Respiratory disease and conditions Flashcards
Describe the physiology of the respiratory system.
Movement of inspired gas into and exhaled gas out of the lungs.
What does the lower respiratory tract consits of?
Branchus
Branchioles
Trachea
Alveolar duct
Avleoli
Respiratory Bronchiole
Lungs
What is the upper respiratory tract made up of?
Nose
sinuses
Pharynx
Larynx
What is the function of Goblet cell mucus ?
- moisten inspired air
- Prevent drying of alveoli
- Traps dust and other airbone particles
What is the function of the cilla ?
- Remove foreign material
- Wavelike motion propels material (coughed up, spit up or swallowed)
What are the different types of disease in the UPPER respiratory tract
?
Common cold
Hay fever
Sinusitis
Pharyngitis/Tonsilitis
Flu
RSV
COVID
What are the different types of disease in the LOWER respiratory tract
Pneumonia (acute)
Chronic Tuberculosis
Chronic obstruction pulmonary disease
Asthma
Cystic Fibrosis
Emphysema
Chronic bronchitis
What is the eitiology and signs of a upper respiratory tract disease?
Etiology: Infection and allergic reaction=inflam
Signs:
* Sneezing
* Watering eyes
* nasal decongestion/discharge
* fever
* sore throat
* cough
* headache
What are the modes of transmission for a upper respiratory tract disease?
- direct oral contact
- inhale airbone droplets
- indirect by hands
- articles contaminated with aerosols
What is the etiology and signs of a lower respiratory tract disease?
Etiology: viral or bacterial
Signs:
* Fever
* Severe cough
* Rapid breathing or difficulty breathing.
What are the modes of transimission for lower respiratrory tract disease?
- direct contact,
- indirect contact/fomite,
- droplet and aerosol
What are the different types of Pneumonia?
- Community acquired Pneumonia (walking)
- Healthcare associated Pneumonia (Nursing home aquired/aspiration ,Hospital aquired )
- Pneumocystics pneumonia
What bacterial is associated with Healthcare associated Pneumonia?
Gram negative bacili (oral bacteria)
due to dysphagia
What bacterial is associated with Pneumocystics Pneumonia?
Pneumocystis Jirovecii
What are the dental management for Pneumonia?
- Standard Precautions
- Biofilm and Perio disease control
- Antimicrobial Mouth rinse
What is the Medical Management for pneumonia?
- Viral: Supportive treatment: Rest, fluids
- Bacterial: Antibotics
- Fungal: Sulfa drugs
What is the cause of tuberculosis?
Mycobacterium tuberculosis
Who is mostly at risk for TB?
- HIV infected
- Alcoholics, IV drugs
- People of shared habitation facilities
- Immigrants from countries with high TB rates
- Healthcare workers
- Medically underserved
What are the clinically active signs of TB?
- Fever
- Weight loss
- Fatigue
- Persistent cough
- Chest pain
- Coughing blood
How is TB diagnosis?
Chest X-ray
Sputum Culture
What is the incubation period for TB?
2 to 10 weeks
What are the latent infection signs for TB?
Usually none
What is the diagnosis for TB in a latent stage?
Skin Test (PPD)/Mantoux tuberculin
What is the incubation period for latent TB?
2 to 10 weeks
What are the medical management for TB?
- Early diagnosis
- initiate effective treatment
- Standard meds: ISONIAZID 300mg (4-9months)
- monitor
- PT education and compliance
- Report to public health department
How to manage dentally a clinically active TB ?
- Urgent care only
- Tx in Hospital
- Provide appropriate isolation and PPE
- Ventilation system
- Rubber dam for isolation
- confirm status 2-3wk; negative ok to treat
How to manage dentally a History TB?
- confirm status
- current negative, treat using standard precautions
- Health history
- obtain medication hx to confirm treamtent was complete
- Advice for regular follow ups
How to manage dentally a Positve TB test?
- consider PT infected and in latent phase
- physician documentation of exam and chest xray
- 9 month of INH
- Ok to treat using Standard precautions
How to manage dentally a sings or symps of TB?
Refer for medical examination with physican
What are the oral manifestations of TB?
Ulcers: irregular on dorsum of tongue, palate, lips, gingiva or buccal mucosa
Needs biopsy for diagnosis
What are the types of Asthma?
