respiratory diseases

Question 1

obstructive lung diseases ?

Answer 1

asthma - 10% of total population

COPD - 1% of total population

Question 2

restrictive lung disease

Answer 2

cystic fibrosis -

8500 people in uk

Question 3

what is asthma (4 characteristics)

Answer 3

chronic inflammatory disored
airway hyper-responsiveness
widespread, variable and reversible airflow limitation
paroxysmal or persistent symptoms (wheeze, cough,chest tightness, mucus hyper-secretion

Question 4

what are the two main developments of asthma ?

Answer 4

environmental allergens, toxic substances

genetic predisposition

Question 5

triggers of asthma

Answer 5

allergens
air irritants
aspirin 
lung infections 
exercise

Question 6

measurement of exercise induced asthma

Answer 6

drop in FEV1 more than 10 %

Question 7

What are the main treatments for asthma ?

Answer 7

relievers - immediate effect - relaxation of airway muscles
preventers - long term effect , reduce inflammation and swelling of airways , inhaled corticosteroids

no cure - remission/excaberation

Question 8

what is COPD?

Answer 8

Common preventable and treatable disease,
characterized by airflow limitation that is usually
progressive and associated with an enhanced
chronic inflammatory response in the airways and
the lung to noxious particles or gases (e.g., cigarette
smoke)

Question 9

what two respiratory conditions come under COPD?

Answer 9

Chronic bronchitis
>inflammation of the bronchi
 phlegm
 persistent cough
• Emphysema
 abnormal and permanent enlargement of the airspaces distal
to the terminal bronchioles
 with destruction of the airspace walls
 without obvious fibrosis
 airways collapse
 shortness of breath

Question 10

risk factors for COPD?

Answer 10

cigarette smoke
occupational dust and chemicals
environmental tobacco smoke
indoor and outdoor air pollution

Question 11

treatment for COPD ?

Answer 11

No cure
• But relief of symptoms through:
>long-acting bronchodilators
>steroids
>mucolytics
>oxygen therapy
• Pulmonary rehabilitation
> including exercise

Question 12

what are the main factors of restrictive lung disease ? (2)

Answer 12

Loss of airway compliance
 lung stiffness
 incomplete lung expansion
Restrictive Lung Disease
• Fibrosis
 formation or development of excess fibrous
connective tissue

Question 13

what is cystic fibrosis ?

Answer 13

Gene mutation

Question 14

what are the symptoms of cystic fibrosis ?

Answer 14

thick and sticky mucus  cough
 frequent lung infections
 digestive problems  prolonged diarrhoea and poor weight
gain

Question 15

what is the treatment for cystic fibrosis >?

Answer 15

No cure
• Medicine
>bronchodilators
>antibiotics
>steroids
>mucolytics
• Chest physiotherapy
• Diet
• Exercise

Question 16

How is cystic fibrosis diagnosed ?

Answer 16

Sweat test
• Genetic test
> carrier testing: mouthwash
> antenatal testing
> new-born: heel-prick

Question 17

FVC

Answer 17

Forced vital capacity

Question 18

FEV1

Answer 18

Forced expiratory

volume in one sec

Question 19

FEV1/FVC

Answer 19

> Tiffeneau ratio

> ~0.80 (or 80%)

Question 20

PEF

Answer 20

peak expiratory flow

Question 21

Lower limit of normal (LLN)

Answer 21

values below 5th percentile of the frequency distribution of
values measured in the reference population are considered
to be below the expected “normal range”

Question 22

what is the bronchodilator test ?

Answer 22

Differential diagnosis between asthma and COPD
• Inhaled b2-agonist
>response of the bronchial smooth muscle to a bronchodilator

Reversibility of the obstruction in asthma only

Question 23

method of bronchodilator test ?

Answer 23

baseline spirometry (FEV1)
>inhalation of a b2-agonist (e.g., 400 mg salbutamol)
>15 min later: spirometry (FEV1)
>if ­ FEV1 ³ 12% and ³ 200 ml: positive test

Question 24

what are the responses of the bronchial smooth muscle ?

Answer 24

compare baseline FEV1 to post - exsposure FEV1

significant fall in FEV1 = sign of AH

Question 25

what is AHR ?

Answer 25

hyper-reactivity of the airway smooth muscle

Question 26

what are the key determinants of the airway response to exercise challenge ?

Answer 26

Endurance-based exercise – to increase ventilatory demand • Constant-load exercise for 6-8 min • High-intensity exercise 
 Dry air (± cold) – to induced dehydration of the airways • No warm-up – to avoid refractory period • Spirometry tests • at rest • at several time points post-exercise (up to 20 min recovery) • fall in FEV1 ≥10% from baseline consistent with EIA/EIB