respiratory conditions Flashcards
respiratory disease
=any of the diseases and disorders of the airways and the lungs that affect human respiration
risk factors: tobacco smoking (including second-hand smoke), air pollution, allergens and occupational risks
s&s: runny, blocked nose & sneezing (thin= allergy, thick= viral infection, blood stained= nasal tumour), cough (morning cough= smokers, productive= chronic bronchitis, dry PM= asthma/ acid reflux, stridor= whooping cough), sputum (excess mucus), breathlessnes, wheezing, chest pain
breathlessness
=shortness of breath
caused by: dyspnoea (increased respiratory effort, tightness in chest), orthopnoea (breathless when lying down), tachypnoea and hyperpnoea (increased breathing & ventilation rate), hyperventilation, paroxysmal nocturnal dyspnoea
s&s: difficulty catching your breath, noisy breathing, very fast, shallow breaths, an increase in your pulse rate, wheezing, chest pain, skin that looks pale and slightly blue, especially around your mouth, cold, clammy skin.
acute bronchitis
=a chest cold and is where the airway of the lungs swell up and produce too much mucus
caused by: viruses that are very similar to regular cold viruses, but you usually only get infected the once. It could, very rarely, be from a bacterial infection or from inhaling harmful chemicals such as tobacco, dust or allergens. It’s an inflammation of the breathing tubes called the bronchi which then cause too much mucus
patho: Inflammation of the bronchial wall leads to mucosal thickening, epithelial-cell desquamation, and denudation of the basement membrane
pop: usually affects young children under 5 or the elderly but there is no ethnicity more likely to get it
risk factors: smoking, low immune resistance that may be from having other illnesses, chronic conditions that compromise the immune system, young or old age, exposure to chemical irritants or fumes so certain occupations, gastric reflux or repeated heartburn that can irritate the throat
s&s: cough, sputum production that’s usually clear, white or yellow, fatigue, shortness of breath, fever, body aches and chills but usually quite mild, chest discomfort and pain, sore throat, headache, runny nose, wheezing
treatment: antibiotics. can treat symptoms with cough medicines, painkillers, humidifying air, increase fluid intake
Bronchiolitis
=a common lung infection in young children and infants
caused by: respiratory syncytial virus
patho: a virus infects the bronchioles. The infection makes the bronchioles swollen and irritated. Mucus collects in these airways, which makes it difficult for air to flow freely in and out of the lungs
pop: Children under 2 and infants under 3 months
risk factors: Being born too early, Having a heart or lung condition, Having a weakened immune system. This makes it hard to fight infections, Being around tobacco smoke, Contact with lots of other children, such as in a child care setting, Spending time in crowded places, Having siblings who go to school or get child care services and bring home the infection.
s&s: runny nose, stuffy nose, cough, slight fever
treatments: lasts 1-2 weeks usually
a machine creates a fine mist of medicine that child breathes into lungs
whooping cough
=a highly contagious respiratory tract infection
caused by: type of bacteria called Bordetella pertussis
patho: Local inflammatory changes occur in the mucosal lining of the respiratory tract. Released toxins. act locally and systemically, although the organism itself does not fully penetrate the respiratory tract, and almost never is found in blood cultures.
pop: children too young to have completed the full course of vaccinations and teenagers and adults whose immunity has faded
risk factors: lack of immunization or impaired immune responses to vaccination
s&s: Runny nose, Nasal congestion, Red, watery eyes, Fever, Cough, uncontrollable coughing, cough provoking vomiting, red/ blue face, extreme fatigue, high pitched whoop during next breath
treatment: Usually hospitalised (infants), Antibiotics, Rest, Fluids, Small meals, Clean air
ddx: viral upper respiratory infection, bronchiolitis, pneumonia, and tuberculosis
pneumonia
=an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material)
caused by: bacteria and viruses that overpower the immune system (community acquired, hospital acquired, healthcare acquired, aspiration pneumonia)
patho: an intricate balance between the organisms residing in the lower respiratory tract and the local and systemic defense mechanisms (both innate and acquired) which when disturbed gives rise to inflammation of the lung parenchyma
pop: children under 2, people
above 65
risk factors: being hospitalised, chronic disease, weakened/ suppressed immune system, smoking
s&s:Chest pain when you breathe or cough, Confusion or changes in mental awareness (in adults age 65 and older), Cough, which may produce phlegm
Fatigue, Fever, sweating and shaking chills, Lower than normal body temperature (in adults older than age 65 and people with weak immune systems), Nausea, vomiting or diarrhea, Shortness of breath
treatment: antibiotics (bacterial pneumonia), cough medicine, fever reducers/ pain relievers, hospitalisation
TB
=a bacterial infection spread through inhaling tiny droplets from the coughs or sneezes of an infected person
caused by: four main mycobacterial species, collectively termed Mycobacterium tuberculosis complex
(Mycobacterium tuberculosis, Mycobacterium bovis - cattle and other animals such as bison, elk, and deer, Mycobacterium africanum, Mycobacterium microti)
patho:Once inhaled into the lung, alveolar macrophages ingest the bacteria; the bacilli then proliferate inside the macrophages and cause the release of neutrophil chemoattractants and cytokines, resulting in an inflammatory cell infiltrate reaching the lung and draining hilar lymph nodes. Macrophages present the antigen to the T lymphocytes with the development of a cellular immune response. A delayed hypersensitivity-type reaction occurs, resulting in tissue necrosis and formation of a granuloma.
