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respiartory conditions Flashcards

1
Q

what is respiratory failure?

A

respiratory system fails in one or both of its gas exchange functions (oxygenation and carbon dioxide elimination) due to dysfunction of one or more essential components of the respiratory system:

Chest wall (including pleura and diaphragm)
Airways
Alveolar – capillary units (respiratory membrane)
Pulmonary circulation
CNS (brain stem) & Nerves

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2
Q

what is causes type 1 respiratory failure?

A

Type 1 is the most common type of respiratory failure and associated with acute diseases of the lung e.g. cardiogenic or non-cardiogenic pulmonary oedema, pneumonia

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3
Q

what causes type 2 respiratory failure?

A

drug over dose, neuromuscular diseases, chest wall abnormality, severe airway disorders i.e. Asthma or COPD

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4
Q

how long does acute hypercapni respiratory failure develop?

A

over minutes to hours; therefore, pH is less than 7.3.

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5
Q

how long does it take for chronic respiratory failure to develop?

A

Chronic respiratory failure develops over several days or longer, allowing time for renal compensation and increase in bicarbonate ion concentration. Therefore, the pH usually is slightly decreased.

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6
Q

what is type 1 respiratory failure?

A

hypoxaemic. failure of oxygen exchange.

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7
Q

what is type 2 respiratory failure?

A

hypercapnic respiratory failure.

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8
Q

what is the managment of respiratory failure?

A

Oxygen supplement
Control of mucus secretions (physiotherapy)
Treatment of lung infection (antibiotics)
Control of airways obstruction (e.g. using bronchodilators, corticosteroids)
Treatment for pulmonary oedema (diuretics)
Reducing load on respiratory muscles

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9
Q

what are some pathophysiological events in respiratory failure?

A
  • Ventilation/Perfusion (V/Q) mismatch
    • Shunting (Severe V/Q mismatch)
    • Diffusion limitation (i.e. alveolar membrane is thickened/destroyed)
    • Alveolar hypoventilation (decreased minute ventilation relative to demand due to airway failure)
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10
Q

what does perfusion mean?

A

the flow of blood through the tissues.

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11
Q

what pathology affecting ventilation can cause a missmatch between ventilation and perfusion?

A

copd as less air gets into the alveoli.

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12
Q

what pathology affecting perfussion can cause a missmatch between ventilation and perfusion?

A

heart failure.

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13
Q

what is a shunt?

A

Under-ventilated areas of the lungs can cause a shunt where venous blood returns to the heart without collecting its normal oxygen quota

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14
Q

what are causes of a shunt?

A

Pneumonia
Atelectasis
Severe pulmonary oedema

Hypoxemia caused by a shunt is more difficult to correct by supplementary oxygen administration

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15
Q

when does shunting occur?

A

Shunting occurs when an illness allows blood to flow through the lungs without picking up enough O2.

Atelectasis- collapsed alveoli

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16
Q

what is the different between a normal lung and a shunt in the lung?

A

in a normal lung oxygenated blood emerges from the pulmonary capillaries.
in a shunt- deoxygenated blood emerges from some pulmonary cappilaries.

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17
Q

what is cardiogenic pulmonary oedmea

A

an accumulation of extra fluid in your lungs that can be life-threatening

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18
Q

what cause cardiogenic pulmonary oedema?

A

Left Ventricular Failure (LVF) – usually as a consequence of MI but can also be consequences of:

Diseases of heart valves
Failures in conduction system of the heart

A reduction in stroke volume (SV) triggers compensatory mechanisms

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19
Q

what is left ventricular heart failure?

A

occurs when there is dysfunction of the left ventricle causing insufficient delivery of blood to vital body organs.
Poor pumping by damaged left ventricle causes blood to back-up pulmonary veins into lungs

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20
Q

what are symptoms of pulmonary oedema?

A

Difficulty breathing
Anxiety
Pale skin
Pink frothy sputum
Hypoxia
Orthopnoea (inability to lie down flat due to breathlessness)
Oedema of ankles in later stage

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21
Q

what is acute respiratory distress syndrome?

