Respiratory conditions

Question 1

Causes of COPD

Answer 1

Smoking
Dust inhalation
Outdoor air pollution
Childhood respiratory conditions

Question 2

What is COPD

Answer 2

Disease characterized by persistent airflow limitation

Question 3

Pathophysiology of COPD

Answer 3

Inhaling noxious particles
Causes mucus gland hypertrophy
Causing increased mucus production
Destruction of ciliated epithelial cells in airway walls
Chronic inflammatory changes, narrowing in small airways
Increase in bronchial smooth muscle, which induces airway narrowing and bronchial inflammation
Loss of alveolar walls

Question 4

Results of destruction of cilia (COPD)

Answer 4

Increase sputum production

Reduced mucociliary clearance

Question 5

Consequences of pathophysiology (COPD)

Answer 5

Airflow limitation and lung hyperinflation
Gas exchange abnormalities
Dyspnoea
Reduced exercise tolerance
Skeletal muscle dysfunction
Reduced cardiac output

Question 6

Airflow limitation and lung hyperinflation (COPD)

Answer 6

Airflow limitation causes gas trapping
Which causes lung hyperinflation
Which places diaphragm in shortened flat position
Therefore reduces its contribution to ventilation

Question 7

Gas exchange abnormalities (COPD)

Answer 7

Due to capillary bed destruction
Causes increased physiological dead space and V/Q mismatch
V/Q mismatch causes oxygen desaturation and therefore increases ventilatory demand and dyspnoea

Question 8

Dyspnoea (COPD)

Answer 8

Dyspnoea due to hyperinflation and gas exchange abnormalities

Question 9

Cause of CF

Answer 9

Mutations in CFTR
Causing reduced secretion of chloride and water
Leading to dehydrated mucus

Question 10

What treatment is integral in CF?

Answer 10

ACBTs

Benefits mucus transport

Question 11

CF symptoms

Answer 11

Breathlessness
Reduced exercise capacity
Productive cough
Possible haemoptysis

Question 12

Exercise and CF

Answer 12

Preserve lung function
Increase FEV and peak expiratory flow rate
Facilitate secretion clearance
Should exercise several times per week

Question 13

Inhalation therapy in CF

Answer 13

Nebulised hypertonic saline
Draw fluid to airway surface
Improve mucociliary clearance

Question 14

CF with haemoptysis

Answer 14

Avoid high pressure PEP and head down tilt

Modify or withhold ACT’s

Question 15

Other training in CF

Answer 15

Weight bearing to maximise bone health

People with CF prone to osteoporosis/fractures

Question 16

Reduced cardiac output consequence (COPD)

Answer 16

Reduced Q limits blood supply and oxygen to the working muscles
Which can cause early onset of lactic acidosis

Question 17

COPD treatments

Answer 17

Bronchodilators
Lung volume reduction surgery
Long term continuous oxygen therapy to manage hypoxaemia
NIV used to manage respiratory failure
Breathing exercises, ACT's

Question 18

What is an exacerbation of COPD

Answer 18

Characterized by a change in baseline dyspnoea, cough and/or sputum production that is beyond their normal and is acute.

Question 19

Pathophysiology of Bronchiectasis

Answer 19

Damage to the cilia
Bacteria remains in airway
Stimulates host inflammatory response
Which damages the bronchial walls
And leads to dilation of bronchi
Leads to cycle where clearance of secretions from dilated bronchi is impaired, secretions become infected, which produces an inflammatory response which results in a progressive destructive lung disease.

Question 20

Bronchiectasis treatment

Answer 20

Hypertonic saline- reduced mucus viscosity, increased sputum clearance and improved lung function
Mannitol- enhance mucociliary clearance
ACBT, PEP and postural drainage to aid secretion clearance
Exercise to improve exercise capacity

Question 21

What is asthma?

Answer 21

Widespread inflammation and airway narrowing

Question 22

Pathophysiology of asthma

Answer 22

Antigen-antibody reaction degranulates mast cells which causes bronchoconstriction.

Question 23

Symptoms of asthma

Answer 23

Wheezing
Cough
Breathlessness
Chest tightness
Hyperinflation
Use of accessory muscles

Question 24

Asthma treatment

Answer 24

Exercise training- increase aerobic capacity to reduce stimulus for exercised induced asthma