Respiratory Disease Flashcards

1
Q

Define respiratory diseases

A

Conditions that affect the organs and tissues responsible for gas exchange

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2
Q

Why is their less deaths due to respiratory disease in southern europe?

A

Less in southern Europe (perhaps because they have a Mediterranean diet which contains more fruit and vegetables)

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3
Q

If smoking doesn’t give you lung cancer then…

A

…you’ll probably get COPD

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4
Q

It is mainly […] countries which die of pneumonia.

A

poor countries

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5
Q

What are the three major categories of pulmonary diseases?

A

– Ventilation
– Diffusion
– Perfusion

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6
Q

What were the conclusions of the study titled “Does Cigarette Smoking make you look ugly and old?”

A

“…the data are consistent with the conclusion that smoking causes skin wrinkling that could make smokers appear unattractive and prematurely old..”

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7
Q

What were the conclusions of the study titled “Cigarette smoking associated with premature facial wrinkling: image analysis of facial skin replicas”?

A
  • smoking-associated facial wrinkling
  • young persons underestimate the harmful cumulative effects of smoking on the skin
  • …Smokers need to be made aware
    of the increased risks of premature skin aging as a result of their smoking habit
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8
Q

Smoking will shorten your life by about…

A

…7 years

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9
Q

Smoking will make you…

A

…ugly

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10
Q

What is COPD the abbreviation for?

A

Chronic Obstructive Pulmonary Disease

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11
Q

Chronic Obstructive Pulmonary Disease (COPD) is due to…

A

bronchitis & emphysema as coexisting
diseases of the lungs

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12
Q

COPD is a…

A

…progressive disability and breathlessness

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13
Q

How many deaths in UK 2017 due to COPD?

A

29,063 deaths in 2017 in the UK

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14
Q

Percentage of general UK population who show signs of COPD?

A

10% of general population show signs of the disease, and 26% of patients are aged 45 years or over have indications of COPD

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15
Q

What happens in emphysema?

A
  • the alveoli break apart and merge into each other, producing ‘holes’ in the lung
  • When one breathes in these
    ‘holes’ inflate more and interfere with air flow in the healthy alveoli.
  • The increase in the amount of air inside the chest is termed hyperinflation.
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16
Q

What is bronchitis?

A

Bronchitis is inflammation of the bronchi causing coughing

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17
Q

Symptoms of Bronchitis?

A

Symptoms include coughing up
sputum, shortness of breath,
wheezing, and chest pain.

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18
Q

Bronchitis can be…

A

acute or chronic

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19
Q

What does it mean for bronchitis to be acute?

A

– Last for several weeks
– Usually associate with infection

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20
Q

What does it mean for bronchitis to be chronic?

A

– Lasts for more than 3 months/year
– Often linked to with COPD

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21
Q

The two categories of respiratory disease are…

A

…Upper and lower respiratory disease

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22
Q

Upper Respiratory disease involves…

A

… structures above the vocal folds

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23
Q

Lower Respiratory disease involves…

A

…all structures below the vocal folds

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24
Q

What are the main causes of Respiratory Disease?

A

– Viruses
– Bacteria
– Fungi
– Man made chemicals
– Trauma
– Unidentified

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25
Q

Airway below larynx is normally…

A

…sterile

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26
Q

Role of mucous in respiratory tract?

A

mucous-covering propels sputum, with the aid of ciliated cells, back up the trachea.

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27
Q

IgA antibodies are present in high concentrations in the …

A

…secretions of the upper respiratory tract (protect against viral attack)

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28
Q

IgG (neutralising bacteria and their toxins) and IgA are found in…

A

…the lower respiratory tract

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29
Q

Macrophages within the lung tissue are a …

A

…potent defence mechanism

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30
Q

Examples of Upper respiratory diseases?