pop: one-third of the world’s population are infected with tuberculosis
risk factors: Contact with high-risk groups (Origination from a high-incidence country), Frequent travel to high incidence areas, Immune deficiency (e.g. hiv, corticosteroids/ immunosuppressant therapy, diabetes etc), lifestyle factors (drug/ alcohol misuse, homelessness etc), genetic susceptibility
s&s: Lack of appetite and weight loss, High temperature, Night sweats, Extreme tiredness or fatigue, A persistent cough that lasts more than 3 weeks and usually brings up phlegm, which may be bloody, Breathlessness that gradually gets worse.
treatment: require 6 months of treatment (CNS TB= 12 mnths), corticosteroids are used as an adjunct at treatment initiation to reduce long-term complications. Directly observed therapy (DOT) is widely recommended
Emphysema
type of COPD (respiratory disease characterized by progressive airflow limitation and tissue destruction as a result of chronic inflammation)
=destruction of alveoli
caused by: Long-term exposure to harmful particles or gases
-Cigarette smoking and second-hand smoke
-Environmental or occupational exposures (e.g.: dust, fumes, chemicals, biomass fuels, coal)
-Childhood asthma or frequent severe respiratory infections in childhood
-Alpha-1 antitrypsin deficiency (AATD
pop: Adults above the age of 40 (incidence increases with age) & Males affected more often than females
risk factors: Smokers (in developed countries), Developing countries and rural areas (more likely to be exposed to biomass from cooking food in poorly ventilated areas)
s&s: Chronic and progressive dyspnoea (shortness of breath),Cough and sputum production, Wheezing and prolonged expiration, Chest tightness as a result of accessory respiratory muscle use, Muscle wasting, especially in the lower limbs, Barrel chest, Central cyanosis (blue skin and lips) when blood oxygen levels are low, Forced expiratory volume in one second to forced vital capacity ratio (FEV1/FVC) less than 0.7
treatment: aim=to improve quality of life.
Smoking cessation, Pulmonary rehabilitation (exercise and education), Annual flu vaccine, Short term bronchodilator beta2-agonist inhalers, Corticosteroid Inhalers. Lung transplantation or other surgical interventions in severe cases where medical therapy does not improve the quality of life
chronic bronchitis
another type of COPD
=long term inflammation of the bronchi
caused by:Long-term exposure to harmful particles or gases
-Cigarette smoking and second-hand smoke
-Environmental or occupational exposures (e.g.: dust, fumes, chemicals, biomass fuels, coal)
-Childhood asthma or frequent severe respiratory infections in childhood
-Alpha-1 antitrypsin deficiency (AATD)
pop: Adults above the age of 40 (incidence increases with age) & Males affected more often than females
risk factors: Smokers (in developed countries), Developing countries and rural areas (more likely to be exposed to biomass from cooking food in poorly ventilated areas)
s&s: Chronic and progressive dyspnoea (shortness of breath),Cough and sputum production, Wheezing and prolonged expiration, Chest tightness as a result of accessory respiratory muscle use, Muscle wasting, especially in the lower limbs, Barrel chest, Central cyanosis (blue skin and lips) when blood oxygen levels are low, Forced expiratory volume in one second to forced vital capacity ratio (FEV1/FVC) less than 0.7
treatment: aim=to improve quality of life.
Smoking cessation, Pulmonary rehabilitation (exercise and education), Annual flu vaccine, Short term bronchodilator beta2-agonist inhalers, Corticosteroid Inhalers. Lung transplantation or other surgical interventions in severe cases where medical therapy does not improve the quality of life
ddx: Asthma, Interstitial lung disease, Bronchiolitis obliterans, Heart failure, Cystic fibrosis, Malignancy
asthma
=a common chronic inflammatory condition that causes breathing difficulty.
caused by: Genes (there is no direct gene linked with asthma, however, several genes alongside a combination of environmental factors influence the development of asthma, Environmental Factors (exposure to allergens or maternal smoking)
patho: involves a number of cells, meditators, nerves and vascular leakage that can be activated by several different mechanisms, including exposure to allergens.
