Bronchitis

Question 1

What is Bronchitis?

Answer 1

Where smoke irritates the lining of the bronchi and they become inflamed

Question 2

What does the body attempt to do during bronchitis?

Answer 2

Clear the chemical irritants, and then ling produces mucus from the goblet cells

Question 3

What clogs the airways?

Answer 3

The production of mucus is excessive and therefore clogs the airways

Question 4

What is the common cause of Bronchitis?

Answer 4

Viral and bacterial infections

Question 5

What is Acute Bronchitis?

Answer 5

usually caused by a viral infection - it lasts for a short period (a few weeks)

Question 6

What is Chronic Bronchitis?

Answer 6

More serious and lasts for more than three months and often recurs over several years

Question 7

What is in the epithelial layer?

Answer 7

Inside the airways, the epithelial layer contains Goblet Cells

Question 8

What are Goblet Cells

Answer 8

They produce mucus

Question 9

What is the role of the mucus?

Answer 9

Mucus traps dust, microbes and other irritants preventing them entering the lungs

Question 10

What do the lungs do in Bronchitis?

Answer 10

The lungs increase mucus production as a defence mechanism

Question 11

What happens when there is excessive mucus?

Answer 11

Can caused clogged airways
Increase coughing
Potential for infection

Question 12

What are the four symptoms of Bronchitis?

Answer 12

Coughing
Wheezing
SOB
Chest discomfort

Question 13

Management and treatment of Bronchitis

Answer 13

• Rest and hydration
• Cough suppressants
• Bronchodilators
• Avoiding irritants

Question 14

What causes the irritation in the airway?

Answer 14

Collection of chemicals, tar and other products of cigarette smoke

Question 15

The ongoing mucus traps causes what?

Answer 15

Causes ongoing irritations
Inflammation to the bronchial tubes

Question 16

How do we clear out the mucus and irritants?

Answer 16

Cough reflex

Question 17

When coughing up mucus, what does this show?

Answer 17

Sputum may be discoloured from trapped irritants

Question 18

What does chronic inflammation cause?

Answer 18

Hypertrophy and Hyperplasia of the Goblet Cells - more obstructive. This makes the goblet cells grow larger.

Question 19

As the Goblet Cells become larger and more numerous, what does this cause?

Answer 19

Even more mucus which clogs the airway and therefore worsening the cycle of cough causing more difficulty in breathing.

Question 20

What are the three treatment strategies to help with coughing and difficulty in breathing?

Answer 20

Bronchodilators - helps open the way
Corticosteroids - reduce inflammation
Expectorants - aids in mucus clearance

Question 21

What does chronic inflammation and irritation cause?

Answer 21

Pulmonary fibrosis

Question 22

What is Pulmonary Fibrosis

Answer 22

This causes the bronchi wall to thicken

Question 23

What does this mean for the fibrosis tissues?

Answer 23

Do not contract and therefore lung function is impaired

Question 24

What is Pulmonary Fibrosis?

Answer 24

When the lung tissue becomes scarred and thickened due to chronic inflammation

Question 25

What can happen to the patient in severe cases?

Answer 25

Hypoxia

Question 26

What do the exposure to higher levels of CO2 cause?

Answer 26

This means the peripheral chemoreceptors, that once signalled to the brain to drive breathing, are no longer sensitive to CO2

Question 27

When the peripheral chemoreceptors are no longer sensitive to CO2 what does this cause?

Answer 27

Hypoventilation

Question 28

What are the symptoms of hypoxia?

Answer 28

SOB Fatigue

Question 29

What are the two managements for hypoxia?

Answer 29

Oxygen therapy Ventilatory support

Question 30

What is hypoxic drive?

Answer 30

Instead of the drive to breath being the detection of high CO2 it now reverts to detecting low levels of O2 instead

Question 31

What is the Assessment of Gas Exchange?

Answer 31

Regular monitoring of O2 and CO2 levels through arterial blood gas tests

Question 32

What is inadequate ventilation?

Answer 32

If the body relies too much on low CO2 levels it may not respond adequately leading to further hypoxia

Question 33

Hypoxia causes a reflex, which is what?

Answer 33

Vasoconstriction of pulmonary arteries in attempt to increase perfusion

Question 34

What does the ECG have for pulmonary hypertension?

Answer 34

Tall pointy p-waves

Question 35

When oxygen levels are low, the pulmonary arteries constrict. Why?

Answer 35

To improve blood flow to better oxygenate parts of the lungs

Question 36

What can the constriction of pulmonary arteries lead to?

Answer 36

Pulmonary hypertension where the pressure in the pulmonary arteries become too high

Question 37

What would the treatment and management be for pulmonary hypertension?

Answer 37

- Oxygen therapy - Medications to reduce pulmonary artery pressure and improve blood flow

Question 38

What is Pulmonary Hypertension when linked to Right Ventricular Hypertrophy?

Answer 38

Pulmonary Hypertension leads to an increase in pressure back down to the right side of the heart. Overtime this causes right ventricular hypertrophy and eventually right ventricular failure.

Question 39

What is the term Cor Pulmonale?

Answer 39

Right ventricular hypertrophy or failure that occurs as a result of lung disease.

Question 40

What are the symptoms of Pulmonary Hypertension and Right Ventricular Hypertrophy?

Answer 40

SOB Fatigue Swelling in legs and ankles Distended neck veins - increased pressure in venous system

Question 41

When giving O2 to those with pulmonary hypertension, what happens?

Answer 41

- It will relieve the reflex vasoconstriction, causing a reduction in pulmonary perfusion. - It can relieve hypoxic pulmonary vasoconstriction.

Question 42

When hypoxic pulmonary vasoconstriction is alleviated through O2 therapy, what does the body do?

Answer 42

Blood flow may be redistributed and in some cases this can result in reduced pulmonary perfusion to area that may not be effectively ventilated

Question 43

Patients with bronchitis, what are they sometimes referred to?

Answer 43

Blue bloaters - due to cyanosis as they are hypoxic

Question 44

What is polycythaemia?

Answer 44

The body attempts to increase its oxygen-carrying capacity by producing more RBC - this is a response to chronic hypoxia.

Question 45

In relation to the kidney detecting low 02, what does the kidney do?

Answer 45

The kidney responds by increase production of erythropoietin, a hormone that stimulates the bone marrow to produce RBC

Question 46

What does Polycythaemia do to the blood?

Answer 46

Increases RBC which can leads to thickened blood

Question 47

What can the thickened blood cause?

Answer 47

- Elevated BP - Increased risk of thrombosis - Strain on heart as it works harder to pump thicker blood

Question 48

When erythropoietin travels through the bloodstream to the bone marrow, what does it bind to?

Answer 48

They bind to specific receptors in the bone marrow called erythroid progenitor cells

Question 49

Those with CKD, what does this do to the production of EPO?

Answer 49

They often experience anaemia therefore the production is reduced

Question 50

How does polycythaemia link to circulation?

Answer 50

Causes sluggish circulation and the pt will appear bloated and plethoric with cyanosis - especially when coughing or on exertion

Question 51

What does heightened RBC mass lead to?

Answer 51

Increased blood viscosity

Question 52

What can sluggish circulation lead to?

Answer 52

Reduce overall blood flow making it more difficult for the heart to pump blood effectively and increases workloads on the heart and lungs

Question 53

What can help reduce blood viscosity?

Answer 53

Hydration

Question 54

What can be done to reduce mass and improve circulation?

Answer 54

Therapeutic phlebotomy which is the removal of blood