A

Common Cold
 Sinusitis
 Allergic Rhinitis
 Croup
 Stridor
 Congenital Laryngeal Stridor / Laryngomalacia
 Pharyngitis/Tonsillitis
 Influenza (Flu)
 Epiglottitis
 Whooping Cough (Pertussis

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31
Q

Examples of Lower Respiratory Infections?

A

 Acute bronchitis and bronchiolitis
— Short-term infection of the airways
 Influenza
— Flu is caused by the influenza viruses.
 Pneumonia
— caused by Streptococcus pneumoniae
 Tuberculosis
— cause by Mycobacterium tuberculosis
 Coronavirus disease
— SARS: SARS-CoV-1 virus
— COVID-19: SARS-CoV-2 virus

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32
Q

What is asthma?

A
  • Chronic inflammation of the bronchi causing swelling of the endothelium and narrowing of the airways
  • Airways may unexpectedly & suddenly narrow
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33
Q

When does asthma often flare up?

A
  • Often in response to an allergen, cold
    air, exercise or infection
  • Has a genetic component
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34
Q

What is bronchial asthma?

A

A hypersensitivity disorder
Bronchospasm, mucosal oedema and excessive
excretion of viscous mucous –> ventilatory insufficiency

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35
Q

Bronchial asthma is most common in…

A

…children under 10

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36
Q

around 80% of (tested) US
children have inadequate…

A

…gastric acid secretion (Hypochlorhydria (or achlorhydria))

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37
Q

Link between candida albicans and respiratory disease?

A
  • Candida albicans: acid protease made by the yeast is causative factor
  • Many people have Candida in their lungs and are asymptomatic
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38
Q

Link between food additives and respiratory disease?

A

Food additives: many involved - mainly food dyes, sodium benzoate and sulphites may be a causative factor of respiratory disease.

39
Q

Link between salt and respiratory disease?

A

Salt: increased intake worsens bronchial reactivity to histamine(??)
- Asthmatics may be salt sensitive

40
Q

What were the conclusions of the study titled “Dietary salt intake as a potential modifier of airway responsiveness in bronchial asthma”?

A
  • lowering dietary salt has reduced the severity of EIB (exercise-induced bronchoconstriction) to subclinical levels
  • Correspondingly, the supplementing of diets to higher than normal salt intake increased EIB significantly
41
Q

What were the conclusions of the study titled “the impact of a medical food containing gammalinolenic and eicosapentaenoic acids on asthma management and the quality of life of adult asthma patients”?

A

Conclusion: The inclusion of the medical food EFF1009 in asthma management regimens can improve patient quality of life and decrease reliance on rescue medication.

42
Q

What were the conclusions of the study titled “Docosahexaenoic acid derivative prevents inflammation and hyperactivity in lung: implication of PKC-Potentiated inhibitory protein for heterotrimeric myosin light chain phosphatase of 17 kD in asthma.”?

A

After oral administration of CRBM-0244, airway leukocyte recruitment, airway mucus, ovalbumin-specific IgE, and proinflammatory markers such as TNF-a and COX-2 were markedly reduced

43
Q

Lungs grow rapidly from…

A

…0-8 years of age

44
Q

How many alveoli does a new born have?

A

10,000,000 alveoli

45
Q

How many alveoli does a 8 year old have?

A

300,000,000 alveoli

46
Q

What slows the rate of lung growth in children?

A
  • Exposure to pollutants (e.g. passive smoking) slows rate of growth
  • Also have a higher exposure to pollutants pollutants/Kg body weight)
    – Spend more time outside
    – Closer to the ground
47
Q

Why is there a proportionally greater obstruction of airways on inhale?

A

on inhale Bronchi are narrower, so irritation/inflammation gives a proportionally greater obstruction of airways

48
Q

Chronic Obstructive Pulmonary Disease describes a group of lung conditions.

Two main ones are…

A
  • Persistent bronchitis –> bronchi become inflamed and narrow
  • Emphysema –> alveoli become damages and deformed
49
Q

What is bronchiectasis?

