Respiration through the lifespan

Question 1

What are the signs and symptoms of asthma?

Answer 1

Breathlessness

Chest tightness

Coughing

Wheezing

Question 2

What is asthma?

Answer 2

A chronic inflammatory condition affecting the airway

can be Extrinsic or Intrinsic

Question 3

Define Intrinstic

Answer 3

Intrinsic factors include the genetic, physiological, and pathological characteristics of an individual; in other words, these are traits that are “intrinsic” to a person rather than being determined by that person’s environment

Question 4

Define Extrinsic

Answer 4

originating from or on the outside
especially: originating outside a part and acting upon the part as a whole
PLEASE CHECK THIS DEFININTION

Question 5

Explain the pathophysiology of asthma

Answer 5

Always some element of breathing obstruction

Airflow is normally limited but reversible

Airway always hyper-responsiveness to stimuli (or trigger factors) causes bronchospasm causes contraction of smooth muscle resulting in narrow airways

Bronchi are always in a state of chronic inflammation (-> eosinophils (WBC for allergies and infections -> release proteins which damage airway lining -> mucous gland hypertrophy and scar tissue allow wall to recover but is thicker

Question 6

fghxftjctyjyctj

Answer 6

Atopic (extrinsic)

Allergic disease in childhood -> hypersensitivity reaction that produes IgE antibodies -> over production of histamine produced
- Enviro allergens

Middle age- late onset
- Respiratory tract infection
- Exercise / cold air
- Emotional stress
- Cigarette smoke & perfume exposure

Question 7

Ebunoluwa is an 8-year-old girl who attends the asthma clinic with the GP practice nurse. Although Ebunoluwa hasn’t had many acute asthma attacks; she often feels mild tightness in the chest and frequently coughs.

Using your knowledge of the pathophysiology of chronic asthma, explain why? (3 marks)

Answer 7

Airflow is normally limited but reversible

The asthmatics airway is always in a condition of being hyper-responsive to stimuli/triggers

Bronchospasm causes contraction of smooth muscle resulting in narrow airways

The bronchi are always in a state of chronic inflammation

There is always some element of obstruction of breathing

Question 8

What is emphysema?

Answer 8

A chronic, irreversible inflammatory condition affecting the airway

Question 9

Oxygen should ALWAYS be withheld from a patient with COPD?

Answer 9

False

Question 10

Which test is used to aid the diagnosis of COPD?

Answer 10

Spirometry

Question 11

At what point does bronchiolitis peak in it’s symptoms?

Answer 11

3-5 days

Question 12

What is the most common cause of bronchiolitis?

Answer 12

Viral

Question 13

What is the most common age group to experience bronchiolitis?

Answer 13

Up to 2 years

Question 14

Bronchiolitis occurs as a result of the _______ of the lining of the ________ cells of the small airways in the lungs causing ______, inflammation and cellular ________ of those cells. It is the inflammation of these cells that can obstruct the airway and ultimately result in _________ .

Answer 14

Bronchiolitis occurs as a result of the INFLAMMATION of the lining of the EPITHIAL cells of the small airways in the lungs causing MUCUS PRODUCTION, inflammation and cellular NECROSIS of those cells. It is the inflammation of these cells that can obstruct the airway and ultimately result in WHEEZING.

Question 15

Select the missing words that describe the three characteristics of Asthma:

1. Airflow limitation which is normally __________ with treatment.
2. Airway hyper-responsiveness from a number of triggers causes _______________. This results in
   _________________ of the airways and _____________ of breathing.
3. __________ of the bronchi is always present and causes the long-term manifestations of asthma such as __________ inflammation leading to _________ of the smooth muscle and constant productions of ________

Answer 15

1. Airflow limitation which is normally [REVERSIBLE] with treatment.
2. Airway hyper-responsiveness from several triggers causes [BRONCHOSPASM]. This results in [NARROWING] of the airways and [OBSTRUCTION] of breathing
3. [inflammation] of the bronchi is always present and causes the long-term manifestations of asthma such as [CHRONIC] inflammation leading to [constriction] of the smooth muscle and constant production of [MUSOUS]

Question 16

Asthma is regarded as an allergic inflammatory response. Which type of inflammatory mediator cell releases histamine in asthma?

Answer 16

Mast Cells

Question 17

What immunoglobulin (antibody type) attaches to mast cells causing them to release histamine which produces the symptoms of Asthma?

