Respiratory, Cardiovascular and Genetic diseases Flashcards
Bacteria which causes tuberculosis
Mycobacterium tuberculosis
Transmission of tuberculosis
Air-borne
Tuberculosis Course of infection
1) Bacteria grows and replicates within upper regions of lungs (high oxygen conc.)
2) Phagocytic white blood cells ingest bacteria, encasing them in tubercles (nodules).
3) Bacteria replicates, damaging alveolar walls + blood capillaries.
4) Results in fibrosis + a reduction in gas exchange.
5) TB may also spread to other organs in the body.
Symptoms of TB
- Persistent cough
- Breathing difficulties and chest pains
- Fatigue and loss of appetite (weight loss)
- Fever and night sweats
- Chest pain
Prevention of TB
- Vaccination
- Better education about TB treatment
- Isolate TB sufferers
- Improved health facilities and treatments
- Better nutrition to strengthen immune system
- Those w/ TB are identified and treated.
- Antibiotics(rifampicin and isoniazid).
- “Directly Observed Treatment, Short-course” (DOTS)
- Surgical treatment - removal of ribs/diseased lungs
What occurs normally when someone contracts TB?
Those w/ a healthy immune system, prevent TB in tubercles from developing further. Bacteria are inactive + don’t replicate.
Asthma
Involves inflammation and tightening of the bronchiole walls when coming into contact w/ an irritating environmental stimuli. Results in decreased air flow to lungs and thus a decreased gas exchange rate.
What occurs during an ‘asthma attack’?
1) Individual comes into contact with irritating stimuli.
2) Causes muscles around walls of bronchioles to contract and become narrower.
3) The lining becomes inflamed and begins to swell.
4) Mucus is over produced, restricting air flow.
How does asthma differ from other lung diseases?
- Surface area of alveoli and elasticity of the lungs are not affected
- Fibrosis due to scarring does not occur
Symptoms of asthma
- Shortness of breath
- Wheezing noise
- Tightening of the chest
- Coughing
What causes shortness of breath associated w/ asthma?
Constriction of the bronchioles
What causes the wheezing noise associated w/ asthma?
Air passing through the very constricted bronchioles
In those w/ asthma, what causes tightening of the chest?
Not being able to ventilate the lungs properly
Why do those w/ asthma have a persistent cough?
It is a reflex response to clear the narrow bronchioles of any obstructions.
Pulmonary Fibrosis
Caused by scarring of lung tissue as fibrous connective tissues form as a result of damage/disease.
What does the scarring seen in pulmonary fibrosis cause?
- Alveoli lining to thicken, reducing efficiency of gas exchange (longer diffusion distance)
- Loss of elasticity in lungs, affecting ability to breathe out (relies on elastic recoil of lung tissue)
Symptoms of pulmonary fibrosis
- Shortness of breath
- Fatigue and weakness
- Pain and discomfort in chest
- Chronic dry cough
What causes shortness of breath in individuals w/ pulmonary fibrosis?
- Thickened epithelial lining of alveoli (greater diffusion distance).
- Loss of elasticity makes ventilation difficult -maintaining a diffusion gradient across gas exchange surface is harder.
- Less O2 - reduced rate of respiration - reduced ATP production. Less ATP available for muscle contraction.
What causes the chronic dry cough in PF sufferers?
Due to fibrous tissue creating an obstruction in the airways of the lungs. Typical reflex is removal by coughing. As fibrous tissue is immovable, nothing is expelled (dry).
What causes pain and discomfort in the chest for PF sufferers?
Due to pressure and damage from mass of fibrous tissue in lungs and more damage from coughing.
What causes weakness and fatigue in PF sufferers?
Reduced intake of oxygen into blood. Rate of respiration decreases, less energy released. Leads to tiredness.
Emphysema
Caused by smoking and air pollution. Leads to irreversible damage of lungs. Caused by progressive destruction alveoli walls leading to development of larger air spaces.
What is the resulting damage of emphysema?
Surface area of alveoli is reduced and alveolar walls become damaged + thicken. Gas exchange becomes less efficient due to reduced SA, + increased diffusion distance. Loss of elasticity of lung tissue (loss of elastin), causes lungs to be less effective at expiration - reducing conc. gradient + rate of diffusion. Lungs less able to supply blood w/ O2, patient becomes breathless more easily. Lack of O2 to muscles reduces respiration.
Symptoms of emphysema
Shortness of breath
Chronic cough
Bluish skin colouration
What causes shortness of breath in those w/ emphysema?
- Difficulty in exhaling (loss of lung elasticity). Lungs can’t be emptied, New air can’t be inhaled so breathless feeling occurs.
- Smaller alveolar SA leads to reduced levels of O2 in blood, so patient breathes more rapidly.
- Also causes barrel-shaped chest due to over-inflation from air getting trapped.
What causes a chronic cough in those w/ emphysema?
