4. Respiratory System Pathologies Flashcards
Rhinitis
Rhinitis is inflammation of the nasal mucosa.
• The inflammation leads to mucosal swelling and an increase in the volume and viscosity of nasal secretions (mucus).
Rhinitis 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) — IgE stimulates mast cells to release histamine.
- ‘Non-allergic rhinitis’ (associated with environmental and lifestyle changes; e.g. pollution, diet, drugs such as NSAIDs, stress, etc).
Rhinitis signs and symptoms
Itchy runny nose, sneezing, stuffy nose, ↓ smell.
Rhinitis complications
Nasal polyps, ear infections, loss of smell.
Rhinitis treatment
Allopathic: Anti-histamines, decongestants, steroid nasal sprays.
Natural: Nutritional (immune modulation and anti-inflammatory) — raw honey, apple cider
vinegar, quercetin, probiotics.
Herbs (e.g. echinacea, nettle), homeopathy, acupuncture.
© CNM: Human Sciences – Respiratory System. BQ.
Common cold
Infection of the upper respiratory tract.
• Those with lower immunity become infected with virus.
Common cold signs and symptoms
gradual onset, lasting two to seven days. ‘Rhinorrhoea’ (runny nose), sneezing, sore throat and mild fever.
Common cold treatment
ALLOPATHIC DRUG TREATMENT:
• Symptomatic: Painkillers, decongestants.
NATURAL TREATMENT:
• Nutritional (immune support) — vitamin C in high
doses, zinc, vitamin D, steam inhalations with mint, thyme, eucalyptus, colloidal silver, rest. Acupuncture and homeopathy.
• Herbal medicine, e.g. echinacea, elderberry.
Influenza (flu)
Influenza is an acute respiratory disease, associated with various strains of the flu virus.
Incubation period: One to four days (time between microbial exposure and first symptoms)
Flu signs and symptoms
Sudden onset: Fever and shivering, malaise, muscle and joint pain, rhinitis, sore throat.
Systemic symptoms, more severe and last longer.
Flu treatment
ALLOPATHIC TREATMENT
• Antiviral drugs — reduces viral shedding. Have to be taken within 48hrs, but very poor effectiveness and adverse effects.
• Antibiotics to prevent secondary bacterial infection (adverse effects: Lowered immunity, diarrhoea, poor digestion and thrush).
• Flu vaccine in vulnerable populations.
NATURAL TREATMENT
• Herbal medicine (immune system support and anti-viral herbs).
• Homeopathy, nutritional (immune support) — garlic, vitamin C in high doses, zinc, vitamin D, quercetin, steam inhalations with mint, thyme, eucalyptus, rest.
Flu complications
- 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 is estimated to have killed between 50-100 million people (2.7-5.4% of the world population -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.
Sinusitis
Inflammation of the membranous lining of one or more of the sinuses (‘rhinosinusitis’).
• Sinusitis can be acute or chronic (> three months).
• Often associated with immune compromise. Frequently follows a respiratory infection. An infected tooth can sometimes cause
the sinuses to become infected, too.
Sinusitis signs and symptoms
- Pain over affected sinus and congestion.
- ‘Sinus headaches’.
- Fever, nasal drip, change in tone of voice, reduced sense of smell.
Sinusitis treatment
ALLOPATHIC DRUG TREATMENT:
• Painkillers, decongestants
NATURAL TREATMENT:
• Nutritional (vitamin C in high doses, zinc, vitamin D, steam inhalations with mint, thyme, eucalyptus).
• Herbal medicine (immune system support, antiviral and decongestant herbs; e.g. eyebright, echinacea).
• Homeopathy, acupuncture. Netty pot drainage.
Nasal polyps
Nasal polyps are soft, non-cancerous (benign) masses of oedematous nasal mucosa.
Nasal polyps causes/risks
- The end product of chronic inflammation, due to: • Viral, bacterial or fungal.
- Allergies: chronic rhinitis.
nasal polyps 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.
Nasal polyps signs and symptoms
- Difficulty breathing, runny nose, persistent stuffiness.
- Chronic sinus infections, reduced sense of smell.
- Dull headaches, snoring, mouth breathing.
- Can cause sleep apnoea.
Nasal polyps treatment
ALLOPATHIC TREATMENT:
• Intranasal steroids (adverse effects).
• Anti-histamines, anti-fungals, surgery.
NATURAL TREATMENT:
• Treat the cause. Nutrition and herbal medicine for immune modulation / support.
• Homeopathy and acupuncture (relieve blockage).
Tonsillitis
Tonsillitis describes inflammation of the tonsils.
Tonsillitis signs and symptoms
- Sore throat that becomes worse when swallowing.
- Fever over 38oC.
- Coughing, headache and red / inflamed tonsils.
Tonsillitis complications
Middle ear infection, quinsy (abscess).
Tonsillitis treatment
ALLOPATHIC TREATMENT:
•Painkillers, antibiotics (adverse effects: Lowered immunity, disturbed gut function (diarrhoea, bloody stools, poor digestion and absorption, candida).