Answer 17

IgE

Question 18

The NEWS2 describes a second oxygen scale for patients at risk of hypercapnic respiratory failure and therefore suggests (following clinician review) a target oxygen saturation of 88-92%.
Describe why a patient who has chronic obstructive pulmonary disease (COPD) may require a lower target oxygen saturation. (8 marks)

Answer 18

Patients with advanced COPD may have chronic obstruction and collapse of their airways in the lungs (1 mark)

This creates a constant increase/retention of carbon dioxide in the blood - the carbon dioxide cannot be expelled (1 mark)

In normal physiology high carbon dioxide level provides the stimulus to breathing /controls respiration – central chemoreceptors in medulla oblongata (1 mark)

As the disease progresses, central chemoreceptors become unresponsive to the constant stimulus of carbon dioxide (1 mark)

Low oxygen level becomes the main stimulus/control for breathing (1 mark)-
peripheral receptors situated in aortic arch and carotid bodies become essential for driving respiration (the hypoxic drive) (1 mark)

Administration of oxygen to normal levels (higher than the COPD patient is used to) may in some patients stop the stimulation to breathe/control of breathing (1 mark)

Carbon dioxide levels then further increase as breathing becomes ineffective (1 mark)

Question 19

In a child with Bronchiolitis, what is the most common cause of the condition?
a) COVID-19 Infection
b) StreptococcalInfection
c) Respiratory Syncytial Virus Infection (RSV)
d) Escherichia Coli Infection (E.Coli)

Answer 19

c) Respiratory Syncytial Virus Infection (RSV)

Question 20

13. Which of the following would you expect to see in a patient with type 1 respiratory failure?
    (1 Mark)
    a) High carbon dioxide, low oxygen
    b) Normal carbon dioxide, high oxygen
    c) Normal carbon dioxide, low oxygen
    d) Low carbon dioxide, normal oxygen

Answer 20

c) Normal carbon dioxide, low oxygen

Question 21

Bronchiolitis progression: at what point does bronchiolitis peak in its symptoms?
a) 3-5 days
b) 1-2 weeks
c) 3 weeks
d) 1-2 days

Answer 21

a) 3-5 days

Question 22

Chronic Obstructive Pulmonary Disease is a combination of which two diseases?
a) Emphysema and Bronchiolitis
b) Emphysema and Bronchitis
c) Asthma and Bronchiolitis
d) Asthma and Bronchitis

Answer 22

b) Emphysema and Bronchitis

Question 23

. Why might a patient with Type 2 Respiratory Failure require very close monitoring when administering high-flow oxygen?
a) Increasing carbon dioxide levels stop the stimulus to breathe
b) Decreasing carbon dioxide levels stop the stimulus to breathe
c) Increasing oxygen levels stop the stimulus to breathe
4. d) Decreasing oxygen levels stop the stimulus to breathe

Answer 23

c) Increasing oxygen levels stop the stimulus to breathe

Question 24

18.What are main characteristics of Asthma?
(3 Marks)

Answer 24

• coughing
• wheezing
• shortness of breath

Question 25

18.What are main characteristics of Asthma? (3 Marks)

Answer 25

* coughing * wheezing * shortness of breath

Question 26

An ‘asthma attack’ is a common term of ‘exacerbation of chronic asthma’. What are the symptoms of ‘exacerbation of asthma’ and what changes occur in the airway that produce these symptoms? (3 Marks)

Answer 26

Use of assessor muscles, shortness of breath and low o2 levels The smooth muscle in the airway is tightened, as well as the airway is inflamed, narrowed and swollen. Extra mucus in the airway. Therefore, less o2 is inhaled. Symptoms are low 02 saturations, audible wheeze, high respiration rate, shortness of breath and use of assessory muscles

Question 27

Bronchiolitis

Answer 27

Bronchiol- bronchioles itis- `inflammation

Question 28

what are some risks of COPD?

Answer 28

* Smokers * Asthma * Air pollution

Question 29

What are the signs and symptoms of Bronchiolitis?

Answer 29

* Initial: Upper resp. symptoms (Nasal congestion, runny nose, cough, sneezing) + fever * Continued: Lower respiratory tract infections (cough, wheezing, high RR) * Emergency: Grunting, nasal flaring, cyanosis, hypoxia, resp failure

Question 30

what is the cause of Bronchiolitis how and where does it start and progress to?

Answer 30

Very contagious viral illness caused by RSV. Starts as an upper resp infection and moves to the chest

Question 31

What's the difference between extrinsic and intrinsic asthma?

Answer 31

A chronic inflammatory condition affecting the airway - Extrinsic asthma occurs when the immune system overreacts to a harmless substance, such as pollen or dust - Intrinsic asthma, as you might've guessed already, is triggered by various non-allergic factors like stress, cold or dry air, smoke, anxiety, viruses or infections, and more.

Question 32

Where do LRTI and URTI occur

Answer 32

LRTI Lower aka below the neck. URTI Upper aka above the neck