A

ARDS is a form of non-cardiogenic pulmonary oedema that can quickly lead to acute respiratory failure .

Fluid accumulates in the lungs interstitium, alveolar space, and small airways, causing the lungs to stiffen

This impairs ventilation and reduces oxygenation of blood.

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22
Q

what other conditions is acute respiratory distress syndrome caused by?

A

direct injury such as:
Pneumonia
Aspiration of gastric secretion
Drowning
Pulmonary embolism
Trauma (severe chest injury)
Inhalation injury (e.g. smoke inhalation)

indirect injury such as:
Sepsis
Massive blood transfusion reaction
Acute pancreatitis
Severe burns

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23
Q

what is the exudative phase in ARDS?

A

Exudative phase (first 24 hrs) with hypoxaemia. Leakage of fluid into the alveoli plus haemorrhage and infiltration of neutrophils

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24
Q

what is the second phase in ARDS?

A

Proliferative phase (14 days after the injury) Persistent hypoxaemia, and reduced lung compliance (decreased surfactant). Thrombi form in the small blood vessels of the lungs

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25
Q

what is the fibrotic phase in ARDS?

A

Fibrotic phase (3 weeks into injury) Widespread pulmonary fibrosis, loss of the normal lung structure and worsening lung compliance

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26
Q

what can lead to pulmonary infection?

A

loss or suppression of cough reflex
too much mucus production and accumulation
injury to the cilia
interference with phagocytic action of alveolar macrophages
pulmonary congestion and oedema

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27
Q

what is pneumonia?

A

inflammation of the lung parenchyma usually caused by an infection. may affect a single lobe or many lobes.

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28
Q

what are symptoms of pneumonia?

A

Cough with phlegm (pus) often green/yellow or brown or blood-stained mucus, may be malodorous (esp. anaerobes)
Fever and chills (sweating and shivering)
Shortness of breathe/faster-shallow breathing
Chest pain which gets worse when breathing or coughing

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29
Q

what are complications of pneumonia?

A

Pleural effusion/pleurisy
Dyspnoea (breathing difficulties)
Sepsis (spread of the infection into blood)

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30
Q

what is COPD?

A

A progressive chronic lung diseases that limit
Air flow and gas exchange. name for a group of lung conditions that cause breathing difficulties.

Usually progressive and is associated with inflammation of the lungs as they respond to noxious particles or gases

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31
Q

what is chronic bronchitis?

A

chronic inflammation of bronchi.

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32
Q

what are symptoms of chronic bronchitis?

A

productive cough of more than 3 months occurring within a span of 2 years, excess mucus production
Chronic wet cough
Shortness of breath
Excess mucus (sputum) production
Wheezing
Tachycardia
Tachypnoea
Pulmonary hypertension
Accessary muscle use
Lowered SPO2
Cyanosis (blue bloater)

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33
Q

what is emphysema?

A

abnormal permanent enlargement of the airspace distal to terminal bronchioles due to damage to alveolar walls (air sacs) within the lung
(pink puffers)

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34
Q

what are symptoms of emphysema?

A

.Chronic cough
Shortness of breath (dyspnea)
Normal/flushed skin tone (pink puffers)
Tachycardia
Tachypnoea
Cyanosis with exacerbation
Pursed lips
Barrel chest
Hypertension
Accessory muscle use
Cachexia (sever muscle wasting)

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35
Q

what causes copd?

A

Smoking is the primary risk factor
Smoker compared to non-smoker, is 10 times more likely to die of COPD

Prolonged exposures to harmful particles and gases from:

breathing in second-hand smoke
industrial pollution (mining coal, silica etc.)
air pollution (car exhaust, chemical gases, vapors, mists & fumes)
dusts from grains, minerals & other materials

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36
Q

what is affected in chronic bronchitisis?

A

Damage to the cilia which become unable to move bacteria and foreign particles out of the lungs

Too much mucus production by goblet cells in airways
Bacteria become trapped in mucus and can cause respiratory infections.
Overgrowth of the smooth muscle cells in the bronchi restricts airflow

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37
Q

what is affected in emphysema?

