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Biomedicine I > 4. Respiratory Pathologies > Flashcards

4. Respiratory Pathologies Flashcards

1
Q

Rhinitis

A

Rhinitis is inflammation of the nasal mucosa. • The inflammation leads to mucosal swelling and an increase in the volume and viscosity of nasal secretions (mucous).

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2
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Rhinitis: Causes

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CAUSES: • Immune compromise (leading to viral, bacterial or fungal infections). I.e. related to emotional stress, medications, diet etc. • ‘Allergic rhinitis’ (e.g. due to pollen, spores, mites) –IgEstimulates mast cells to release histamine. • ‘Non-allergic rhinitis’ (associated with environmental & lifestyle changes e.g. pollution, diet, drugs such as NSAIDs, stress etc).

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3
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Rhinits: Signs and Symptoms

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• Itchy runny nose, sneezing, stuffy nose, ↓ smell.

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4
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Rhinitis: Complications

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Nasal polyps, ear infections, loss of smell

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5
Q

Rhinitis: Treatment

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TREATMENT: •Allopathic: Anti-histamines, decongestants, steroid nasal sprays.

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6
Q

Common Cold

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Infection of the upper respiratory tract. • Those with lower immunity become infected with virus. SIGNS & SYMPTOMS: gradual onset, lasting 2-7 days: • ‘Rhinorrhoea’ (runny nose), sneezing, sore throat & mild fever. ALLOPATHIC DRUG TREATMENT: • Symptomatic: Painkillers, decongestants.

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7
Q

Influenza

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Influenza is an acute respiratory disease, associated with various strains of the flu virus. • Incubation period: 1-4 days(time between microbial exposure and first symptoms). • Symptomstend to besystemic, more severe andlast longer. • Flu vaccinations often don’t provide effective immunity as the virus mutates (the vaccine also produces significant side effects).

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8
Q

Influenza: Signs and Symptoms

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• Sudden onset: Fever and shivering, malaise, muscle & joint pain, rhinitis, sore throat.

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9
Q

Influenza: Treatment

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ALLOPATHIC TREATMENT: • Antiviral drugs –reduces viral shedding. Has to be taken within 48 hrs, but very poor effectiveness & side effects! • Antibioticsto prevent secondary bacterial infection. (side effects: lowered immunity, diarrhoea, poor digestion & thrush). • Flu vaccinein vulnerable populations:

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10
Q

Influenza: Complications

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• Secondary infections while the immune system is depleted due to primary flu infection. • Post viral syndrome (chronic fatigue syndrome) following compromised immune system. • Morbidity / mortality - influenza pandemics such as the pandemic of 1918 which wiped out a third of the European population & killed more than twice that in the war (consider that this pandemic followed WWI after huge loss and distress!). • Pigs are known as “mixing reservoirs” as they can host both human and non-human viruses, potentially allowing the mixing of viral genes creating a new virus.

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11
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Cold vs Flu

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12
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Sinusitis

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  • Inflammation of membranous lining of one or more of the sinuses (‘rhinosinusitis’).
  • Sinusitis can be acute or chronic (>3 months).
  • Often associated with immunocompromise. Frequently follows a respiratory infection. An infected tooth can sometimes cause the sinuses to become infected too.
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13
Q

Sinusitis: Signs and Symptoms

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  • Pain over affected sinus & congestion.
  • ‘Sinus’ headaches.
  • Fever, nasal drip, change in tone of voice, reduced sense of smell.
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14
Q

Sinusitis: Treatment

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• Painkillers, decongestants.

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15
Q

Nasal Polyps

A

Nasal polyps are soft, non-cancerous (‘benign’) masses of oedematous nasal mucosa.

CAUSES/RISKS:
• The end product of chronic inflammation,due to:
• Viral, bacterial or fungus.
• Allergies: chronic rhinitis.
PATHOPHYSIOLOGY:
• Chronic inflammation causes the blood vessels in the lining of the nose and sinuses to become more permeable, allowing water to accumulate in the cells.
• Over time, as gravity pulls on these waterlogged tissues, they may develop into polyps.

