Respiratory Disease Flashcards
Define respiratory diseases
Conditions that affect the organs and tissues responsible for gas exchange
Why is their less deaths due to respiratory disease in southern europe?
Less in southern Europe (perhaps because they have a Mediterranean diet which contains more fruit and vegetables)
If smoking doesn’t give you lung cancer then…
…you’ll probably get COPD
It is mainly […] countries which die of pneumonia.
poor countries
What are the three major categories of pulmonary diseases?
– Ventilation
– Diffusion
– Perfusion
What were the conclusions of the study titled “Does Cigarette Smoking make you look ugly and old?”
“…the data are consistent with the conclusion that smoking causes skin wrinkling that could make smokers appear unattractive and prematurely old..”
What were the conclusions of the study titled “Cigarette smoking associated with premature facial wrinkling: image analysis of facial skin replicas”?
- 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
Smoking will shorten your life by about…
…7 years
Smoking will make you…
…ugly
What is COPD the abbreviation for?
Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease (COPD) is due to…
bronchitis & emphysema as coexisting
diseases of the lungs
COPD is a…
…progressive disability and breathlessness
How many deaths in UK 2017 due to COPD?
29,063 deaths in 2017 in the UK
Percentage of general UK population who show signs of COPD?
10% of general population show signs of the disease, and 26% of patients are aged 45 years or over have indications of COPD
What happens in emphysema?
- 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.
What is bronchitis?
Bronchitis is inflammation of the bronchi causing coughing
Symptoms of Bronchitis?
Symptoms include coughing up
sputum, shortness of breath,
wheezing, and chest pain.
Bronchitis can be…
acute or chronic
What does it mean for bronchitis to be acute?
– Last for several weeks
– Usually associate with infection
What does it mean for bronchitis to be chronic?
– Lasts for more than 3 months/year
– Often linked to with COPD
The two categories of respiratory disease are…
…Upper and lower respiratory disease
Upper Respiratory disease involves…
… structures above the vocal folds
Lower Respiratory disease involves…
…all structures below the vocal folds
What are the main causes of Respiratory Disease?
– Viruses
– Bacteria
– Fungi
– Man made chemicals
– Trauma
– Unidentified
Airway below larynx is normally…
…sterile
Role of mucous in respiratory tract?
mucous-covering propels sputum, with the aid of ciliated cells, back up the trachea.
IgA antibodies are present in high concentrations in the …
…secretions of the upper respiratory tract (protect against viral attack)
IgG (neutralising bacteria and their toxins) and IgA are found in…
…the lower respiratory tract
Macrophages within the lung tissue are a …
…potent defence mechanism
Examples of Upper respiratory diseases?
Common Cold
Sinusitis
Allergic Rhinitis
Croup
Stridor
Congenital Laryngeal Stridor / Laryngomalacia
Pharyngitis/Tonsillitis
Influenza (Flu)
Epiglottitis
Whooping Cough (Pertussis
Examples of Lower Respiratory Infections?
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
What is asthma?
- Chronic inflammation of the bronchi causing swelling of the endothelium and narrowing of the airways
- Airways may unexpectedly & suddenly narrow
When does asthma often flare up?
- Often in response to an allergen, cold
air, exercise or infection - Has a genetic component
What is bronchial asthma?
A hypersensitivity disorder
Bronchospasm, mucosal oedema and excessive
excretion of viscous mucous –> ventilatory insufficiency
Bronchial asthma is most common in…
…children under 10
around 80% of (tested) US
children have inadequate…
…gastric acid secretion (Hypochlorhydria (or achlorhydria))
Link between candida albicans and respiratory disease?
- Candida albicans: acid protease made by the yeast is causative factor
- Many people have Candida in their lungs and are asymptomatic
Link between food additives and respiratory disease?
Food additives: many involved - mainly food dyes, sodium benzoate and sulphites may be a causative factor of respiratory disease.
Link between salt and respiratory disease?
Salt: increased intake worsens bronchial reactivity to histamine(??)
- Asthmatics may be salt sensitive
What were the conclusions of the study titled “Dietary salt intake as a potential modifier of airway responsiveness in bronchial asthma”?
- 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
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”?
Conclusion: The inclusion of the medical food EFF1009 in asthma management regimens can improve patient quality of life and decrease reliance on rescue medication.
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.”?
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
Lungs grow rapidly from…
…0-8 years of age
How many alveoli does a new born have?
10,000,000 alveoli
How many alveoli does a 8 year old have?