Lung damage + the body’s effort to remove damaged tissue + mucus (can’t be removed normally), due to destruction of cilia on bronchioles.
What causes the bluish skin coloration seen in sufferers of emphysema?
Low levels of oxygen in the blood due to poor gas diffusion in the lungs.
Diagnosis of emphysema
Lung function tests, chest X-rays, measurements of blood, O2 + CO2 levels and examination of sputum.
X-ray shows abnormally translucent lings w/ few normal blood vessel markings.
Emphysema can’t be cured as lung tissue cannot be regrown, however what are the possible treatments?
- Stop smoking (prevent further damage)
- Antibiotic drugs (control infection)
- Non-invasive positive-pressure ventilation (NIPPV), involves the wearing a nasal mask, supplied w/ air at slightly higher than atmospheric pressure.
- Drugs to widen bronchi (bronchodilators by inhaler)
- Steroid drugs (reduce inflammatory swelling)
- Oxygen therapy
- Alpha-1-antitrypsin replacement in individuals shown to have a deficiency in enzyme
- Exercise/training (increase physical ability)
- Surgery to remove worst affected parts
Cardiovascular disease
Diseases of the heart and circulatory system.
Coronary heart disease
Affects the coronary arteries (supply heart muscle w/ glucose and oxygen). Reduced flow of blood along the coronary arteries is caused by atheromas. Increased risk of myocardial infarction.
Atheroma
Presence of fatty material (particularly cholesterol + low-density lipoproteins) within the wall of arteries under the endothelial lining of the artery.
Atherosclerosis
Disease where plaque builds up inside the arteries. Over time, the plaque hardens and narrows the arteries.
Process leading to atherosclerosis
Atheromas plaques are deposited in the artery, over time they grow in size and begin to block the lumen. This causes an increase in blood pressure as the artery narrows.
As a result, macrophages in the blood get deposited under the endothelium and develop into fatty bodies (rich in cholesterol).
What other diseases do atheromas increase the risk of?
- Thrombosis
- Aneurysm
- Peripheral vascular disease
- Cerebrovascular accident (stroke)
Thrombosis
Formation of a blood clot caused when an atheroma breaks through the endothelium of the blood vessel, interrupting the flow of blood.
Complications of thrombosis
- Blocks blood vessels, reducing blood supply to tissues beyond. Can cause a heart attack if in the coronary artery.
- Blood flow to heart tissue decreases causing it to die as it can not respire (lack of O2, glucose, etc)
- Can also occur with other tissue regions if they become deprived of oxygen.
Embolus
When a thrombus is carried from its place of origin and blocks another artery
Aneurysm
- Weakening of artery walls due atheromas.
- Weakened points swell to form a balloon-like, blood filled structure called an aneurysm. Often haemorrhage (blood loss to body part)
How is an aneurysm treated if detected before bursting?
Section of artery replaced with a synthetic tube
Peripheral vascular disease
Narrowing of the arteries in lower extremities, leads to an increased risk of thrombosis. Leads to circulatory problems with inadequate oxygen being supplied to the legs, feet etc. increasing the risk of infection
Symptoms of cerebrovascular accident
- 10% of strokes are caused by bleeding from arteries in the brain, directly damaging the brain’s tissues and causing loss of blood supply.
- Symptoms depend on region of brain affected.
- Slurred speech, confusion, difficulty in walking, arm and leg weakness and numbness along one side
Cerebrovascular accident/Ischaemic stroke
- Obstruction of the cerebral artery (supplies blood to brain).
- Atheroma cause blockage, increasing risk of blood clot blocking artery.
- Clots often arise from carotid arteries in neck, and travel to the brain blocking the arteries supplying the cerebellum.
Risk factors associated with cardiovascular disease
Age Smoking Gender Stress Diet High blood pressure Genetic predisposition - overproduction of cholesterol by liver Exercise Diabetes
Why does risk of cardiovascular disease increase w/ age?
Fat is deposited in the walls of the arteries throughout life.
Why does smoking increase the risk of cardiovascular disease?
Chemicals in smoke diffuse into the blood and affect properties of endothelial cells of arteries, increasing their uptake of fat. Nicotine increases heart rate and blood pressure, making CHD more likely. Nicotine can also cause higher cholesterol levels.
How does gender affect the risk of cardiovascular disease?
Hormones like progesterone and estrogen use more fat in their synthesis, so less fat is available in the blood of females, making them less likely to develop atheromas.
How does stress increase the risk of cardiovascular disease?
Causing an increase in blood pressure and also affects hormone levels, leading to increased fat deposition in arteries.
How does diet affect the risk of cardiovascular disease?
Intake of animal fat containing a higher proportion of saturated fats/cholesterol increases blood cholesterol and low-density lipoproteins in the blood increasing the risk of atheroma and associated diseases.
What is the role of high density lipoproteins (HDLs)?
Remove cholesterol from tissues and transport it to the liver for excretion protecting the arteries against heart disease.