A

Alveolar walls are damaged and large air pockets form that reduces the surface area and so the rate of gas exchange.

Most individuals with emphysema show symptoms of chronic bronchitis concurrently, since smoking is an underlying risk factor for both conditions

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38
Q

what does emphysema result in the alveoli changing by??

A

enlargement of the alveoli and a reduction in the surface area

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39
Q

what symptoms would you look for when diagnosing a patient with COPD?

A

dyspnea, chronic cough, sputum production, and/or a history of exposure to risk factors for the disease

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40
Q

what does a spirometry do?

A

is required to make the diagnosis; the presence of a post-bronchodilator FEV1/FVC < 0.70 confirms the presence of persistent airflow limitation and thus of COPD.

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41
Q

what is the treatment of respiratory failure?

A

Oxygen supplement

Control of mucus secretions (physiotherapy)

Treatment of lung infection (antibiotics)

Control of airways obstruction (e.g. using bronchodilators, corticosteroids)

Treatment for pulmonary oedema (diuretics)

Reducing load on respiratory muscles

42
Q

what is asthma?

A

a disease that affects the breathing passages of the bronchioles. causing inflammation and muscle tightening around the airways making it harder to breathe

43
Q

what are symptoms of asthma?

A

chest pain tightness, difficulty breathing, wheezing or a spasmodic cough that worsens at night

44
Q

what happens to the walls of the passage when you have asthma?

A

When the inflammation is “triggered” the walls of the passages swell, and the openings fill with mucus. Muscles within the breathing passages contract (bronchospasm), causing even further narrowing of the airways.
this narrowing makes it difficult for air to (exhaled) from the lungs. This resistance to exhaling leads to an asthma attack

45
Q

what is obstructive lung disease?

A

a disease which causes resistance, obstruction to exhaled air

46
Q

what is COPD?

A

chronic obstructive pulmonary disease.
a group of diseases that includes not only asthma but also chronic bronchititis and emphysema.

47
Q

can asthma be reversed?

A

no only controlled.

48
Q

what causes COPD?

A

tobacco, smoking, occupational exposures.

49
Q

what are the symptoms of copd?

A

shortness of breath, cough, mucus production, wheezing, chest tightness.

50
Q

what is emphysema?

A

long term progressive disease of the lungs that causes shortness of breath due to over inflation of the alveoli.
the lung tissue involved in gas exchange of gases is impaired or destoryed.over inflated

airflow on exhalation is slowed or stopped because over inflated alveoli do not exchange gases when a person breathes due to little movement of gases out of the alveoli.

51
Q

what happens in emphysema when thee lung tissue is damaged?

A

the tissue normally holds the small airways open allowing air to leave on exhalation.
when damaged the airways collapse, the lungs cant empty and the air gets trapped in the alveoli.

52
Q

what causes emphysema?

A

smoking as the smoke goes directly into the airway and affects the airway responsibe for clearing mucus.

lung cells are also affected by smoking as they cannot fight bacteria due to the tar build up.

53
Q

what are symptoms of emphysema?

A

cough, wheezing, barrel chest,

54
Q

what is chronic bronchitis?

A

bronchitis- inflammation of the airways in the lungs.
acute bronchitis- happens when inflammation comes on quickly and resolves within 2-3 weeks.
chronic bronchitis- a cough with mucus persists for most days for at least 3 months and at least 2 years in a row.

55
Q

what is chronic bronchitis caused by?

A

smoking, inhaling irritating fumes or dust, viruses such as the flu, bacteria.

56
Q

what are risk factors for chronic bronchitis?

A

advanced age, weakened immune system, smoking, COPD and exposure to lung irritants.

57
Q

what are symptoms of chronic bronchitis?

A

cough that is pesistant for most days of the month for at least 3 months and at least 2 years in a row.
wheezing,
shorntess of breath.

58
Q

what are the treatments for chronic bronchitis?

A

cough suppressants, bronchodilator inhalers, nebulizer trreatments,

59
Q

what is bronchiectatis?

