Case 10 Flashcards
What is an acute illness?
Short duration and comes on suddenly. Eg flu
What is a chronic illness?
Long duration and develops slowly. Eg diabetes
Examples of acute lower resp tract (lung) infections?
Acute bronchitis
(Infective) exacerbation of chronic lung disease
Pneumonia
Examples of chronic lower resp tract conditions (Lung diseases)?
COPD
Asthma
Bronchiectasis
Tuberculosis
What is an obstructive lung disease?
A disease which causes airflow limitation, so exhalation is difficult
What are interstitial lung diseases?
A group of diseases characterised by inflammation and scarring of lung tissue
What is acute bronchitis?
Acute inflammation of bronchi (typically no underlying condition)
What is pulmonary fibrosis?
Chronic disease which thickening and scarring of lung tissue
This makes lungs less elastic and leads to difficulty breathing
What is infective exacerbation of chronic lung disease?
Inflammation of bronchi of a patient with an underlying chronic lung condition
What is pneumonia?
Infection of lung interstitium, alveoli and airways
How is pneumonia classified?
By source, location of infection (bronchi or lobes) and pathogen causing it
How does pneumonia inhibit normal lung function?
Inflammation means alveoli filled with fluid and pus, so gas exchange is less efficient
Name and explain 3 physical defence mechanisms of lungs?
Nose - filters, warms, humidifies
Larynx - coughing
Lungs - mucociliary clearance
What is auscultation?
Listening to sounds in the body
What is bronchiectasis?
Abnormal and permanent dilation of bronchial tubes
This can result in a build up of mucus, making them more susceptible to infection
How does bronchiectasis inhibit normal lung function?
Widening and scarring of lungs causes chronic inflammation, this results in chronic inflammation.
This damages bronchial walls, weakens normal clearing mechanisms
Leads to persistent coughing and increased mucus production
What is central cyanosis?
Central cyanosis is a generalized bluish discoloration of the body and the visible mucous membranes
What does COPD stand for?
Chronic Obstructive Pulmonary Disease
What is COPD?
Airflow obstruction which is progressive (worsens over time) and non-reversible
Causes of COPD?
Smoking (both tobacco and cannabis)
Exposure to pollutants, dusts, fumes etc
Recurrent resp infections
Old age
Symptoms of COPD?
Breathlessness
Chronic cough
Regular sputum production
Winter exacerbations
Wheeze
Progressive symptoms (getting worse over time)
What is dyspnoea?
Difficulty breathing
Treatments for COPD?
Bronchodilators (relax muscles around airways)
Inhaled corticosteroids (reduce inflammation)
Pulmonary rehabilitation (programme including exercise and education)
Smoking cessation support
Flu vaccinations to prevent resp infections which can exacerbate COPD
Oxygen therapy to maintain blood O2 conc
…Exercise can also have benefits to COPD patients
Why should a COPD patient not be given 100% oxygen?
Giving 100% oxygen to COPD patients may reduce their drive to breath and cause increased CO2 levels.
What are the 2 types of COPD?
Chronic bronchitis
Emphysema
What is emphysema?
Long term progressive disease of lungs
Loss of alveolar walls, reducing surface area for gas exchange
An obstructive lung disease
How is normal lung function inhibited by emphysema?
Alveoli are destroyed and lung elasticity is lost
Reducing ability to exhale
What is chronic bronchitis?
Enlargement of mucus secreting glands in trachea and bronchi
This leads to hypersecretion of mucus, narrowing air passages
This causes cilia to be immobilised and damaged
This causes bronchial mucosal inflammation
Which causes progressive limitation of airflow
Effect of common bacterial respiratory infection on production of sputum?
Increased sputum production
Increased mucus production as a defence mechanism against bacteria
This may become thicker and/or discoloured due to debris/dead bacteria/immune cells
What methods are there to stop smoking?
Nicotine replacement therapy (patches/ gum/ nasal spray/ e-cigs)
Medications like Zyban and Champix to reduce cravings and withdrawal symptoms
Stop smoking services and behavioural support
Impacts of smoking on respiratory system?
Carcinogenic substances in tobacco, damage lung cells — Incr. risk of lung cancer)
Irritates airways — chronic bronchitis
Damages alveoli — emphysema
Weakens immune system — increased likelihood of resp. Infections
Cilia damaged, so mucus build up
How do penicillins kill bacteria?
Disrupt bacterial cell walls
How do macrolides kill bacteria?
Halt protein production in bacteria
How do fluoroquinolones kill bacteria?
Interfere with bacterial DNA synthesis
How do tetracyclines kill bacteria?
Inhibit bacterial protein synthesis
What is 1 QALY?
1 year of healthy, pain free and disability free life
What is <1 QALY?
1 year of life with pain or disability
What is 0 QALY?
A life not worth living, equivalent to being dead
What is -1QALY?
Life quality is worse than being dead
What is role of alveoli and how are they adapted for their function?
Exchange CO2 and oxygen
Large surface area and thin walls lined with capillaries
Role of mucus in a healthy lung?
Protective barrier, traps and removes dust, debris and micro-organisms
Cilia and mucus waft trapped material up throat