• Surgery (tonsillectomy) — loss of immune tissue.
NATURAL TREATMENT:
• Nutritional (support immune system and reduce inflammation), lozenges, gargles, colloidal silver.
• Herbal medicine — anti-microbial, immune support; i.e. echinacea, calendula, sage.
• Homeopathy and acupuncture.
Quinsy (peritonsillar abscess)
An abscess that has formed around the tonsils, occurring as a result of tonsillitis.
Quinsy (peritonsillar abscess) Signs and symptoms
• Severe unilateral throat pain, dysphagia, unilateral earache, trismus (limited mouth opening), fever, swollen lymph nodes.
Quinsy (peritonsillar abscess) treatment
- Allopathic: Antibiotics, pus drainage, surgery.
* Alternative: Herbal medicine, nutritional support, lozenges, gargles, colloidal silver. Homeopathy and acupuncture.
Pharyngitis
An acute inflammation of the mucous membrane of the pharynx.
Usually accompanies colds and tonsillitis and is often accompanied by swollen lymph nodes.
Pharyngitis treatment
ALLOPATHIC TREATMENT:
• Painkillers for virus (adverse effects). • Antibiotics — adverse effects.
NATURAL TREATMENT:
• Herbal medicine (anti-microbial, immune support),
nutritional (support immune system and reduce inflammation), lozenges, gargles, acupuncture. Homeopathy.
Laryngitis
Laryngitis describes inflammation of the larynx.
Can be acute or chronic:
• Acute: Viral, bacterial.
• Chronic: Overuse — repeated strain, irritants (smoke, fumes), acid reflux.
Laryngitis signs and symptoms
- Hoarseness, weak voice or voice loss.
- Sore / dry / tickly throat.
- Dry cough.
- Difficulty breathing (in children).
Laryngitis treatment
ALLOPATHIC TREATMENT:
• Antibiotics (consider adverse effects). • Avoid smoking and smoke, maintain oral hygiene.
NATURAL TREATMENT:
• Herbal medicine (anti-microbial, immune support); i.e. echinacea, boswellia, turmeric, ginger, red sage.
• Nutritional (support immune system and reduce inflammation) — garlic, onions, steam inhalations. Homeopathy and acupuncture.
Asthma
Asthma is a chronic airway disease with reversible narrowing of the bronchi and bronchioles.
- An inflammatory condition combined with bronchial hyper-responsiveness with varying degrees of immune cell infiltration.
- Airflow obstruction due to oedema, mucus buildup and 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.
Possible reasons for increasing 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.
Extrinsic (or ‘atopic’) asthma
Affecting children typically, immunologically mediated with an increase in IgE antibodies. Brought on by exposure to allergens e.g. pollen, dust, animal dander.
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, dust, etc.
Atopic triad
- Hay fever
- Asthma
- Eczema
Asthma signs and symptoms
- Recurrent episodes of breathlessness and 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.
Asthma diagnosis
- Based on signs / symptoms and history.
* Spirometry.
Asthma treatment
ALLOPATHIC TREATMENT:
• Bronchodilators (blue inhaler).
• Corticosteroids (brown inhaler) — many adverse effects.
NATURAL TREATMENT:
• Nutritional — fruit and vegetables, antioxidants (e.g. vitamin C and E, quercetin), onions and garlic, omega-3s, magnesium (bronchodilator), eliminate food allergens.
• Herbal medicine; e.g. boswellia, turmeric, astragalus, gingko, liquorice.
• Homeopathy and acupuncture.
• Avoid irritants (dust, smoke etc.) and allergens, allergy treatment, breathing exercises, manual therapy.
Asthma attack
- An asthma attack can be life-threatening.
- Do not hesitate to call for help. It is severe if the patient cannot speak in sentences and has more than 25 breaths per minute (tachypnoea).
- Encourage the patient to sit down (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.
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 mucus to flush it out. If mucus is overproduced, the respiratory system attempts but struggles to clear it.
- This can increase airway resistance and hence breathing difficulties.
Bronchitis signs and symptoms
- Hacking unproductive cough, becoming productive within days (thick yellowy mucus).
- Fever, sore throat, shortness of breath, headache, runny or blocked nose, muscle pain.
- Signs: Crackles on auscultation, tachypnoea, tachycardia, cyanosis.
Bronchitis treatment
- Allopathic: Antibiotics (adverse effects).
- Alternative: Herbal medicine (anti-microbial, immune support), nutritional (support immune system and reduce inflammation), avoid irritants. Homeopathy, acupuncture.
Chronic Obstructive Pulmonary Disease (COPD)
COPD causes airflow limitation that is progressive and not fully reversible. The airflow limitation is due to airway and functional lung tissue damage.
• 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 and destroyed, leading to reduced gas exchange.
Chronic bronchitis:the bronchial lining is constantly irritated and inflamed→thick mucus.
COPD causes
• Smoking (accounts for 90% of COPD in Western countries).
• Exposure to lung irritants (air pollution, industrial chemicals,
dusts, etc.), genetic susceptibility.