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16
Q

Nasal Polyps: Signs and Symptoms

A

• Difficulty breathing, runny nose, persistent
stuffiness.
• Chronic sinus infections, reduced sense of smell.
• Dull headaches, snoring, mouth breathing.
• Can cause sleep apnoea.

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17
Q

Nasal Polyps: Treatment

A
  • Intranasal steroids (side effects!).
  • Anti-histamines, anti-fungal, surgery.
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18
Q

Tonsilitis

A
  • Tonsillitis describes inflammation of the tonsils.
  • Common type of infection in children 5-10 years & 15-25 years.
  • Viral (common cold or flu virus) or bacterial (streptococci).
  • Short incubation period.
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19
Q

Tonsilitis: Signs and Symptoms

A
  • Sore throat that becomes worse when swallowing.
  • Fever over 38oC.
  • Coughing, headache & red/inflamed tonsils
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20
Q

Tonsilitis: Complications and Treatment

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• Middle ear infection, Quinsy (abscess).
ALLOPATHIC TREATMENT:
• Painkillers, antibiotics ( side effects: lowered immunity, disturbed gut function (diarrhoea, bloody stools, poor digestion & absorption, candida).
• Surgery (tonsillectomy) – loss of immune tissue!

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21
Q

Quinsy

A
  • An abscess that has formed around the tonsils, occurring as a result of tonsillitis.
  • Mostly affecting adolescents & young adults.
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22
Q

Quinsy - Signs and Symptoms

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Severe unilateral throat pain, dysphagia, unilateral earache, trismus (limited mouth opening), fever, swollen lymph nodes.

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23
Q

Quinsy: Treatment

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• Allopathic: Antibiotics, pus drainage, surgery.

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24
Q

Pharyangitis

A
  • An acute inflammation of the mucous membrane of the pharynx.
  • Usually accompanies colds and tonsillitis and is often accompanied by swollen lymph nodes

ALLOPATHIC TREATMENT:
• Painkillers for virus (side effects!)
• Antibiotics -side effects!

