer 3

condition which cause reduced lung volume

reduced compliance means a decrease in the vital capacity

Question 4

an increase in airway resistance and a decrease in the outflow pressure lead to

Answer 4

a decreased forced expiratory volume FEV and an increase in residual volume RV
(looks like chest is overinflated)

Question 5

chronic obstructive pulmonary diseases

Answer 5

chronic bronchitis = narrowing of airways

emphysema= elastic recoil of lings lost

Question 6

what is chronic bronchitis

Answer 6

inflammation of the bronchi
irritants cause inflammation in bronchi
abnormal mucus secretion
plugs airways 
prone to infection leads to further inflammation

Question 7

two types of bronchitis

Answer 7

acute due to bacteria/virus

chronic due to smoking or environmental irritants

Question 8

symptoms of chronic bronchitis

Answer 8

airway obstruction
shortness of breath/wheezing
chest pain
chronic (productive) cough

Question 9

treatment of bronchitis

Answer 9

stop smoking
bronchodilators
antibiotics

Question 10

mechanism of emphysema

Answer 10

smoking triggers the release of neutrophils and macrophages which release elastase
elastase is normally inactivated by a1 antitrypsin but some COPD patients have a genetic deficiency of a1 antitrypsin
elastase is therefore not inactivated and goes on to destroy alveolar walls (emphysema)

Question 11

why does emphysema lead to a chronically over inflated lung

Answer 11

the compliance is significantly above normal

leading to increased residual volume which leads to an increased forced forced residual capacity

Question 12

symptoms of emphysema

Answer 12

shortness of breath on exertion
hyperventilation
expanded chest

Question 13

lifelong smokers

Answer 13

loss of alveoli is permanent and irreversible
give enzyme supplements in a1 antitrypsin deficiency
lung transplant, supplemental O2

Question 14

symptoms of asthma

Answer 14

bronchoconstriction
oedema of airway mucosa
mucus secretion
-all lead to increased airway resistance

Question 15

causes of asthma

Answer 15

hypersensitivity reaction to allergens 
air pollution 
exercise and cold air 
emotional stress
genetics ?

Question 16

mechanism of asthma

Answer 16

mast cell activation
leading to histamine and cytokine release
leading to oedema, mucus, smooth muscle contraction

Question 17

treatment of asthma

Answer 17

bronchodilators eg salbutamol

anti-inflammatories

Question 18

2 main disorders of restrictive lung disease

Answer 18

fibrosis- the development of excessive connective tissue, makes lungs stiffer
respiratory distress syndrome (IRDS, ARDS, SARS)

Question 19

restrictive lung disease symptom

Answer 19

alveolar walls become rigid

Question 20

mechanism for acute restrictive lung disease

Answer 20

sepsis or sever trauma
protein exudation
oedema

Question 21

mechanism for chronic restrictive lung disease

Answer 21

industrial dust, drugs, rheumatism leads to inflammation which leads to fibrosis

Question 22

honeycomb lung

Answer 22

alveoli are replaced by fibrotic tissue leading to decreased lung compliance

Question 23

causes of honeycomb lung

Answer 23

inhaled environmental and occupational pollutants
cigarette smoke
autoimmune disease

Question 24

which are more common, upper respiratory tract infections or lower respiratory tract infections

Answer 24

upper

Question 25

pneumonia

Answer 25

caused by bacteria
affects bronchi and alveoli
inflammatory exudate fills alveoli leading to consolidation
the lung tissue becomes firm and airless

Question 26

what is tuberculosis caused by

Answer 26

inhalation of highly contagious mycobacterium tuberculosis

Question 27

what are the two phases of tuberculosis

Answer 27

latent: asymptomatic, non infectious, granuloma in lung tissue
active: spreads to bronchioles and circulation

Question 28

mechanism of tuberculosis

Answer 28

bacteria is inhaled, enters the alveoli where the bacteria moves to lymph nodes and replicates in alveolar macrophage (Ghon focus)
collagen is deposited around bacteria
the lymph nodes erode releasing bacteria

Question 29

consequences of tuberculosis

Answer 29

the bacteria can drain into the bronchioles or the blood vessels
destruction of alveoli

Question 30

treatment of tuberculosis

Answer 30

difficult due to antibiotic resistance