Effects of cigarettes on respiratory tract
- Smoking cigarettes and inhaling other irritants leads to high levels of oxidative stress in the respiratory tract.
- Oxidative stress damages the delicate cilia and promotes chronic inflammation throughout the respiratory tract.
• Cells are damaged and scar.
This, as well as excess mucus production leads to airflow obstruction.
COPD signs and symptoms
- Chronic cough with sputum, dyspnoea.
- Prolonged expiration and 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.
COPD complications
- Chronic hypoxaemia→pulmonary hypertension. • Recurrent respiratory infections.
- Respiratory failure.
COPD treatment
ALLOPATHIC TREATMENT:
• Smoking cessation. Bronchodilators, corticosteroids, oxygen therapy.
NATURAL TREATMENT:
• Herbal medicine:
- Anti-inflammatory and immune enhancing (i.e. echinacea, andrographis, cat’s claw).
- Mucous membrane support (i.e. goldenseal, eyebright).
- Nutritional (support immune system and reduce inflammation), i.e. vitamin C, zinc, quercetin, ginger.
- Avoid irritants (dust, smoke, etc.) and allergens; allergy treatment, acupuncture and homeopathy.
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.
Pneumonia signs and symptoms
- Cough and purulent sputum which may be blood-stained.
- Breathlessness, fever, malaise.
- Signs: Tachypnoea, crepitations on auscultation.
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.
Pulmonary fibrosis causes
- Idiopathic (IPF): Unknown, may be genetic, presents around 70 years.
- Smoking, asbestos, some drugs, radiation therapy, accompanies some diseases (autoimmune, e.g. RA).
Pulmonary fibrosis signs and symptoms
• Progressive dyspnoea, chronic cough, fatigue, discomfort in the chest, loss of appetite, weight loss.
Pulmonary fibrosis treatment
Currently no effective allopathic treatments.
NATURAL TREATMENT:
• Herbal medicine (anti- inflammatory, bronchodilators, immune modulation).
• Nutritional (support immune system and reduce inflammation).
• Avoid irritants (dust, smoke, etc.) and allergens, allergy treatment.
• Acupuncture and homeopathy.
Obstructive Sleep Apnoea
Intermittent and repeated upper airway collapse during sleep leading to interrupted breathing.
Obstructive Sleep Apnoea causes
Obesity, male gender, middle-aged, smokers, alcohol, sedatives, nasal obstruction (rhinitis, polyps).
Obstructive Sleep Apnoea treatment
nasal continuous positive airway pressure (CPAP), lifestyle modification. It is essential to treat the cause.
Obstructive Sleep Apnoea signs and symptoms
Loud snoring, daytime sleepiness, morning headache, morning
drowsiness, nocturnal choking, reduced libido. Diagnosis by
polysomnography.
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 buildup of air shifting the heart away).
Pneumothorax causes
- Spontaneous — rupture of cyst / pocket of air, tuberculosis, cystic fibrosis, emphysema.
- Traumatic (damage to pleura) — fracture, surgical complication.
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.
Pneumothorax signs and symptoms
• Dyspnoea and pleuritic (sharp) chest pain. • Cyanosis. • Loss of consciousness, coma. • Signs: Reduced breath sounds, decreased cardiac output.
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).
Pleurisy signs and symptoms
- Dyspnoea.
- Sharp chest pain while breathing — aggravated by inspiration, coughing, sneezing or moving around. Dry cough. May be relieved with shallow breathing.
- Dullness with percussion, friction rub on auscultation.
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.
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.
Pulmonary embolism treatment
- A medical emergency — poor prognosis if untreated. Potentially life-threatening as it can lead to cardiac arrest and heart failure.
- Emergency: anti-coagulation therapy and oxygen.
- Prevention: Regular exercise, hydration and an anti-inflammatory diet.
- Nutrition — anti-coagulants, e.g. essential fatty acids (EFAs), vitamin E.
- Herbs that act as anti-coagulants to prevent clotting, e.g. turmeric, ginkgo, ginger.
Cystic Fibrosis
A multi-organ genetic disease that
affects chloride channels and subsequently key exocrine glands.
- Chloride channels help maintain the proper balance of salt and water within a cell. A genetic mutation causes a dysfunction of salt and water balance.
- Mucus (or secretions) are thick and clog up the lungs and some digestive organs.
- Causes chronic respiratory infections and pancreatic enzyme insufficiency.
- Lung disease is the principal cause of death.
Cystic Fibrosis signs and symptoms
- Respiratory symptoms: Persistent cough, sputum production, recurring lung infections, wheezing, chest pain.
- GIT symptoms: Bloating, obstruction, bleeding, dyspepsia, malnutrition.
Cystic fibrosis treatment
- Allopathic: Antibiotics, physiotherapy, bronchodilators, mucolytics.
- Natural: Herbal medicines (reduce mucus, support digestion, lung function), nutritional (support immune system and maximise nutritional status), avoid irritants and allergens, acupuncture (clear mucus and support lungs and digestion).