25
Laryngitis
• Laryngitis describes inflammation of the larynx. • Can be acute or chronic: • Acute:viral, bacterial. • Chronic:overuse -repeated strain, irritants (smoke, fumes), acid reflux. SIGNS & SYMPTOMS: • Hoarseness, weak voice or voice loss. • Sore / dry / tickly throat. • Dry cough. • Difficulty breathing (in children). ALLOPATHIC TREATMENT: • Antibiotics (consider side effects). • Avoid smoking and smoke, maintain oral hygiene.
26
Asthma
* Asthma is a chronic airway disease with reversible narrowing of the bronchi & bronchioles. * Aninflammatory condition combined with bronchial hyper-responsiveness with varying degrees of immune cell infiltration. * Airflow obstruction due to oedema, mucous build-up & smooth muscle proliferation (= problems exhaling). * Asthma can develop at any age, but most commonly affects children under 10 years of age, with another peak in the elderly. * ‘Leukotrienes’ are key chemical inflammatory mediators in asthma. They are bronchoconstrictors
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Increased prevalence of Asthma
* Earlier weaning. * Inadequate exposure to pathogens in childhood. * Inherited dysbiosis (imbalance of gut flora) and antibiotic use in children. * Food additives. * Leaky gut syndrome. * Nutritional deficiencies i.e. C, D, E, magnesium.
28
Extrinic Asthma
* Extrinsic (or ‘atopic’) asthma: * Affecting children typically, immunologically mediatedwith an increase in IgEantibodies. Brought on by exposure to allergens e.g. pollen, dust, animal dander
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Intrinsic Asthma
* A bronchial reaction that is not due to antigen-antibody stimulation. Adult onset typically. * Common triggers include anxiety, chemicals, exercise, cold air, drugs (NSAIDs, beta blockers), stress, dustetc.
30
Asthma: Signs and Symptoms
* Recurrent episodes of breathlessness & chest tightness. * Wheezing when exhaling. * Nocturnal coughing, occasionally with thick clear or yellow sputum. * Accessory muscles of ventilation are overused and can cause aching in the neck and upper back.
31
Asthma: Diagnosis
* Based on signs/symptoms and history. * Spirometry.
32
Asthma: Treatment
* Bronchodilators (blue inhaler) * Corticosteroids(brown inhaler) –many side effects.
33
Asthma Attack
* An asthma attack can be life-threatening. * Do not hesitate to call for help! It is severe if the patient can not speak in sentences and has more than 25 breaths per minute (tachypnoea). * Encourage the patient to sit down (do not lie down) and take slow, steady breaths. Try to keep the patient calm. * Use Inhaler (usually blue bronchodilator) every 30-60 seconds, up to a maximum of 10 puffs. * CALL AN AMBULANCE IF YOU CAN NOT GET THE PATIENTS SYMPTOMS UNDER CONTROL.
34
Bronchitis
* Bronchitis describes inflammation of the bronchial tubes. Inflammation can be acute or chronic. * Viral or bacterial infections can result from compromised immunity (considered a lower respiratory tract infection). Can be associated with environmental irritants. * When an irritant enters the airways, goblet cells secrete mucous to flush it out. If mucous is overproduced, the respiratory system attempts but struggles to clear it. * This can increase airway resistance and hence breathing difficulties.
35
Bronchitis: Signs and Symptoms
* Hacking unproductive cough, becoming productive within days (thick yellowy mucous). * Fever, sore throat, shortness of breath headache, runny or blocked nose, muscle pain. * Signs: Crackles on auscultation, tachypnoea, tachycardia, cyanosis.
36
Bronchitis: Treatment
• Allopathic: Antibiotics (side effects).
37
Chronic Obstructive Pulmonary Disease (COPD)
• COPD causes airflow limitation that is not fully reversible and is progressive.The airflow limitation is due to airway and functional lung tissue damage. • Associated with a chronic inflammatory response of the lungs (usually, to inhaled toxins). • COPD refers to a combination of two main pathologies (of varying proportions):  Emphysema -\> walls of the alveoli damaged & destroyed, leading to reduced gas exchange.  Chronic bronchitisthe bronchial lining is constantly irritated & inflamed -\> thick mucous.
38
COPD: Signs and Symptoms
* Chronic cough with sputum, dyspnoea. * Prolonged expiration & wheeze. * Frequent infections. * Signs: Tachypnoea, breathlessness on exertion, pursed lips breathing, patients may lean forward and rest arms on the table, flapping tremor, cyanosis, hyperinflation of chest (“barrel chest”), clubbed nails.
39
COPD: Complications
* Chronic hypoxaemia pulmonary hypertension. * Recurrent respiratory infections. * Respiratory failure.
40
COPD: Treatment
* Smoking cessation. * Bronchodilators, corticosteroids, oxygen therapy.
41
Chronic Bronchitis
Pathology: •Inflammation & thickening of bronchial lining withmucous hyper-secretion. Key symptoms: •Cough & wheezing Appearance: •Blue bloater.