300,000,000 alveoli
What slows the rate of lung growth in children?
- 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
Why is there a proportionally greater obstruction of airways on inhale?
on inhale Bronchi are narrower, so irritation/inflammation gives a proportionally greater obstruction of airways
Chronic Obstructive Pulmonary Disease describes a group of lung conditions.
Two main ones are…
- Persistent bronchitis –> bronchi become inflamed and narrow
- Emphysema –> alveoli become damages and deformed
What is bronchiectasis?
- Enlargement of parts of the airways
- Mucus accumulation –> susceptibility to
infection - Scarred tissue –> permanent damage
What are some causes of bronchiectasis?
- Severe lung infection, often during
childhood - Cystic fibrosis
- Primary ciliary dyskinesia
- Lack of immunity to infection
- Asthma
- Blockage (choking) or gastric reflux
Fried onion and apple juice help reduce inflammation of the lungs because…
…they contain Quercetin.
What are the intrinsic risk factors for pulmonary disease?
-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
What are the major risk factors for pulmonary disease?
- Tobacco smoke
- Second hand tobacco smoke
- Indoor air pollutants & outdoor air pollutants
- Allergens (sulphide, paint)
- Cardiovascular disease
What are the under investigation risk factors for pulmonary disease?
- Diet and nutrition
- Sedentary lifestyle
- Post infectious chronic respiratory diseases
- Genetic predisposition (asthma and cancer)
Symptoms of lung disease?
- Chronic cough
- Shortness of breath
- Chronic mucus production
- Wheezing
- Coughing up blood
- Chronic chest pain
Define chronic cough
eight weeks or longer is considered chronic.
Define Shortness of breath
With little or no exertion or it doesn’t go
recede after exercising
Define Chronic mucus production
lasting a month or longer
Wheezing is…
…a sign that something unusual is blocking your
lungs’ airways or making them too narrow.
Define Chronic chest pain
especially if it gets worse when you
breathe in or cough
What are the Functional diagnostic tests for respiratory disease?
- 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
What are the challenge diagnostic tests for respiratory disease?
- 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
What general diagnostic tests used for respiratory disease?
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
Sputum colour can be used as a…
…diagnostic tool in non-cystic fibrosis bronchiectasis
Large amount of sputum = ?
infection
Thick green or brown sputum = ?
pneumonia or infection
yellow or grey sputum = ?
allergic or inflammatory response
Haemoptysis sputum (has blood in it ) = ?
tuberculosis or carcinoma
Pink and/or frothy sputum = ?
Severe pulmonary oedema
What are the treatments of respiratory disease?
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
Lung cancer is one of the…
…major killers in the UK
What are the risk factors for preventable respiratory disease?
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)
Much of the variation in mortality between social classes is due to…
…smoking
Why are individuals with social inequalities more likely to smoke?
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.
Levels of smoking
have fallen more
quickly in the…
…professional classes
Smoking more common in…
…the unskilled and poor, and rarer in (more wealthy) professionals.
Link between indoor pollutants and respiratory disease?
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
Why is it not good to have wood burning fires around babies and young children?
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.
Link between outdoor pollutants and respiratory disease?
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)?
Is the MOT effective?
Is the MOT effective? Lots of smelly vans about releasing toxic fumes despite “MOT”.
What do all allergic diseases result from?
All allergic diseases result from a complex interaction between genes, allergens and co-factors which vary between regions and geographical areas.
WHat are allergens?
Allergens are antigens reacting with specific IgE antibodies
Where do allergens originate from?
- Mites
- Animals
- Insects
- Plants
- Fungi
- Small molecular weight chemicals
Allergens have a well established role in…
…asthma
- due to Ag-Ab interactions (immunological response)
Exclusive breast-feeding for 6 months effective for…
…allergy prevention
Exposure to allergens is a trigger for symptoms in …
…sensitised individuals with asthma
Work-related respiratory conditions can have…
…long latency periods
Work-related asthma is the UK’s…
…fastest growing occupational disease
In low and middle income countries, occupational illness are not …
…adequately recognised as a problem ñ most patients not compensated and have to continue to work
Give some examples of Occupation-related indoor pollutants.
Apart from second-hand tobacco smoke:
Indoor allergens
Nitrogen oxides
Formaldehyde
Volatile organic compounds
Indoor-generated particulate matter
Carbon monoxide
What were the conclusions of the study titled “Breastfeeding as a modifier of the respiratory effects of air pollution in children”?
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.
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”?
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.