- Extrinisic
- Atopic
- Allergic
(Environmental, occupational-latex, allergic stimulus-active mast cells,IgE- mediated hypersentivity reaction) - Instrinsic
- Nonallergic
(specific triggers unidentifiable, endogenous factors-stress)
Outside allergic triggers, Triggers in the body
What are the most common cause of Asthma induced?
Drug or food induced: asprinin, NSAIDS, Betta blocker, food substance
Excerise-induced: vigorous activity, thermal inhalation changes
Infection- induced: Virsuses, bacteria, fungi provoked, teatment of infection
What arer the different types of asthma medications?
Anti-inflammatory agents: long term
Systemic corticosteriod: Prednisone
Inhaled Corticosteriod: Vanceril
Leukotriene modifer: Singulair
Mast Cell stabilizer: Intal
Bronchodilators (Acute episode)
Beta-2 agonist: Albuterol, serevent
Methylxanthine: Theophylline
Both can be combined
What are drugs to avoid with Asthmatic Patients?
Asprin (also in othe meds)
Sulfite (in local anesthetics)
NSAIDS
What drugs decrease respiratory functions ?
Narcotics
Barbitunrates
What are harmful drug to druh interations?
Erythromycin and Ciporofloxacin while talking theophylline
What are the medical management for asthma PT?
Limit trigger exposure
Participate in activity
maintain pulmonary function
minimize attacks
Control symptoms
Avoid adverse effects
What are some dental management fro asthamatic Pt?
Appt time- based on attack
Decrease office scents
Bring inhaler
use inhaler before appt
implement stress reduction protocols (N2O or diazepam)
Cautioned use of air polisher and ultrasonic scaler
T/F is Acetaminophen okay to use with Astma PT?
True
What are the oral manifestations with Asthma?
Xerostomia
Increase in caries
Gingivitis
Oral candidiasis (corticosteriod)
What is chronic obstructive pulmonary disease?
Group of lung disease that blocks airflow and make it difficult to breathe
What are the most common cause of COPSD?
Chronic Bronchitis
Emphysema
What is Chronic Bronchitis
excessive cough and mucus production with expectorant
What is Emphysema?
Air spaces are damaged and enlarged/ damaged alveoli
What is the primary etiology fro COPD?
Tobbaco
Occupational and environmental pollutant exposure
What are the exacerbating factors for COPD?
Smoking
Environmental pollutants
viral infections
Allergy
Genetic factors
What are the medical treatment for COPD?
Stop smoking
Decrease pollutant exposure
Vaccinations
Bronchodiators
Excercise
Water/nutrition
What are the clinical presentation for Chronic Bronchitis ?
Cyanotic
Overweight
Elevated hemoglobin
Periphrial edema
Rhonchi and wheezing
What are the clinical presentation for emphysema?
Older and thin
Sever dyspnea
quiet chest
X-ray: hyperinflation
What is the dental management for COPD?
- Assessment
- Vitals monitoring
- Tobacco cessation (stop)
- Dismiss and refer to physician if signs are present
- Stable and Controlled avoid depressing respiration
What is the oral manifestation for COPD?
Poor oral hygiene
Periodontitis
Aspiration pneumonia
What is cystic fibrosis?
Affects pancreas liver and lungs
What are cystic fibrosis Disease characterisitcs?
critical features: mucous secretions
Pulmonary implairment
Opportunistic bacterium: pseudomonas aeruginosa
Respiratory failure: Pneumothorax (callapsed lung)
pulmonary HTN
What are the early stages of Cystic fibrosis?
Persistent cough
No mucus
Recurrent pneumonia
Salty skin or sweat
Excessive appetite but poor weight gain
What are the late-stages of Cystic fibrosis?
- Chronic cough
- Mucus production and vomiting
- cyanosis and digital clubbing
- Pneumothorax
- Pulmonary HTN causing right heart failure
What are the medical management of cystic fibrosis?
- Phhysical activity
- Diet
- ANtibiotics
- NSAIDS
- Mucus-thinning (pulmozyme)
- Inhalation solution (Tobramycin neubulizer)
What is the dental management for cystic fibrosis ?
Semi-supine or upright chair position
What are the oral manifestations for cystic fibrosis?
Halitosis
Gingivitis with xerostomia
Lower lip enlarged, swollen, dry
enlargement of salivary glands (advanced)