42
Emphysema
Pathology: •Dilation of alveolar sacs by destruction of alveolar wall, leading to collapse of alveoli during expiration Key symptoms: •Breathlessness Appearance: •Pink puffer
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Pneumonia
* Pneumonia is an infection of the alveoli and terminal bronchioles, mostly bacterial. * Associated with an infiltration of neutrophils with inflammation and oedema. * Most common in infants, children and the elderly. Higher risk if the patient is immune suppressed.
44
Pneumonia: Signs and Symptoms
* Cough andpurulent sputum which may be blood-stained. * Breathlessness, fever, malaise. * Signs:tachypnoea, crepitations on auscultation (crackling. rattling)
45
Pulmonary Fibrosis
• Gradual replacement of the one layer thick epithelial cell lining in alveoli with fibrotic tissue. • Fibrotic (scar) tissues are less able to exchange oxygen and CO2. CAUSES: • Idiopathic: Unknown, may be genetic, presents around 70 years. • Smoking, asbestos, some drugs, radiation therapy, accompanies some diseases (autoimmune e.g. RA). SIGNS & SYMPTOMS: • Progressive dyspnoea, chronic cough, fatigue, discomfort in the chest, loss of appetite, weight loss TREATMENT: Currently no allopathic treatment
46
Obstructive Sleep Apnoea
* Intermittent and repeated upper airway collapse during sleep leading to interrupted breathing. * Causes / risks include: Obesity, male gender, middle aged, smokers, alcohol, sedatives, nasal obstruction (rhinitis, polyps). * Treatment with Nasal Continuous Positive Airway Pressure (CPAP), lifestyle modification. It is essential to treat the cause.
47
Obstructive Sleep Apnoea: Signs and Symptoms
• Loud snoring, daytime sleepiness, morning headache, morning drowsiness, nocturnal choking, reduced libido. Diagnosis by polysomnography.
48
Pneumothorax
* A pneumothorax describes air accumulation within the pleural cavity, causing part or all of a lung to collapse. * Air enters via defect in visceral or parietal pleura(e.g. rib fracture). * Can be “simple”(i.e. heart remains central) or “tension”(unstable -progressive build up of air shifting the heart away).
49
Pneumothorax: Causes
* Spontaneous-rupture of cyst/pocket of air, tuberculosis, cystic fibrosis, emphysema. * Traumatic(damage to pleura) -fracture, surgical complication.
50
Pneumothorax: Signs and Symptoms
* Dyspnoea and pleuritic (sharp) chest pain. * Cyanosis. * Loss of consciousness, coma. * Signs: Reduced breath sounds, decreased cardiac output.
51
Pneumothorax: Treatment
• A pneumothorax is a medical emergency and typically requires a chest drain (via the lateral ribcage) where accumulated air can be expelled. The patient is often given oxygen and the pleura will require repair.
52
Pleurisy
* Pleurisy describes pleural inflammation. * The pleural surfaces become coated with inflammatory materials and are hence roughened, (producing the friction rub on auscultation). * Causes include a tumour or infection (e.g. pneumonia).
53
Pleurisy: Signs and Symptoms
* Dyspnoea. * Sharp chest pain –aggravated by inspiration & coughing. * Dry cough, shallow breathing. * Dullness with percussion, friction rub on auscultation.
54
Pulmonary Embolism
* A pulmonary embolism results from obstruction within the pulmonary arterial tree. * The embolus (mobile clot) often occurs as a result of a thrombosis, travelling up from one of the deep veins in the legs (i.e. a DVT). * Fat embolisms can occur following bone fractures.
55
Pulmonary Embolism: Signs and Symptoms
* Symptoms: Dyspnoea, pleuritic chest pain, cough, coughing blood, calf pain (if following a DVT). * Signs: Tachypnoea, tachycardia, crackles on chest auscultation.
56
Pulmonary Embolism: Treatment
• A medical emergency –poor prognosis if untreated. Potentially life threateningas it can lead to cardiac arrest & heart failure. TREATMENT: • Emergency: anti-coagulation therapy and oxygen. • Prevention: regular exercise, hydration & an anti-inflammatory diet.
57
Cystic Fibrosis
* A multi-organ genetic disease of exocrine glands. * Recessive disease of chromosome 7 that affects chloride channels. This alters the amount of Cl-and Na+secreted. * Excessive Cl-, Na+and water are absorbed from the airways (& pancreas, gallbladder). * Mucous or secretions arethick and clog up the lungs and some digestive organs. * Causes chronic respiratory infections & pancreatic enzyme insufficiency. * Lung disease is the principal cause of death
58
Cystic Fibrosis: Signs and Symptoms
* Respiratory symptoms: Persistent cough, sputum production, recurring lung infections, wheezing, chest pain. * GIT symptoms: Bloating, obstruction, bleeding, dyspepsia, malnutrition.
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Cystic Fibrosis: Treatment
Antibiotics, physiotherapy, bronchodilators, mucolytics.

Biomedicine I (18 decks)

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