Respiratory diseases

Question 1

Dyspnoea

Answer 1

difficult or laboured breathing DIB or SIB

Question 2

Orthopnoea

Answer 2

difficulty breathing when laid flat

Question 3

Apnoea

Answer 3

cessation / lack of breathing

Question 4

Tachypnoea

Answer 4

RAPID respiration

Question 5

Hypoxemia

Answer 5

Low O2 in the blood

Question 6

Hypoxia

Answer 6

LOW O2 in the tissue

Question 7

cyanosis

Answer 7

bluish discolouration LOW O2

Question 8

Hypercapnia

Answer 8

High CO2 in the tissue

Question 9

What does COPD stand for

Answer 9

Chronic obstructive pulmonary diseases

Question 10

What is COPD

Answer 10

progressive, irreversible lung damage that reduces air flow and ability to breath.

UMBRELLA term - for two main respiratory chronic disease

-chronic bronchitis
-emphysema

Question 11

What causes COPD

Answer 11

by chronic smoking but sometimes industrial activity (eg: work in a hazardous environment without proper PPE or heavy pollution

Question 12

Name symptoms of COPD

Answer 12

Constantly low oxygen saturations (SpO2 less than 95%)

Constant dyspnoea and/or wheezing.

Persistent mucus build-up in the lungs and a continuous productive cough

More frequent chest infections due to tissue damage.

Question 13

COPD Pathophysiology

Answer 13

Alveoli lose elasticity and shape - making it harder to EXHALE

Air trapped in the lungs

Bronchial tubes become inflamed and narrowed

Thick mucus builds causing a chronic cough

Question 14

Explain what happens in the bronchioles for COPD

Answer 14

Bronchitis is inflammation of the airway. Specifically, of the lining of the bronchial tree

Question 15

Define Chronic Bronichitis

Answer 15

Chronic bronchitis → thickening and scarring of the bronchial lining → airway becomes narrower and stiffer.

Also → Hypertrophy and hyperplasia of mucus-producing structures (seromucous glands and goblet cells)
This fills the airways with mucus.

Question 16

What defines the term chronic bronchitis

Answer 16

diagnosis confirmed if the patient has a daily cough that produces purulent sputum for 3 months or more in at least 2 consecutive years.

Question 17

Emphysema

Answer 17

damage to the alveoli wall.

Disintegration of the alveolar walls → alveolar sacks contain fewer individual alveoli → abnormally low surface area available for gas exchange.
Loss of elasticity of the alveoli walls → reduces their ability to “elastically recoil” during exhalation → exhalation more difficult.
Emphysema therefore makes breathing more difficult, and reduces how much O2 is obtained and how much CO2 is released from each breath.

Question 18

COPD Pathophysiology

Answer 18

airways that are narrower, constantly inflamed, in-elastic and full of mucus.
Alveolar sacs that are distended, with fewer individual alveoli: greatly reduced surface area for gas exchange.
…result in the symptoms of COPD, as well as poor ventilation (low values in FEV1 and PEFR tests) and therefore hypoxia, resulting in low SpO2.

Question 19

Treatment / management for COPD

Answer 19

keep SpO2 in known COPD patients between 88% and 92% to avoid hypercapnia

to support and open airways Salbutamol may be used

Question 20

Bronchiectasis

Answer 20

An uncommon disease, usually secondary to an infection.

abnormal, permanent dilation of one or more proximal and medium bronchi

Question 21

what does bronchiectasis cause within the bronchi

Answer 21

weakening of bronchial walls via destruction of their muscular and elastic components.

Bronchial wall inflammation, ulceration and/or scarring.
Oedema

this makes the lungs more likely to get infected

Question 22

Asthma

Answer 22

Chronic inflammatory condition.

bronchial spasm, inflammation and increased mucus production → wheezing & difficult breathing (lower FEV1 and PEFR).

acute periods called asthma attacks.

Question 23

Explain what happens to the bronchioles during an asthma attack

Answer 23

the bronchioles are lined with smooth muscle.

This spasms and constricts as well as increasing mucus this results in wheezing difficulty breathing or no ability to breath.

inflammation intensifies, obstructing the airway significantly/almost totally
acute bronchoconstriction
airway oedema
mucous plug formation
airway remodelling – increasing stiffness

These obstructions increase resistance to airflow → decrease ability to expel air → hyperinflation of the lungs → breathing difficulty → less O2.

Question 24

how can asthma be managed

Answer 24

nebulizers (inhalers) containing a bronchodilator (eg: adrenaline receptor agonists, salbutamol)

Question 25

Cystic Fibrosis CF

Answer 25

A genetic condition in which the body excessively produces large amounts of mucus, particularly in the respiratory tract and intestines.

Question 26

Symptoms of or following CF Cystic Fibrosis

Answer 26

recurring chest infection.

wheezing/ SOB/ coughing/ damage to airway e.g bronchiectasis

difficulty putting on weight/growing

Jaundice skin and eyes

diarrhoea/constipation/bowel obstruction

patients with CF can also develop related conditions e.g liver problems/infertility/diabetes/thin/weaking of bones

Question 27

Pneumonia

Answer 27

caused by infection of the lungs.

