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Principles of physiology > lecture 8- respiratory diseases > Flashcards

lecture 8- respiratory diseases Flashcards

1
Q

What are the diseases that affect the airways?

A

Asthma
COPD
Bronchitis
Emphysema*

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2
Q

What are the diseases that impact the alveoli?

A

Pneumonia
Tuberculosis
Lung Cancer
Acute respiratory distress
syndrome (ARDS)

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3
Q

What is emphysema?

A

*Emphysema as a singular
disease is a disease of the
alveoli

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4
Q

What happens in spirometry?

A

Spirometry is the most common of the pulmonary function tests.
It measures lung function, specifically the amount and/or speed of air
that can be inhaled and exhaled.

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5
Q

What does spirometry measure? What is it helpful in assessing?

A

Spirometry is helpful in assessing breathing patterns that identify
conditions such as asthma, pulmonary fibrosis, cystic fibrosis, and COPD.

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6
Q

What does a spirometry graph look like in a restrictive and obstructive disease?

A

obstructive takes longer for lung volume to fill up

restrictive the lung volume cannot reach the normal levels

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7
Q

What does Covid do, what are the symptoms and mechanisms?

A
  • Affects Upper and Lower Respiratory Systems
  • Causes Pneumonia and Lung Damage (fibrosis)
  • Damage in the alveoli results in hypoxia, hypoxaemia
    and oedema
  • Decreased oxygen saturation (SaO2 <93%) or
    partial pressure of oxygen (PaO2
    ) occurs
    (hypoxemia).
  • ~5% of patients will develop ARDS, sepsis, and
    multiorgan failure
  • Many pathophysiological events in COVID-19 affect
    either lung perfusion or ventilation
  • Altered lung mechanics due to progressive lung oedema
    related to sustained pulmonary inflammation, alveolar
    collapse, atelectasis, and fibrosis further impair global
    lung function, resulting in progressive tissue hypoxia
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8
Q

What diseases primarily affect the alveoli and why and which diseases primarily affect the airways and why?

A
  • Primarily Alveoli Affected
  • COVID-19 (SARS-CoV-2)
  • Pneumonia
  • Primarily Airways Affected
  • Chronic Obstructive Pulmonary Disease
    (COPD)
  • Asthma
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9
Q

What part of your respiratory system does covide affect?

A
  • Affects Upper and Lower Respiratory Systems
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10
Q

What does covid cause? Where does damage occur and what does this result in?

A

Causes Pneumonia and Lung Damage (fibrosis)
* Damage in the alveoli results in hypoxia, hypoxaemia
and oedema

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11
Q

Compare early stage and late stages of covid in the alveoli

A

early- thrombosis occurs
middle- pulmonary oedema occurs
late- fibrosis occurs

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12
Q

What causes pneumonia, what are the symptoms and mechanisms?

A
  • A common acute respiratory infection
  • Is a lower respiratory tract infection (LRTI)
  • Affects the alveoli and distal airways
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13
Q

What part of the respiratory system does pneumonia affect?

A
  • Is a lower respiratory tract infection (LRTI)
  • Affects the alveoli and distal airways
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14
Q

What are the most common causes of pneumonia?

A
  • Bacteria: Streptococcus pneumoniae
  • Respiratory Viruses
  • Haemophilus influenzae
    -sars cov-2
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15
Q

What types of microorganisms can cause pneumonia? What are the atypical types?

A

Bacteria and viruses

  • Legionella pneumophila is an atypical bacteria

Streptococcus pneumoniae is a typical bacteria

  • Respiratory Viruses
  • Haemophilus influenzae
    Sars-CoV-2
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16
Q

Regarding the mechanisms what is the immune resistance and tissue resistance?

A

go to lecture

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17
Q

Describe the congestion, red hepatization, grey hepatization and resolution stages

A

Four stages of pneumonia - histopathology
1. Congestion - Pulmonary capillaries dilated and serous fluid
leaks out capillaries into the alveoli
2. Red Hepatization
Red blood cells and immune cells travel to the alveoli. Since
there are more red blood cells, the lungs may appear red. The
lungs also become dry, airless, and firm, often resembling the
liver.
3. Grey hepatization
an avascular stage - lack of blood vessels in the tissue of the
lungs. During this stage, the lungs take on a greyish
colour. Neutrophils in alveolar spaces, rbcs disintegrate
4. Resolution

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18
Q

How many stages of histopathology are there regarding pneumonia?

A

4

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19
Q

What causes COPD, what are the symptoms and mechanisms?

A

Causes progressive decline in lung function – poorly reversible airway obstruction
Includes 2 main diseases; Bronchitis (narrowing of small airways) and Emphysema
(damage to alveoli).
Often caused by smoking (in addition to many others)

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20
Q

What does COPD do to the functioning the lungs? What are the 2 main diseases of COPD? What often causes COPD?