A
  • Enlargement of parts of the airways
  • Mucus accumulation –> susceptibility to
    infection
  • Scarred tissue –> permanent damage
50
Q

What are some causes of bronchiectasis?

A
  • Severe lung infection, often during
    childhood
  • Cystic fibrosis
  • Primary ciliary dyskinesia
  • Lack of immunity to infection
  • Asthma
  • Blockage (choking) or gastric reflux
51
Q

Fried onion and apple juice help reduce inflammation of the lungs because…

A

…they contain Quercetin.

52
Q

What are the intrinsic risk factors for pulmonary disease?

A

-Intrinsic Risk Factors
1) Genetic predisposition
- asthma
- COPD (Chronic Obstructive Pulmonary Disease)
- carcinoma
2) Cardiac or Circulatory pathologies
- Source for pulmonary edema
- Source for pulmonary emboli

53
Q

What are the major risk factors for pulmonary disease?

A
  1. Tobacco smoke
  2. Second hand tobacco smoke
  3. Indoor air pollutants & outdoor air pollutants
  4. Allergens (sulphide, paint)
  5. Cardiovascular disease
54
Q

What are the under investigation risk factors for pulmonary disease?

A
  1. Diet and nutrition
  2. Sedentary lifestyle
  3. Post infectious chronic respiratory diseases
  4. Genetic predisposition (asthma and cancer)
55
Q

Symptoms of lung disease?

A
  • Chronic cough
  • Shortness of breath
  • Chronic mucus production
  • Wheezing
  • Coughing up blood
  • Chronic chest pain
56
Q

Define chronic cough

A

eight weeks or longer is considered chronic.

57
Q

Define Shortness of breath

A

With little or no exertion or it doesn’t go
recede after exercising

58
Q

Define Chronic mucus production

A

lasting a month or longer

59
Q

Wheezing is…

A

…a sign that something unusual is blocking your
lungs’ airways or making them too narrow.

60
Q

Define Chronic chest pain

A

especially if it gets worse when you
breathe in or cough

61
Q

What are the Functional diagnostic tests for respiratory disease?

A
  • Spirometry: Measures various aspects of lung capacity
  • Peak flow: Measures how fast air can exit the lungs
  • Pulse oximetry: Measures the oxygenation of the blood
  • Plethysmography: More exact way to calculate lung capacity
  • Diffusion Capacity test: Measures how well O2 passes into the blood
62
Q

What are the challenge diagnostic tests for respiratory disease?

A
  • Uses some of the methods above, both before and after inhaling methacholine, a drug know to irritate the airways and cause narrowing
  • Often used to rule out asthma
63
Q

What general diagnostic tests used for respiratory disease?

A

1) Imaging tests
- X-ray, CT scan including angiograms, PET scan, Ultrasound
2) Invasive tests
- Bronchoscopy: a camera is inserted into the airways
- Biopsy of the Pleural: Looking for oedema

64
Q

Sputum colour can be used as a…

A

…diagnostic tool in non-cystic fibrosis bronchiectasis

65
Q

Large amount of sputum = ?

A

infection

66
Q

Thick green or brown sputum = ?

A

pneumonia or infection

67
Q

yellow or grey sputum = ?

A

allergic or inflammatory response

68
Q

Haemoptysis sputum (has blood in it ) = ?

A

tuberculosis or carcinoma

69
Q

Pink and/or frothy sputum = ?

A

Severe pulmonary oedema

70
Q

What are the treatments of respiratory disease?

A

1) Surgery
- Lung transplant
- Lung lobectomy: removal of one of the lungs
- Lung volume reduction surgery: removes most disease part of lung
to help the rest function more efficiently
2) Oxygen therapy

71
Q

Lung cancer is one of the…

A

…major killers in the UK

72
Q

What are the risk factors for preventable respiratory disease?