A

damage to the walls of the bronchial tubes with loss of smooth muscle and loss of elasticty of the segments of bronchi.
this prevents secretions from being adequately cleared from the lungs

60
Q

what is bronchiectasis cause by?

A

may be congenital or acquired.
cystic fibrosis is the most common cause.

61
Q

what are symptoms of bronchiectatsis?

A

increased sputum production,
bloody sputum,
shortness of breath,
weakness, and
fatigue

62
Q

how is bronchitis diagnosed?

A

history
ct scan

63
Q

what is bronchiectasis?

A

damage to the walls of the bronchial tubes with loss of smooth muscle and elasticity of the bronchi.
this prevents secretions from being adequately cleard from the lungs

64
Q

what is acute bronchitis?

A

the inflammation of the bronchies usually caused by a viral infection. bacteria and chemicals may cause this too.
a cough that begins suddenly usually due to a viral infection involving the larger airways.

65
Q

what is bronchitis’s called in infants?

A

respiratory syncytial viruses and affects the small bronchi and bronchioles more than the large one.

66
Q

what are symptoms of acute broncitis?

A

runny nose, nasal stuffiness, and sore throat.

67
Q

what is pulmonary fibrosis?

A

a lung disease that occurs when lung tissue becomes damaged and scarred. making it hard for the lungs to work.

68
Q

what are symptoms of pulmonary fibrosis?

A

Shortness of breath.
Dry cough.
Extreme tiredness.
Weight loss that’s not intended.
Aching muscles and joints.
Widening and rounding of the tips of the fingers or toes, called clubbing.

69
Q

what is sarcoidosis?

A

inflammation of various tissues of the body. starts mainly in the lungs or lymph nodes.

70
Q

what happens when sarcoidosis progresses?

A

microsopic lumps of specific form of inflammation called granulomas appear in the affected tissues. these will disappear over time or the tissue will remain inflamed and become scared.

71
Q

what other organs, in order, can get affected by pulmonary fibrosis?

A

lungs, lymph nodes, liver, skin, heart, nervous system and kidneys.

72
Q

what are the symptoms of pulmonary fibrosis?

A

shortness of breath, a cough that wont go away, can also show up on the skin as a rash: tender, red bumps called subcutaneous sarcoidosis on the shins of the leg, inflammation of the eyes.
weight loss, fatigue, night sweats, fever

73
Q

does pulmonary sarcodisis go away by itself or not?

A

yes after 24-26 month.

74
Q

what is lung cancer?

A

a group of diseases characterized by abnormal growths (cancers) that started in the lungs.
when cells in the lungs grow out of control and form tumors

75
Q

what group of lung cancer characterized by?

A

the cell size and cell type of the tumors.

76
Q

what is the most common type of lung cancer?

A

adenocarcinoma- making up 30-40% of cases

77
Q

what are the causses of lung cancer?

A

smoking, passive smoking and enviromental fumes

78
Q

who are at a greater risk of lung cancer?

A

tuberculosis, copd patients.
a patient with COPD had 4-6 times the greater risk of lung cancer even when smoking is excluded.

79
Q

what is pneumonia?

A

lung inflammation by an infection caused by different types of microorganisms, including bacteria, viruses, fungi and parasites.
the alveoli fill with pus resulting in colonization of the lungs.

80
Q

what are symptoms of pneumonia?

A

oxygen blood saturation falling from normal to below go and it will continue to go down,
severe discomfort,

81
Q

what is pulmonary edema?

A

an excess collection of watery fluid in the lungs.
fluid in the lungs makes it hard for gaseous exchange.

82
Q

what causes pulmonary edema?

A

if excess fluid enters the alveolus or if fluid builds up in the space between the alveolar wall and capilliary wall.
o2 and co2 molecules have a greater distance to travel and nay not be able to be transfered betwen the lung and blood- causing shortness of breath.

83
Q

what causes pulmonary edema?