A

Causes progressive decline in lung function – poorly reversible airway obstruction

Includes 2 main diseases; Bronchitis (narrowing of small airways) and Emphysema
(damage to alveoli)

Often caused by smoking (in addition to many others)

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21
Q

Compare the look of normal and emphysematoud lungs

A

normal- healthy bronchioles and alveoli

COPD- thick and narrow bronchioles with excess mucus
-destruction of alveolar walls

22
Q

Describe emphysema, bronchitis and smooth muscle hypertrophy and airway fibrosis

A
  • Emphysema
  • Abnormal permanent enlargement of airspaces distal to
    the terminal bronchioles
  • Centrilobular emphysema (CLE) and panlobular
    emphysema (PLE)
  • Airways Disease (Bronchitis)
  • An infection of the main airways of the lungs(bronchi),
    causing them to become irritated and inflamed.
  • The main symptom is coughing, which may bring up
    yellow-grey mucus (phlegm).
  • Smooth Muscle Hypertrophy and Airway Wall
    Fibrosis
    *
  • Smooth muscle mass may or may not be increased in
    COPD
    Whether or not airway hyperresponsiveness is a primary
    cause of fixed airflow obstruction continues to be a topic
    of debate
  • Regardless, chronic airway inflammation from cigarette
    smoke causes constriction and hypertrophy of even
    normal airway smooth muscle
23
Q

What are the environmental stimuli that cause bronchitis?

A

viruses (infant), allergens (child) and tobaco smoke (teen and beyond)

24
Q

How do the environmental causes of COPD change as someone ages?

A

viruses (infant), allergens (child) and tobaco smoke (teen and beyond)

25
Q

Describe the adaptive immune pathway regarding COPD

A

an altered immune response results in a memory cell (b or t cell) triggering an effector cell (eosinophil or mast cell) that triggers type 2 cytokines which results in end organ dysfunction and cause AECs to produce excess mucus and cause chronic inflammatory disease

26
Q

Describe the innate immune pathway regarding COPD

A

as a result of an altered immune response (caused by genetic susceptibility) AECs trigger innate immine cells to go trigger type 2 cytokines which cause ASMCs to trigger airway hyperreactivity- causing chronic inflammatory disease

27
Q

What are the signs and symptoms of someone with bronchitis COPD?

A

BRONCHITIS:
SIGNS: Chronic cough & sputum, exertional dyspnoea, overweight, often cyanotic

SYMPTOMS: Fatigue, Low PO2 promotes desaturation of blood and
stimulates erythropoiesis (rbc prod)
* Total lung capacity (TLC) remains unchanged
* Respiratory volume (RV) increased because
residual volume is increased.

28
Q

If you see an increase in respiratory volume but your lung capacity stays the same what type of condition could that be?

A

bronchitis

29
Q

What are the signs and symptoms of someone with emphysema COPD?

A

SIGNS: distended neck veins, weight loss, prolonged expiration
SYMPTOMS: distress
* Accessory respiratory muscles used
* PO2 ~75 mm Hg – almost full saturation.
* Total lung capacity (TLC) and Respiratory
volume (RV) increased because residual
volume is increased.

30
Q

What are the signs and symptoms of emphysema?

A

SIGNS: distended neck veins, weight loss, prolonged expiration
SYMPTOMS: distress
* Accessory respiratory muscles used
* PO2 ~75 mm Hg – almost full saturation.
* Total lung capacity (TLC) and Respiratory
volume (RV) increased because residual
volume is increased.

31
Q

What is the difference between a sign and a symptom?

A

sign is a visual distinction and symptom is a condition caused by the disease

32
Q

How is P02, total lung capacity and respiratory volume affected by emphysema and how are accessory respiratory muscles affected?

A
  • Accessory respiratory muscles used
  • PO2 ~75 mm Hg – almost full saturation.
  • Total lung capacity (TLC) and Respiratory
    volume (RV) increased because residual
    volume is increased.
33
Q

What are the causes, symptoms and mechanisms of asthma?

A

Intermittent periods of reversible airway obstruction leading to airflow problems

SIGNS:
wheezing, exertional dyspnoea
SYMPTOMS:
distress, tightness in chest

34
Q

Whata are intrinsic causes? What is allergic asthma?

A

INTRINSIC CAUSES:
Non-immune mechanism (e.g. cold air temperature, exercise, aspirin)

Allergic asthma is a breathing condition where the airways you breathe through tighten when you inhale an allergen.

