Respiratory 2 Flashcards
what is obstructive sleep apnea ?
- happens during sleep
- obstruction in upper oropharyngeal airway
- leads to cease in breathing, hypoxia will wake person up
what does OSA cause?
- tiredness and ^ risk cardiovascular disease
what is the cause of sleep apnea?
obesity
enlarged tonsils
microbes
smoking
oedema
hypertension
what is the tx for OSA?
CPAP machine at night
continuous positive airway pressure
mandibular advancement prothesis = hold mandible and tongue forward and upon up upper airway - occlusion needs too be monitored
what is fibrotic lung disease ?
lung tissue becomes scarred and fibrous
cannot be reversed and is progressive
what are the causes of fibrotic Lung disease ?
drugs
autoimmune disease = rheumatic arthritis
what is the management of FLD?
- long term 02
- lifestyle modifications
what is sarcoidosis ?
- an eg of FLD
- Systemic disease causes granulomas throughout whole body
- breathlessness
what areas in the body does sarcoidosis affect?
kidney - can affect drug metabolism
liver
eyes
gingival enlargement
cranial neuropathy (cranial nerves)
what can respiratory tract infections be divided into?
upper and lower RTI
- depending on where the infection is ie. above or below the larynx
what can happen if someone has URTI?
can progress and descend to LRTI if not managed properly
how does one get RTI?
Viral, common cold or flu, covid or bacterial or fungal
what are the dental links to RTI?
- a pt with poor OH likely to have colonisation oropharynx with bacteria and cause infection
- aspiration of a foreign body during a dental procedure can travel to lungs and cause aspiration pneumonia or abscess
- if foreign body remains higher up in respiratory tract = BLS choking
what is pneumonia ?
infection of lung parenchyma itself (multiple bacterial/ viral infections)
what are the symptoms of pneumonia?
- cough - with green yellow sputum
- chest pain - sharp pain when breathing in
- pleuritic pain (pleura around lungs are inflamed, they rub together when lungs expand on inhalation)
- purulent sputum
- fever
- breathlessness
- pleurisy
- hypoxia
how do we treat bacterial pneumonia ?
antibiotics
some severe cases - hospital admissions
pts may become hypoxic due to reduction in surface of alveoli available for gas exchange as they’re blocked up with bacteria and inflammatory cells
what is strep throat caused by?
streptococcus pyogenes
who usually gets strep throat
children
what is strep throat an eg of ?
upper respiratory tract infection
what are the symptoms of strep throat
sore throat
fever
maculopapular skin rash
swollen cervical lymph nodes
if you were doing an oral exam on a strep throat pt what would you see?
soft palate petechiae (tiny dots red and pharynx)
strawberry tongue (red swollen and bumpy)
tonsil inflamed
what happens if strep throat isn’t treated properly ?
causes rheumatic fever
which bacteria is TB caused by ?
mycobacterium tuberculosis
- we have a vax for it
what is TB ?
causes severe lung disease w/ scarring of lungs
symptoms of TB
cough
fever
weight loss
night sweats
heamoptysis (coughing blood)
how do we treat and prevent TB?
vax
antibiotics (Mycobacterium TB has a thick cell wall which prevents against certain antibiotics )
what are the 2 types of TB?
active (infectious) and latent (chronic and non infectious)
how do we deal with pts who have active TB in clinics?
minimising aerosol procedures
- use rubber dam avoid GA as th bacteria affects machines
- keep in mind staff that are immune suppressed
- ultrasonic scaler can’t use
which bacteria causes legionaries disease ?
legionella
they grow in stagnant water (keep water supply clean in dentistry)
pneumonia symptoms
what is bronchiectasis
cycle of recurrent infections and resulting damage
triggered by severe infections that causes damages to bronchial walls
or genetic abnormality eg. cilia
= this damage to brachial walls causes an ^ susceptibility for further infections and so on
COPD v bronchiectasis
Bronchi are dilated due to damage
pt becomes chronically hypoxic due to lung damage therefore severe bronchiectasis should be treated as pts who are risk of type 2 respiratory failure so need to get 02 checked
where the target of 88- 92% Sts are reached again
what is cystic fibrosis?
genetic disease
caused by inefficient chloride channel in cell membrane which disrupts ion transfer across cell membrane thus fluid transfer across cell membrane - necessary in lungs as mucus needed to soft away infections
= mucus therefore becomes very sticky and so difficult for cilia to waft away
what can CF lead to if there are recurrent infections ?
severe bronchiectasis
where else can be affected by CF other than the lungs?
- plugging in pancreatic ducts = pts can’t secrete pancreatic enzymes for digestion can cause malnutrition
how do we manage CF?
drugs to thin mucus down
chest radiotherapy
may need long term antibiotics
pancreatic enzymes to aid nutrition
home 02
lung transplant (short supply an lifelong immunosuppression to avoid rejection, these have side effects eg. infections)
what is the life expectancy of CF ?
short life
only half live past 40
what can lung cancer be divided into ?
small (neuroendocrine tumour progresses rapidly) and non small cell (common but slow can be surgically removed)
what is the main risk factor for lung cancer ?
smoking
what are the signs and symptoms of lung cancer ?
new cough that doesn’t go away (over 2 weeks)
haemoptysis
breathlessness
wheezing
chronic chest pain
stridor
fatigue
weightloss
horners syndrome
what is Horners syndrome?
tumour at top of apex of lung
compress nerves there
causes ptosis mitosis and anhidrosis
what is ptosis?
droopy eyelid
what is miosis ?
constricted pupil
what is anhydrous
no sweating on that side of face
why can tumours do to nearby structures?
compares them
what are some signs that a tumour is compressing nearby areas?
- difficulty swallowing
- pain on swallowing
could be tumour in oesophagus - facial and neck swelling = tumour in thorax that’s compressing where the veins drain out from the head and neck = blood stays at the back of neck causing swelling
- hoarse voice due to tumour compressing nerve supply on vocal coords
how do we treat lung cancer ?
- chest xray - to visualise tumour
- bronchoscopy - placing a scoop down throat and trachea to visualise airways
biopsy
-aspiration fluid around lungs - where we can find cancer cells - staging ct scan = of throat abdomen and pelvis to check for metastases
how do we treat
- depends on type of cancer and metastases
- chemotherapy
- radiotherapy
- surgery
what do chemotherapy drugs cause in pts with LC ?
further drugs = to relive side effects of analgesia= laxatives, anti sickness meds
support
what are the signs, symptoms, risk factors and tx of laryngeal cancer ?
- laryngectomy = ppl who have this can longer breathe thru mouth and nose but thru a hole in neck called stoma or trachestomy
can loose ability to speak because of this - in emergency o2 needs to go through stoma not mouth and nose
