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Gymnastics and tumbling > Chapter 15 (Respiratory Diseases) > Flashcards

Chapter 15 (Respiratory Diseases) Flashcards

1
Q

What is a pollutant?

A

A substance released into environment which can harm organisms or environment itself.
Can exert short-term effects or long-term with extended exposure.

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2
Q

Examples of pollutants?

A

Tobacco smoke contains chemical pollutants (CO, tar, nicotine)
Asbestos fibres -> lung cancer
Fungal spores, eg, Aspergillus mould - aspergillosis in people with weakened immune system

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3
Q

Definition of chronic disease?

A

Slow onset
Long duration
Slow recovery (may be incurable)

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4
Q

Definition of acute disease?

A

Rapid onset
Short duration
Relatively quick recovery

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5
Q

Short term effects of pollutants on the respiratory system?

A

irritation of nose and throat
Upper respiratory infections, such as chronic bronchitis and pneumonia
Allergic reactions
Aggravate medical conditions, eg, asthma

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6
Q

Long term effects of pollutants on respiratory system?

A

Chronic respiratory disease, eg chronic bronchitis, emphysema.
Causes COPD

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7
Q

Causes of lung cancer?

A
  • Develop due to specific DNA mutations
  • Caused by carcinogens (many in tobacco smoke)
    eg, benzopyrene activates p53 (tumour suppressor gene)

NOT FINISHED!!!!

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8
Q

Stages of lung cancer development?

A

Contains carcinogens /mutagens
Carcinogens cause proto-oncogenes to form oncogenes
Uncontrolled mitosis
Tumour forms
Tumour may spread by metastasis and can be malignant or benign.

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9
Q

Symptoms of lung cancer?

A

Usually no signs or symptoms in early stages
Tumour may grow large enough - Blocks airways.

  • Breathlessness
  • Wheezing
  • Persistent cough
  • Blood stained sputum
  • Loss of appetite
  • Fatigue
  • Unexplained weight loss
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10
Q

Explanation of lung cancer symptoms?

A

Mutation occurs - changes proto-oncogenes into oncogenes
Cells divide by uncontrolled mitosis
Cells change in their response to growth factors and cell signals.
No apoptosis occurs
Cells don’t differentiate and become specialised.

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11
Q

Treatment for lung cancer?

A

Surgery
Chemotherapy
Radiotherapy.

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12
Q

What is asthma?

A

Caused by inflammation and narrowing of bronchi
Triggers: Fur, exercise, cold air, tobacco smoke
Chronic condition
Severe onset - acute asthma exacerbation - asthma attack.

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13
Q

Causes of asthma?

A

Not fully known
Genetic and environmental factors
Increase risk of developing asthma if both parents have disease.
Increase risk linked to:
- Smoking cigarettes
- Inhalation of other air pollutants
- High ozone levels
- Specific allergies

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14
Q

Symptoms of asthma?

A

Vary widely

  • Coughing
  • Wheezing
  • Difficulty breathing
  • Chest tightness.
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15
Q

Explanation of asthma symptoms?

A

Cells lining bronchioles release histamines
Histamines make epithelial cells become inflamed and swollen
Histamines stimulate goblet cells
Mucus production increases in bronchi and bronchioles
Contraction of smooth muscle in bronchi and bronchioles walls
Inflammation occurs - swelling in walls
Lumen of bronchi and bronchioles reduces
Air flow restricted.

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16
Q

Treatments for asthma?

A

Incurable
Treatment can be fast-acting, long-acting.
Inhaler delivers medication
Beta-agonists
Steroids

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17
Q

What do beta-agonists do?

A

Relievers
Act as bronchodilators
- Provide immediate relief
- Used prior to exercise or during asthma attack.
- Some can be used in conjunction with steroids to provide long-term control
- Some chemicals are similar to adrenaline and attach to csm of smooth muscle cells in bronchioles.
Relax smooth muscle
Widen lumen of bronchi.

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18
Q

What do steroids do?

A

Corticosteroids used for long term control.
Taken daily
Reduce sensitivity of lining of the airways
Decrease probability and severity of attack.
Reduce inflammation of bronchi.

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19
Q

Discovering potential drugs information?

A

Many new drugs are based on traditional folk medicine from plant products.
50% prescription drugs are derived from chemicals in plants/synthetic forms of plant products.
Chemicals from plants have physiological effects on body that alleviate symptoms of disease.

20
Q

Medicinal drugs that have come from a plant source?

A

Theophylline
Topotecan
Quinine
Aspirin

21
Q

Theophylline information?

A

Plant source: cocoa beans (Theobroma cacao), tea leaves
Physiological effect: Muscle relaxant (relaxes smooth muscles in bronchi walls)
Anti-inflammatory

Treatment: COPD, asthma

22
Q

Topotecan information?

A

Plant source: Camptotheca acuminata
Physiological effect: Anti-cancer properties, Anti-microbial properties

Treatment: Lung cancer, bacterial infections

23
Q

Quinine information?

A

Plant source: Cinchona sp
Physiological effect: Reduces fever, painkiller, anti-inflammatory.

Treatment: Anti-malarial

24
Q

Aspirin information?

A

Plant source: Salix alba (willow)
Physiological effect: Anti-inflammatory, painkiller

Treatment: painkiller, anti-thrombic

25
Q

Dangers of deforestation?