35
Q

Explain the extrinsic mechanism explained throug the diagram

A

EXTRINSIC CAUSES:
Response to inhaled antigen
* Type I hypersensitivity reaction
where antigen binds to IgE on
surface of Mast cells.
* Mast cells “degranulate”
releasing histamine locally.
* Airway smooth muscle contracts.
* Attraction of other leukocytes
(eosinophils) to the site.
* Mucosal inflammation/oedema

36
Q

What is asthma airway inflammation a complex process of?

A
  • A complex process of immune cells,
    inflammatory cytokines and growth factors.
37
Q

How is Th2-type inflammation spread across the population?

A
  • Th2-type inflammation occurs in >80% of
    children and in the majority of adults
    with asthma in association with sensitization
    to environmental allergens, such as those
    from dust mites, fungi, pets and pollens
38
Q

What is the lymphocyte 2 response usually composed of?

A
  • The inflammatory infiltrate that
    accompanies T helper 2 (Th2) lymphocyte
    responses is mainly composed of eosinophils
    but also includes mast cells, basophils,
    neutrophils, monocytes and macrophages.
39
Q

What is the pathophysiology of Asthma when regarding the decline of lung function overtime?

A
  • a subset of individuals with asthma exhibit an
    accelerated decline in lung function over their
    lifetime,
  • which, in severe chronic disease, manifests as
    fixed airflow obstruction.
  • this decline is especially prominent in lateonset asthma.

there is a decrease in volume and expiratory flow rate

40
Q

What are the causes, symptoms and mechanisms of cystic fibrosis?

A

➢A multisystem disease
➢Cause: mutations in the cystic fibrosis
transmembrane conductance regulator
(CFTR)
* chromosome 7
* codes for a c-AMP regulated chloride
channel
* Abnormal mucous product; less volume
and is more sticky than normal.

41
Q

What is cystic fibrosis? What does it cause and result in?

A

➢A multisystem disease
➢Cause: mutations in the cystic fibrosis
transmembrane conductance regulator
(CFTR)

resulting in Abnormal mucous product; less volume
and is more sticky than normal.

42
Q

Describe the mechanism of cystic fibrosis from gene defect all the way to mucus obstruction

A
  1. CFTR GENE is defective
  2. defective ion transport
  3. defective mucociliary clearance
  4. mucus obstruction which can cause infection and can cause inflamation and can cause more mucus obstruction (goes in circles)
43
Q

What are the causes, symptoms and mechanisms for interstitial lung disease?

A
  • Group of ~100 chronic lung
    disorders
  • Characterised by inflammation &
    scarring
  • Known causes
    Environmental and
    occupational exposure – Si,
    Asbestos, Be
    Autoimmune disease
    Drug-induced
    Idiopathic
44
Q

What is interstitial lung disease, what is it charachterised by? What are the known causes?

A
  • Group of ~100 chronic lung
    disorders
  • Characterised by inflammation &
    scarring
  • Known causes
    Environmental and
    occupational exposure – Si,
    Asbestos, Be
    Autoimmune disease
    Drug-induced
    Idiopathic
45
Q

What is systemic sclerosis?

A
46
Q

Describe the 3 levels of interstitial lung disease

A

I – lack of alveolar space and lymphocyte
infiltration
II – CD4 cell accumulation
III – lack of CD8 cells (innate response)

47
Q

Describe the impact of interstitial lung disease regarding bronchitis aleolitis and vasculitis

A

*Bronchiolitis: inflammation of the
small airways (bronchioles).
*Alveolitis: inflammation of the air
sacs where oxygen and carbon
dioxide exchange in the blood
takes places (alveoli).
*Vasculitis: inflammation that
involves the small blood vessels
(capillaries).

48
Q

what diseases affect the interstitium?

A

Interstitial lung disease

49
Q

what diseases affect the pleura?

A

Pleural effusion
Mesothelioma

50
Q

describe empthysema

A
  • Emphysema
  • Abnormal permanent enlargement of airspaces distal to
    the terminal bronchioles
  • Centrilobular emphysema (CLE) and panlobular
    emphysema (PLE)
51
Q

describe airways disease (brinchitis)

A
  • An infection of the main airways of the lungs(bronchi),
    causing them to become irritated and inflamed.
  • The main symptom is coughing, which may bring up
    yellow-grey mucus (phlegm).
52
Q

describe Smooth Muscle Hypertrophy and Airway Wall
Fibrosis

A
  • Smooth muscle mass may or may not be increased in
    COPD
    Whether or not airway hyperresponsiveness is a primary
    cause of fixed airflow obstruction continues to be a topic
    of debate
  • Regardless, chronic airway inflammation from cigarette
    smoke causes constriction and hypertrophy of even
    normal airway smooth muscle

Principles of physiology (21 decks)

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