Respiratory Disease Flashcards
definition of asthma
reversible airflow obstruction via bronchial hyper reactivity - muscles used to breath in but breathing out an issue as no muscles to expel air = wheezing
why airway lumen shrinks in asthma
- allergen triggers IgE
- causes b and t cell interactions leading to mast cell degranulation
- causes bronchial smooth muscle contraction, mucosal oedema and excessive mucous secretion
symptoms of asthma
- cough
- wheezing in expelling air
- shortness of breath
- worse at night and in morning
- diurnal variations
how to gather evidence of asthma
peak expiratory flow rate (PEFR)
asthma occurs in two events - can be worse later in the second event - what is the name of this response and what are the types of drugs administered to deal with each event?
asthma biphasic response
- short term 1st event = agonist
- later longer event = corticosteroids
what are the 5 corse asthma drugs
- intermittent short acting beta adrenergic agonists
- regular long acting beta adrenergic agonists
- 2 MUST be used alongside an inhaled response
- then use 3 or 4 - inhaled corticosteroids (low dose)
- if not enough use 4 - inhaled corticosteroids (high dose)
- adjuvant therapy (for severe cases)
purpose and action of beta adrenergic agonists
- for asthma and reduce bronchioconstriction
purpose, action and when use required of corticosteroids
- for asthma, has immune and epithelial actions
- take EVERY DAY if taking >3 beta adrenergic agonists a week
what 4 things the dental team need to know about asthma in relation to patients
- if they have it
- know severity
- what sets off
- know how to assess/treat patient having acute attack
how are patients placed into the 4 tears of asthma severity
- mild (blue and brown inhalers standard here)
- bottom level = occasional short acting beta adrenergic agonist
- second level = above and short acting corticosteroid
- moderate (blue and purple)
- third level = moved to using long acting beta adrenergic agonist and high dose inhaled corticosteroid
- more severe
- have to use other drugs
- most severe
- hospitalised by asthma in the last year
definition of Chronic Obstructive Pulmonary Disease (COPD)
- mixed airway (large and small) obstructive reversible and irreversible destructive lung disease
name of process in COPD that destroys the alveoli, small and large airways and how it works
- Bronchiectasis
- excessive mucous allows chronic infection damaging walling of airways and muscles of the walls
name of the alveolar destruction caused by COPD’s bronchiectasis
- emphysema
COPD risk factors
- asthma
- pollution
- age
- chronic bronchitis
- smoking
outcomes of COPD
- reduced SA for gas exchange
- heart failure
- pneumonia risk
- respiratory failure (types 1&2)
how is COPD managed
- oxygen supply
- long acting bronchodilators
- stopping smoking
- ## antibiotics
what are the two types of respiratory failure that can occur due to COPD
type 1 - hypoxia/hypoxaemia = low oxygen [absorbed] (alveolar effect)
- reduced SA for gas exchange
- thickened alveolar walls
- hyperventilate to compensate
- THOUGH high oxygen in lungs just cant be absorbed
type 2 - Hypercapnia and hypoxia (poor ventilation)
- only in acute respiratory failure
- restrictive lung defects/narrowing of airways
- only 20% difference needed to trigger
- NOT treated with short term methods as messes up in long run due to respiration rate linked to O2 in blood
what is cystic fibrosis
- genetic disease, recessive on chromosome 7 CFTR gene
- defect in cell chloride channels causing excessively sticky mucous secretions (either makes channel not open properly, pass Cl properly or at all)
symptoms of cystic fibrosis
consistent cough
poor weight gain
persistent diarrhoea
repeated staphlococcus chest infections
- potentilly chronic bronchitis/bronchiectasis and malnutrition
- prone to liver disfunction, osteoporosis, reduced fertility and diabetes symptoms
treatment for cystic fibrosis
- physiotherapy to remove mucous
- medication
- lungs = bronchiodilators, steroids and antibiotics
- digestive system = supplements and pancreatic enzyme replacement
- stem cell therapy
- CFTR modulators = help regulation of Cl channels
- transplantation and exercise
what are the two groups of lung tumours
- small cell (25%)
- non-small cell
- squamous cell carcinoma (40%)
- large cell
- ademocacinoma
lung cancer symptoms
- cough
- haemoptysis
- pneumonia
- metastasis
- dysphagia, superior vena cava obstruction,
treatment of lung cancer
- periphery = removal
- small cell = chemoradiotherapy to extend life as incurable
4 stages of lung cancer
stage i. localised (not at lymph nodes) and <5cm
ii. 5-7cm, localised but in nearby lymph nodes
iii. >7cm, localised but spread to other areas of chest
iv. metastatic
what is sleep apnoea
- oral muscles relax causing airway obstruction for short periods when sleeping
- can cause hypoxia
what are the treatments for sleep apnoea
mechanical
i. oral appliance pulls tongue forward
ii. CPAP machine = mask keeping pressure on airways
therapy
- prevent sleeping on back
- bags over shoulders