A

Thousands of species are under threat of extinction due to deforestation and climate change as plants may be made extinct before the chemicals are discovered.

26
Q

What is chronic bronchitis and emphysema?

A

Chronic respiratory diseases

27
Q

Causes of chronic bronchitis

A

Tar deposited in airways

28
Q

Symptoms of chronic bronchitis?

A

Shortness of breath
Wheezing
Fatigue
Blood-stained sputum
Persistent cough

29
Q

Explanation of chronic bronchitis symptoms?

A

Hypertrophy of goblet cells
Stimulates production of mucus from goblet cells.
Excess mucus paralyses cilia
Cilia become unable to waft mucus up the throat.
Mucus accumulates in airways with pathogens - Infections
excess mucus also reduces lumen of bronchi and bronchioles
Mucus accumulates in alveoli → Increases diffusion distance for O2 and CO2.
inflammation occurs

30
Q

Treatments for chronic bronchitis?

A

Incurable
Medication can be taken to reduce symptoms - ie, steroids and bronchodilators.

31
Q

Causes of emphysema?

A

Presence of bacterial filled mucus in alveoli
Ventilation is impaired due to destruction of elastic lung tissue

32
Q

Symptoms of emphysema?

A

Chronic bronchitis and emphysema occur simultaneously together as COPD

  • Shortness of breath
  • Shallower breathing
  • Difficulty in exhalation - requires effort (has to become active process due to lack of passive elastic recoil)
  • Development of barrel chest (due to continual use of internal intercostal muscles)
  • Partial pressure of oxygen in blood is decreased.
33
Q

Changes to lung structure (alveoli) because of COPD?

A

Fewer alveoli (ruptured alveoli)

Larger air spaces

Smaller SA

34
Q

Changes to lung structure (bronchioles) because of COPD?

A

No cilia in bronchioles

Build up of scar tissue

Walls less folded

Reduced smooth muscle, connective tissue and elastin.

35
Q

Explanation of emphysema/ COPD symptoms?

A

Large no. Phagocytic WBC attracted to sites of infection in alveoli
Phagocytes release elastase
Elastase digests tissue to enable phagocytes to reach infections
Elastase hydrolyses peptide bonds in elastin in alveoli walls.
Alveoli become enlarged, burst and become damaged
Reduces SA for gas exchange. Elastin permanently stretched- prevents elastic recoil, so it becomes harder to remove stale air from lungs.

36
Q

Treatment for emphysema/COPD?

A

Emphysema and bronchitis treated together as COPD

Medication can be taken to reduce symptoms, ie, steroids, bronchodilators.

37
Q

Preclinical trials info?

A

Testing is done in a laboratory using cells, tissues and 2 different types of live mammals.

Can take ~5.5 years.

If drug is considered safe and effective, it will enter clinical trials.

38
Q

Prior to clinical trials info?

A

Detailed plan and justification submitted to research and ethics commitee.

Researchers must prepare leaflet for patients-

Who can participate in trial
Possible risks/benefits to patients
Who is funding the trial

If approved, clinical trial…

39
Q

What are clinical trials testing drugs for?

A

Toxicity - whether they will cause harm

Efficacy - How well they work

Dose - How much needs to be taken for the best results

40
Q

What are placebos?

A

Tablets/capsules that look identical to the new drug but contain no active ingredient.

Used to ensure valid and reliable data is collected with no bias.

41
Q

Types of trials?

A

Single blind trial - patient doesn’t know if they are being given a drug or placebo but doctor knows.

Double blind trial - “ Neither patient nor doctor knows.

Triple blind trial - “ Neither patient nor doctor nor statistician knows

Blind trials allow for the placebo effect to prevent subconscious bias.

42
Q

What is peer review?

A

When other scientists check the work of the original scientists to make sure testing has been rigorous enough. This helps to prevent false claims.

43
Q

Phase 1 of clinical trials

A

Safety

Involves 10 to 20 healthy people
Take 7 years
Healthy volunteers given low doses
Doses increase until the upper limit of a safe dose is established
If the drug is safe further clinical trials are carried out to find the optimum dose for the drug - best effect with minimal side effects.

44
Q

Phase 2 of clinical trials?

A

Efficacy

Involves 200 people
~ 8.5 years
Assesses effectiveness of drugs
50% healthy volunteers given drug, 50% given placebo.

45
Q

Phase 3 of clinical trials?

A

Confirmation of results

New drug compared to current treatment already licensed

More participants, ie 1000s.

Takes ~ 11 years

Participants have the disease so placebo not used.

Large sample size needed to enable sufficient data to be collected to analyse it statistically and determine if there is significant difference in benefit.

Trials are randomised.

Participants should be of same age group, ethnic background, etc..

46
Q

Phase 4 of clinical trials?

A

Takes ~12.5 years

Occurs post licensing.

Doctors able to prescribe drug.

Enables long-term benefits to be assessed

Enables possible side effects to be monitored.

47
Q

Role of NICE?

A

National Institute for Health and Care Excellence.

Uk organisation that assesses clinical and cost effectiveness of health technologies.

Aim - to ensure all NHS patients have access to most clinically and cost effective treatments available.

Evaluates whether effectiveness of drugs is sufficient to justify its use.

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