The severity of asthma is dependent on the interplay between airway inflammation and airway wall remodelling.
pop: More common in more developed countries (seen mostly in the UK, New Zealand and Australia).
risk factors: Cold air and exercise, Atmospheric pollution and irritant dusts, vapours or fumes, Diet, Emotion, Drugs (NSAIDs and betablockers), Allergens
s&s: During an asthma attack wheezing, shortness of breath, feeling of a tight chest and cough can be experienced which is often worse at night, especially if the disease is uncontrolled. Attacks can vary in frequency and duration as well as being precipitated by a wide range of triggers
treatment: Control of extrinsic factors which may trigger an attack (pets, smoke, pollen etc).
-Drug treatment (Anti-inflammatories, oral corticosteroids, inhaled corticosteroids, and antibiotics)
ddx: Chronic obstructive pulmonary disease (COPD), Cystic Fibrosis, Foreign body aspiration, Heart failure, Pulmonary embolism (PE), Tuberculosis
cystic fibrosis
=an inherited condition that causes a build-up of thick sticky mucus in the lungs, digestive system, and other organs
caused by: cannot be caught or developed; it is diagnosed at birth. If you are not born with Cystic Fibrosis, you could still be a Cystic Fibrosis gene carrier
Both parents must carry the Cystic Fibrosis gene for a child to be born with Cystic Fibrosis.
caused by a mutation of the Cystic Fibrosis Transmembrane Conductance (CFTR) protein gene. The CFTR gene controls the flow of salt and fluids in and out of cells, when this gene is affected, it causes a build-up of thick, sticky mucus in the body’s ducts
pop: affecting more than 10,800 people in the UK. 1 in 25 people are carries for the fault gene
risk factors: family history of the disease
s&s: Recuring chest infections, wheezing, coughing, shortness of breath, and damage to the airways (bronchiectasis), difficulty putting on weight and growing, yellowing of the skin and the whites of the eyes (jaundice), diarrhoea, constipation, or large, smelly faeces, a bowel obstruction in newborn babies
treatments: they should be seen at least every 3 months and have an annual review. Lung function (FEV1) and body mass index (BMI) should be recorded at every appointment, as they have prognostic importance. Chest physiotherapy for mucus clearance with active cycle of breathing, Prophylactic antibiotics and antibiotics for acute exacerbations guided by sputum culture (oral, inhaled, or intravenous), inhaled bronchodilators, Mucolytics (oral or inhaled) Hypertonic saline or dornase alfa, pancreatic enzymes (Creon), diabetic control (usually with insulin)
lung cancer
a type of cancer that forms in the tissues of the lungs. Cancer that begins in the lungs is known as primary lung cancer. Cancer that spreads to the lungs from another part of the body is known as secondary lung cancer
caused by: Smoking (main cause both in smokers and individuals exposed to second-hand smoke), Occupational (exposure to asbestos or radon gas), Air pollution, Previous lung disease
patho: developed from an exposure to environmental pollutants and carcinogens (substances known to produce cancer or increase the risk of developing cancer) as well as genetic mutations that contribute to the development of lung cancer.
pop: African American Men are most likely to develop lung cancer
risk factors: Smoking, Age (65+ years), Exposure to second-hand smoke, Previous radiation therapy, Exposure to radon gas, Exposure to asbestos and other carcinogens, Family history
s&s: A persistent cough, Coughing up blood, Persistent breathlessness, Unexplained tiredness and weight loss, An ache or pain when breathing or coughing
treatments: Surgery – wedge resection (remove the tumour), segmental resection (remove larger part of the lung), lobectomy (remove entire lobe of one lung) or pneumonectomy (remove entire lung).
-Radiation therapy – kills cancer cells via high-powered energy beams.
-Chemotherapy – kills cancer cells via drugs.
-Palliative care – to reduce signs and symptoms of cancer and side effects of treatment.
Pneumothorax
=a collapsed lung occurring when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse
caused by: chest injury, lung disease, ruptured air blisters, mechanical ventilation
patho: The alveolar and atmospheric pressures are greater than the intrapleural pressure. Therefore, connections between the alveoli and pleural space, or surrounding atmosphere and pleural space, will lead to air moving down a pressure gradient into the pleural space.
This increases the intrapleural pressure, potentially compressing the lungs. Air will continue to move into the pleural space until the pressure gradient equilibrates or the connection into the pleural space seals off
pop: Men, 20-40 years, Tall, underweight people
risk factors: smoking, genetics, previous pneumothorax
s&s: sudden chest pain and shortness of breath. Severity of symptoms may depend on how much of the lung is collapsed
treatment: goal in treatment is to relieve the pressure on your lung, allowing it to re-expand
observation, needle aspiration, chest tube insertion, nonsurgical repair or surgery. You may receive supplemental oxygen therapy to speed air reabsorption and lung expansion
