#4 Respiratory System

Question 1

Acute Bronchitis

Answer 1

is an acute infection or inflammation of the airways or bronchi
and is usually self-limiting.

Question 2

Asthma

Answer 2

obstruction is caused by exacerbation episodes of bronchial inflammation,
bronchiole mucosal oedema, bronchospasm and increased mucus production.

Question 3

Bronchiolitis

Answer 3

is a rather common, viral-induced lower respiratory tract
(bronchiolar) infection that occurs almost exclusively in infants and young toddlers.

Question 4

Chronic Bronchitis

Answer 4

is a chronic infection or inflammation of the airways or bronchi

Question 5

Chronic obstructive pulmonary disease (COPD)

Answer 5

is a syndrome that includes
the pathological lung changes consistent with emphysema, chronic bronchitis or
chronic asthma.

Question 6

Croup

Answer 6

is an acute inflammation of the upper airways and almost always occurs in
children between 6 months and 5 years of age. In 85% of cases, croup is caused by
a virus. Airway obstruction occurs in the subglottic region of the trachea, just below
the vocal cords.

Question 7

Cyanosis

Answer 7

is a bluish discoloration of the skin and mucous membranes caused by
increasing amounts of desaturated or reduced haemoglobin (which is bluish) in the
blood

Question 8

Cystic fibrosis

Answer 8

is an autosomal recessive inherited disease that results from
defective epithelial chloride ion transport. Although cystic fibrosis affects many
organs the most important effects are on the lungs and in 90% of cases, chronic
pulmonary infections eventually lead to respiratory failure and death.

Question 9

Diluents

Answer 9

The agent most commonly used to dilute respiratory secretions is normal
saline, administered by ultrasonic nebulizer.

Question 10

Dyspnoea

Answer 10

is the subjective sensation of uncomfortable breathing, the feeling of not
being able to get enough air. Sometimes referred to as difficulty in breathing.

Question 11

Emphysema

Answer 11

is abnormal permanent enlargement of gas-exchange airways
accompanied by destruction of alveolar walls. Obstruction results from changes in
lung tissue.

Question 12

Expectorants

Answer 12

act by an irritant action on the mucous membranes, which increases
the secretion of mucus from bronchial secretory cells, facilitating ciliary action and
productive coughing and soothing and lubricating dry tissues.

Question 13

Haemoptysis

Answer 13

Is the coughing up of blood or bloody secretions

Question 14

Hypercapnia

Answer 14

increased carbon dioxide in the arterial blood (increased PaO2).

Question 15

Hypoxaemia

Answer 15

reduced oxygenation of arterial blood (reduced PaO2)

Question 16

Hypoxia

Answer 16

reduced oxygenation of cells in tissues e.g. oxygen saturations below
90%.

Question 17

Mucolytic drugs

Answer 17

exert a disintegrating effect on mucus, facilitating removal of
mucus or other exudates from the lung, bronchi or trachea by postural drainage,
coughing, spitting or swallowing e.g. acetylcystine

Question 18

Muscarinic antagonists

Answer 18

one of the many pharmacological effects of muscarinicreceptor antagonists (antimuscarinic drugs) such as atropine is inhibition of bronchial
secretions. Dries secretions. E.g. ipratropium

Question 19

Non-small cell lung cancer

Answer 19

Squamous cell carcinoma accounts for about 30% of
bronchogenic carcinomas. These tumors are typically located near the hilum and
project into the bronchi. Adenocarcinoma (meaning that the tumor arises from the
glands) constitutes 35–40% of all bronchogenic carcinomas.

Question 20

orthopnoea

Answer 20

dyspnea when a patient is lying down.

Question 21

pertussis

Answer 21

is caused by the bacterium Bordetella pertussis. The symptoms are thick
secretions, a chronic cough and spasm following coughing fits, which give a
characteristic ‘whoop’ sound — hence the common name ‘whooping cough’

Question 22

Pneumonia

Answer 22

is infection of the lower respiratory tract caused by bacteria, viruses,
fungi, protozoa or parasites. The alveoli and terminal bronchioles fill with infectious
debris and exudate.

Question 23

Pulmonary embolism

Answer 23

is occlusion of a portion of the pulmonary vascular bed by
an embolus, which can be a thrombus (blood clot), tissue fragment, lipids (fats),
foreign body or an air bubble (air embolism). More than 90% of pulmonary emboli
result from clots formed in the veins of the legs and pelvis.

Question 24

Small cell lung cancer

Answer 24

Small cell carcinomas constitute 15–20% of bronchogenic
carcinomas. Most of these tumors are central in origin

Question 25

Status asthmaticus

Answer 25

defined as a severe asthmatic episode that does not respond to pharmacological management.

Question 26

Tubercluosis

Answer 26

is an infection caused by Mycobacterium tuberculosis, a bacterium that usually affects the lungs but may invade other body systems. Inflammation in the lung causes activation of alveolar macrophages and neutrophils.

Question 27

What is Pneumonia

Answer 27

Pneumonia is a form of acute respiratory infection that affects the lungs. The lungs are made up of small sacs called alveoli, which fill with air when a healthy person breathes. When an individual has pneumonia, the alveoli are filled with pus and fluid, which makes breathing painful and limits oxygen intake.

Question 28

Typical bacteria associated with pneumonia

Answer 28

Gram Pos - Strepococcus Pneumoniae - Pneumococcus Stephlococcal pneumonia gram neg - legionella pneumophilia

Question 29

Aetiology of Pneumonia

Answer 29

Infectious micro-organisms Typical - Gram pos, gram neg bacteria Atypical - viral - influenza, fungal CNS dep - loss of gag reflex impaired immune system - pregnant, old and hiv Smoking - damages Cilia Local lung pathologies - CA and COPD

Question 30

Pathophysiology of pneumonia

Answer 30

4 stages of inflam res congestion - vascular enlargement, intraveolar fluid and numerous bacteria, lung tissue is heavy, boggy and red. Red hepatization - massive exudation with RBC, WBC and fibrin filling up the alveolar spaces. affected area appears firm, red and airless with a liverlike consistency Gray hepatization - progressive disintegration of RBC and persistence of a fibrin exudate resolution - consolidated exudate within alveolar spaces undergoes enzymatic digestion to produce debris that is later absorbed, ingested by macrophages or coughed up.

Question 31

Clinical manifestations

Answer 31

Hyperthermia, productive cough, haemoptysis, pain or discomfort, hypoxia, tachypnoea, use of accessory muscles, tachycardia

Question 32

What are the routine investigations and findings for pneumonia

Answer 32

FBC - elevated white cell count Blood cultures - systemic INF Sputum speci - MC & S Urinalysis - Blood sugar Level Urea and Electrolytes - Low sodium and high potassium Chest Xray - Inflam, fluid - patchiness bronchoscopy and pleurodesis

Question 33

Potential complications of Pneumonia

Answer 33

Miscarriage, sepsis, respiratory failure, scarring of lung tissue, empyema, pulmonary abscess.