The alveoli fill with fluid

Question 28

pneumonia main symptom

Answer 28

VERY productive cough

Question 29

Risk factors of Pneumonia

Answer 29

Streptococcus
secondary infection
after influenza or parainfluenza

Hospitalised “ill” patients

Cigarette smoking

Excess Alcohol

Bronchiectasis

Bronchial obstruction eg: carcinoma ‘cancer’

Immunosuppression

IV Drug users

Inhalation from oesophageal obstruction

Question 30

All signs and symptoms of pneumonia

Answer 30

Hyper/hypothermia

rapid breathing

USE of accessory muscles

Tachycardia

central cyanosis

altered mental state

ODD breath sounds crackling/rhonchi/wheeze

decrease intensity breath sounds

dull percussion

lymphadenopathy

pleural friction rub (may be able to hear this)

Question 31

Viral Pneumonia

Answer 31

Viruses infect the respiratory tract causing inflammation and damage to the endothelial lining (making bacterial infection more likely)

This is called SARS
severe acute respiratory syndrome

example - disease caused by SARS - COVID 19

Question 32

what is SARS

Answer 32

Severe Acute Respiratory Syndrome

Question 33

name another VIRAL lung infection

Answer 33

common cold - cause by caused by Rhinovirus infection.
Influenza or “flu” caused by Influenza virus infection

Question 34

Common cold symptoms

Answer 34

nasal discharge and congestion, sneezing and pharyngeal irritation) are caused by local inflammatory response to viral infection in the respiratory tract.

Question 35

Influenza symptoms

Answer 35

nasal discharge and congestion, sneezing and pharyngeal irritation) are caused by local inflammatory response to viral infection in the respiratory tract.

acts by infecting the respiratory tract, but can lead to systemic infection and symptoms

Question 36

What is TB

Answer 36

caused by infection of Mycobacterium Tuberculosis, an Intracellular bacteria that can infect the lungs or spread to other tissues, or stay hidden and dormant for decades.

Question 37

What are the signs and symptoms of TB

Answer 37

Cough
Weight loss/anorexia
Fever
Night sweats
Hemoptysis
Chest pain (can also result from tuberculousacute pericarditis)
Fatigue

Question 38

What is Pleuritic chest pain ?

Answer 38

Pain associated with the pleurae. e.g. the sack that supports and protects the lungs.

The presence of pain receptors in the parietal pleurae means this inflammation generates pleuritic chest pain: a sharpchest paincaused by forceful or deep breathing, coughing and sneezing.

Question 39

How do patients react when showing symptoms of Pleuritic chest pain ?

Answer 39

perceived dyspnoea due to consciously or subconsciously suppressing breathing to avoid pain.

sharp chest pain - by forceful/deep breathing/coughing or sneezing

Question 40

Pneumothorax

Answer 40

abnormal build up of AIR within the pleural space. the pressure build creates difficulty breathing.

Question 41

what section of the body does pneumothorax affect

Answer 41

Pleura - membranous sac surround the lungs. with small space in-between for pleural fluid

consists of two layers
- visceral pleura
-parietal pleura

Question 42

What causes a pneumothorax

Answer 42

mainly trauma - blunt/ penetrating

underlying lung disease ‘COPD/CF/cancer/infection.

OR without cause:
SPONTANOUEOUS pneumothorax

Question 43

Describe what tension pneumothorax is

Answer 43

Damage to the pleural tissue acting as a one way valve.

pressure builds within the pleural sac through inhalation but CANNOT escape on expiration.

Exceeding atmospheric pressure causes the affected lung to collapses resulting in respiratory failure/obstructive shock .

Question 44

how is a tension pneumothorax treated

Answer 44

‘popping the chest ‘needle thoracocentesis

supporting the patients airway through ALS management

Question 45

symptoms of tension pneumothorax

Answer 45

tachypnoea/ uneven breath sounds/chest pain/shock symptoms

Question 46

pulmonary hypertension

Answer 46

Manifests as oedema in the lungs and pleura effusion

High BP in the pulmonary vessels, caused as a side effect of various other pathologies including Chronic lung disease or Pulmonary Embolism.

pulmonary venous hypertension is often due to Left-sided heart failure, a disease with the bicuspid/mitral valve or ventricular hypertrophy.

Question 47

IF Chronic Pulmonary hypertension : what do patients develop

Answer 47

develop thickening of the alveoli walls (fibrosis) which hinders gas exchange and therefore breathing.

Question 48

Define respiratory failure.

Answer 48

insufficient O2 from the air passing through the respiratory membrane in the lungs into the blood

Question 49

What are the TWO types of respiratory failure

Answer 49

Type 1 RF: resp. system does not provide adequate O2 to the body > hypoxemia.
Type 2 RF: resp. system doesn’t remove CO2 from the body sufficiently > hypercapnia.

Question 50

What is the purpose of the Medulla

Answer 50

Assists in supporting the respiratory system sending signals (neurons from the brain) for the system to function on a subconscious level and support humans in living