C15 - Respiratory Diseases

Question 1

What’s a pollutant?

Answer 1

A substance released into the environment or the environment itself.

E.g. Fungal spores or smoking regularly

Question 2

What’s an acute condition?

Answer 2

One with a rapid onset but quick recovery time.

Question 3

What’s a chronic condition?

Answer 3

One that develops more slowly but lasts a long time or is incurable.

Question 4

What’s an allergen?

Answer 4

A substance that causes an allergic reaction

Question 5

What’s a COPD?

Answer 5

A chronic obstructive pulmonary disorder

Question 6

What is metastasis?

Answer 6

The spreading of cancer from one organ to another when a tumour breaks off and travels to another part of the body.

Question 7

What’s asthma?

What causes asthma?

Answer 7

A COPD as a result of inflammation and narrowing of the bronchi in the lungs.
This is due to the muscle walls contracting in bronchioles tubes.

Allergens: pollen, dust, aerosols, nuts.
Inflammation
Inheritance

Question 8

What are the symptoms of asthma?

Answer 8

Short of breath

Wheezing

Chest tightness

In the bronchi and bronchioles, mucus production increases, the smooth muscles contract and inflammation causes the swelling in the walls. This narrows the lumen, restricting air flow.

Question 9

How can asthma be treated?

Answer 9

There’s no cure

Drugs, inhalers and bronchodilators can be given.

Question 10

What is lung cancer?

What causes lung cancer?

Answer 10

When cells grow and divide uncontrollably forming a tumour caused by DNA mutations.

The mutations can be caused by smoking (90%) or carcinogens which spread from carcinomas and stop normal cell function.

Question 11

What are symptoms of lung cancer?

Answer 11

Short of breath
Coughing (up blood)
Loss of weight
Wheezing

Sputum (music from the lungs) is likely to be stained with blood if the tumour damages lung tissue.

Question 12

How is lung cancer treated?

Answer 12

Chemotherapy- using toxic chemicals

Radiotherapy- using gamma rays

Surgical removal
(Identified by X-ray and CT scans)

Question 13

What are steroids?

Answer 13

(Corticosteroids) are a method of controlling asthma long term by reducing inflammation of the bronchi.

Question 14

What are beta-agonists?

Answer 14

A method of treating asthma.
They are used before exercise or acute asthma attacks.

They act as bronchodilators and relax the smooth muscle, widening the lumen of the bronchi.

Question 15

What’s chronic bronchitis?

What causes chronic bronchitis?

Answer 15

The narrowing of the bronchi.

It is caused by tar, a chemical released from cigarettes, which can be deposited in the airways of a smoker.
The tar causes inflammation, stimulates mucus production by goblet cel,s and paralyses cilia on ciliates epithelial cells.
The cilia are then no longer able to move mucus up the airways.
Mucus containing dirt and microorganisms builds up in the airways trapping bacteria and leading to an infection.

Mucus narrows bronchi and increases diffusion distance for oxygen and carbon dioxide.

Question 16

What causes chronic bronchitis?

Answer 16

Smoking

It is caused by tar, a chemical released from cigarettes, which can be deposited in the airways of a smoker.
The tar causes inflammation, stimulates mucus production by goblet cel,s and paralyses cilia on ciliates epithelial cells.
The cilia are then no longer able to move mucus up the airways.
Mucus containing dirt and microorganisms builds up in the airways trapping bacteria and leading to an infection.

Mucus narrows bronchi and increases diffusion distance for oxygen and carbon dioxide.

Question 17

What are the symptoms of chronic bronchitis?

Answer 17

Short of breath

Wheezing

Blood-stained sputum

Persistent cough producing excess mucus

Fatigue

Question 18

How is chronic bronchitis treated?

Answer 18

No cure

Similar to asthma, steroids and bronchodilators are used.

Question 19

What is emphysema?

What causes emphysema?

Answer 19

It is the breaking down of alveoli walls.

Many white blood cells are attracted to sites of infection in the alveoli due to the presence of bacteria filled mucus.
These phagocytes produce the enzyme ‘elastase’ which digests tissue to enable phagocytes to reach infections.
The elastase breaks down proteins such as elastin in the alveoli walls.
The inhibitor ‘AIAT’ which prevents this damage occurring in healthy people is deactivated in smokers.

This causes the alveoli to become enlarged, damaged and burst and the elastin is permanently stretched.

Question 20

What causes emphysema?

Answer 20

Smoking which prevents the inhibitor ‘AIAT’.

Many white blood cells are attracted to sites of infection in the alveoli due to the presence of bacteria filled mucus.
These phagocytes produce the enzyme ‘elastase’ which digests tissue to enable phagocytes to reach infections.
The elastase breaks down proteins such as elastin in the alveoli walls.
The inhibitor ‘AIAT’ which prevents this damage occurring in healthy people is deactivated in smokers.

This causes the alveoli to become enlarged, damaged and burst and the elastin is permanently stretched.

Question 21

How is emphysema treated?

Answer 21

No cure.

Emphysema and chronic bronchitis are treated together as COPD with steroids and bronchodilators.

Question 22

What are the symptoms of emphysema?

Answer 22

Short of breath

Shallow breaths

Barrel chest - muscles don’t contract well so lungs don’t fully open.

Wheezing

Question 23

What medicines can be derived from plants?

What plants do they come from?

Answer 23

Quinine - Cinchona sp

Aspirin - sailx alba (willow)

Theophylline - theobroma cacao (cocoa)

Paclitaxel - taxis brevifolia (yew tree)

Question 24

What are the properties and uses of medicines derived from plants?

Answer 24

Quinine - Fever reducing, painkilling and anti inflammatory. Used for anti malaria

Aspirin - Anti inflammatory, painkilling. Painkiller and anti-thrombotic

Theophylline - muscle relaxant, anti inflammatory. COPD and asthma treatment

Paclitaxel - inhibits mitosis. Anti-cancer drug

Question 25

What occurs during drug trials?

Answer 25

Phase 1: Human trials testing on healthy volunteers. (10-20 volunteers over approx 5.5 yrs).
This is done to ensure there are no side effects as they have stronger immune systems.

Phase 2: Trials on few patients to see if it is effective.

Phase 3: Trials on many patients to see how it compares to existing drugs. The drug is then released once approved.

Phase 4: Trials are carried out to see if it can be beneficial for other purposes and look in to long term side effects.

Question 26

What is the difference between blind and double blind trials?

Answer 26

In blind trials, the patient doesn’t know if the drug is real or placebo.
In double blind trials, neither the patient nor doctor knows.

Question 27

What 2 measurements can be taken using a peak flow meter?

Answer 27

PEFR and FEV1

Peak expiratory flow rate and forced expiratory volume.

Question 28

What are examples of COPDs

Answer 28

Asthma
Chronic bronchitis
Emphysema

Question 29

How does tobacco smoke cause changes in the lining of the bronchioles and alveoli leading to the development of COPD?

Answer 29

Tar causes inflammation

Scar tissue formed

Goblet cells, produce / secrete, more mucus causing cilia to become, paralysed / damaged / prevented from working

Mucus, not removed (by cilia) becomes infected so
airways become narrowed / blocked

Large numbers of, macrophage / neutrophils, in alveoli produce elastase. (Due to bacteria filled mucus).
Alpha-1-antitrypsin (AIAT), the inhibitor of elastase,
is inactivated by chemicals in smoke.

Elastin / elastic fibres / protein, in walls of alveoli broken down

Alveoli become, enlarged / damaged / burst and prevented from stretching and recoiling therefore there is less surface area for gas exchange.