A

 Cold weather
 Tobacco smoking
 Second hand tobacco smoke
 Indoor & Outdoor pollution
 Allergens
 Occupational risks and vulnerability (Certain careers can include working with certain chemicals which damage the lungs. EG: Breathing in chemicals of paint.)
 Diet
 Level of fitness (in particular exercising the lungs)

73
Q

Much of the variation in mortality between social classes is due to…

A

…smoking

74
Q

Why are individuals with social inequalities more likely to smoke?

A

Individuals more likely to smoke due to social inequalities perhaps because they have little to no pleasure. Smoking gives individuals the pleasure they are missing in their lives.

75
Q

Levels of smoking
have fallen more
quickly in the…

A

…professional classes

76
Q

Smoking more common in…

A

…the unskilled and poor, and rarer in (more wealthy) professionals.

77
Q

Link between indoor pollutants and respiratory disease?

A

Solid fuels :
- 3 billion people (almost all in low and
middle income countries) rely on wood,
dung and crop residues for fuel
- Burnt in simple stoves with incomplete
combustion
- Estimated 1.5 - 1.8 million premature
deaths a year; approx. 1 million of these
occur in children under 5 years of age

78
Q

Why is it not good to have wood burning fires around babies and young children?

A

due to the produced smoke. Stunts growth and development. Lungs of babies develop in the first months of life. Smoke produced by wood burning stoves has a similar effect.

79
Q

Link between outdoor pollutants and respiratory disease?

A

Mainly traffic-related air pollution
Long term exposure to combustion-related
fine particulate air pollution
Diesel cars / petrol cars
Environmental risk factors for
cardiorespiratory diseases & lung cancer
Particular concern in low and middle
income countries  older fleet? Less
control over emissions (MOT)?

80
Q

Is the MOT effective?

A

Is the MOT effective? Lots of smelly vans about releasing toxic fumes despite “MOT”.

81
Q

What do all allergic diseases result from?

A

All allergic diseases result from a complex interaction between genes, allergens and co-factors which vary between regions and geographical areas.

82
Q

WHat are allergens?

A

Allergens are antigens reacting with specific IgE antibodies

83
Q

Where do allergens originate from?

A
  • Mites
  • Animals
  • Insects
  • Plants
  • Fungi
  • Small molecular weight chemicals
84
Q

Allergens have a well established role in…

A

…asthma

  • due to Ag-Ab interactions (immunological response)
85
Q

Exclusive breast-feeding for 6 months effective for…

A

…allergy prevention

86
Q

Exposure to allergens is a trigger for symptoms in …

A

…sensitised individuals with asthma

87
Q

Work-related respiratory conditions can have…

A

…long latency periods

88
Q

Work-related asthma is the UK’s…

A

…fastest growing occupational disease

89
Q

In low and middle income countries, occupational illness are not …

A

…adequately recognised as a problem ñ most patients not compensated and have to continue to work

90
Q

Give some examples of Occupation-related indoor pollutants.

A

Apart from second-hand tobacco smoke:
 Indoor allergens
 Nitrogen oxides
 Formaldehyde
 Volatile organic compounds
 Indoor-generated particulate matter
 Carbon monoxide

91
Q

What were the conclusions of the study titled “Breastfeeding as a modifier of the respiratory effects of air pollution in children”?

A

CONCLUSION: Breastfeeding is associated with smaller associations between air
pollution and respiratory conditions in children, suggesting that breastfeeding reduces
susceptibility to the respiratory effects of pollutants.

92
Q

What were the conclusions of the study titled “The relation of Serum Levels of Antioxidant Vitamins C and E, Retinol and Carotenoids with Pulmonary Function in the General Population”?

A

Our findings support the hypothesis that antioxidant vitamins may play a role in respiratory health and that vitamin E and b-cryptoxanthin appear to be stronger correlates of lung function than other antioxidant vitamins.

93
Q
A