A

often classified as cardiogenic due to a cardiac problem (heart failure or congestive heart failure).

when the heart muscle is not able to pump effectively there is a backup of blood returning from the lungs to the heart. this causes an increase in pressure within the blood vessels of the lung resulting in excess fluid leaking from the vessels into the lung tissue.

cardiomyopathy,
previous viral infection,
thyroid problems,
alchohol or drug abuse

84
Q

what is non cardiogenic pulmonary edema?

A

damage to the lung tissue and subsequent inflammation of the lung tissue. this can cause the tissue that lines the structures of the lung to swell and leak fluid into the alveoli. incraesing oxygen distance.
kidney failure,
inhaled toxins,
pneumonia,
adult respiratory distress syndrome.

85
Q

what are symtoms of pulmonary edema?

A

shortness of breath, coughing, wheezing, sweating.

86
Q

what is infulenza?

A

acute viral infection of the nose, throat and lungs

87
Q

what are symptoms of the flu?

A

fever, head and body aches coughing and a stuffy or runny nose.

88
Q

what is cystic fibrosis?

A

disease that causes sticky, thick mucus to build up in organs, including the lungs and the pancreas. In people who have CF, thick mucus clogs the airways and makes it difficult to breathe.

89
Q

what other organs can cystic fibrosis affect?

A

causes cysts and scarring (fibrosis) in the pancreas.
plus thick mucus can block ducts that release digestive enzymes.
CF can also affect the liver, sinuses, intestines an sex organgs.

90
Q

is cystic fibrosis developed or congetial?

A

congenial, born with it

91
Q

what are the 2 types of cystic fibrosis?

A

classic- affects multiple organs, diagnosed in first few years of life.

atypical cystic fibrosis- milder form of disease. affect 1 organ, symptoms come and go. diagnosed in older children or adults.

92
Q

what are the symptoms of cystic fibrosiss?

A

Frequent lung infections (recurrent pneumonia or bronchitis).
Loose or oily poop (stool).
Trouble breathing.
Frequent wheezing.
Frequent sinus infections.
A nagging cough.
Slow growth.
Failure to thrive (inability to gain weight despite having a good appetite and taking in enough calories).

93
Q

what causes cystic fibrosis?

A

inherit two mutated CFTR genes, one from each biological parent (it’s inherited in an autosomal recessive manner).
parent doesnt have to have it can just carry the gene.

94
Q

how is cystic fibrosis diagnosed?

A

screening

95
Q

what is mesothelioma?

A

a type of cancer that develops in the lining that covers the outer surface of some of the bodys organs.
mesothelial cells are a layer of specalised cells that line the body cavities including the pleura (lining of the lung), peritoneum (lining of the abdominal cavity) and pericardium (lining of the heart) these can grow abnormally and turn into tumours

96
Q

what is pulmonary hypertension?

A

the pressure in the pulmonary arteries abnormally rising due to the tightening or constriction of the blood vessels carrying blood to the lungs.

97
Q

what can pulmonary hypertension be caused by?

A

chronic (long-standing) lung disease, such as emphysema or chronic bronchitis (also known as chronic obstructive pulmonary disease or COPD), obstructive sleep apnea, cystic fibrosis, or other chronic lung diseases.
congestive heart failure.
recurrent blood clot formation in the pulmonary arteries or blood clots traveling from the legs to the pulmonary arteries may result in pulmonary hypertension (chronic thromboembolic pulmonary hypertension).

98
Q

how would you treat pulmonary hypertension?

A

vasodilators (relax the blood vessels),
oxygen therapy,

99
Q

what is tuberculosis?

A

an infectious disease that destroys the lung tissue through bacteria. it is curable.

100
Q

what happens to the lungs in tuberculosis?

A

can cause:
cavities: large holes in the lungs that form when normal lung tissue is destroyed and relaced with gas/
bronchiectasis- widening of the airways
fibrotic scar tissue in the upper lobes of the lungs

101
Q

what are symptoms of tuberculosis and how is it treated?

A

a cough which produces blood and phlegm,
fever,
tiredness and weakness,
loss of appetite,
weight loss and breathlessness.
treated with antibotics for 6 months

conditions of the body (6 decks)

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