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YR 3 - Illness and Wellbeing > Respiratory Disorders > Flashcards

Respiratory Disorders Flashcards

1
Q

what 2 ways are non-infectious chronic lung diseases classified as?

A

obstructive or restrictive

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2
Q

what are the FEV1 and FCV measurements?

A

FEV1 = forced expiratory volume in 1 second

FVC = forced vital capacity

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3
Q

Basing on FEV1 and FVC, how do you know if a non-infectious chronic lung disease is obstructive or restrictive?

A

FEV1:FVC ratio - normal = 0.75-0.8

if less than 0.7 = obstructive
if it is high = restrictive

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4
Q

give 3 obstructive lung diseases.

A

asthma
chronic bronchitis
emphysema

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5
Q

define asthma and the two types

A

obstructive lung disease which is IgE-mediated

type 1 - reversible hypersensitivity

type 2 - allergic inflammation

Atopic - caused by allergen and sensitisation
Non-atopic - no evidence of antigen sensitivity

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6
Q

what can trigger asthma?

A

allergens
chemical irritant
strong smells
temp change
exertion
stress

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7
Q

describe the aetiology and pathogenesis of athsma

A

aetiology
- immunological reaction

pathogenesis
- person exposed to stimulus antigen
- elicit T cell response
- IgE antibodies produced, stay on mast cells
- re-exposure
- antibodies bind to antigen
- mast cells degranulate
- release inflammatory mediators
= bronchospasm
= vascular permeability
= oedema
= narrow airway

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8
Q

describe the clinical features of asthma

A

bronchospasm

airway inflammation

oedema

episodic bronchoconstriction
- due to increased airway sensititivty
- inflammation of bronchiole walls
- increased mucus secretion

cought, wheeze, dyspnoea, tight chest

use accessory muscles in chest

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9
Q

how is asthma managed?

A

short-acting relievers
- inhaled b2 antagonists
- salbutamol, terbutaline

long-acting reliervers
- inhaled b2 antagonists
- salmeterol, formoterol
- inhaled corticosteroids
- beclometasone, budesonide, fluticasone

bronchodilators
- inhaled antimuscuranic agents - ipratropium
- oral corticosteroids - prednisolone 40mg daily

steroid sparing agents

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10
Q

define chronic obstructive pulmonary disease

A

a group of diseases causing airflow blocking and damage is irreversible

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11
Q

what 2 obstructive lung diseases come under COPD?

A

chronic bronchitis
emphysema

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12
Q

describe chronic bronchitis and the pathogenesis

A

a persistent cough with sputum production
- for 3 months or 2 consecutive years
- no other identifiable causes

pathogenesis:
- chronic airway irritation - 90% smoking
- epithelium lining airway damaged
- dysfunctions cilia

  • mucous hyper secretion
  • mucus gland hypertrophy
  • goblet cells metaplasia
    === lots of mucus secreted into airways
    = obstruction
  • chronic inflammation
    = fibrosis
    = obstruction
  • decreases alveolar ventilation
  • decreased gas exchange
  • alveolar hypoxia

= ventilation mismatch
= pulmonary vasoconstriction

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13
Q

overall result of chronic bronchitis? (3)

A

hypoxaemia - low oxygen in the blood/low partial pressure in blood

hypercapnia - excess carbon dioxide in the blood - not expelling it

pulmonary hypertension - due to pulmonary vasoconstriction

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14
Q

describe emphysema and its pathogenesis.

A

irreversible abnormal enlargement of airspace distal to terminal bronchioles, with damage to alveolar wall and capillary beds

pathogenesis:
- airway irritation - smoking
- inflammatory response - cytokines, proteases
- alveolar connective tissue breaks down
- capillary bed gets damaged
- loss of recoil
- bronchioles collapse
- airways obstruct
- affects different parts of acini - small air sacs on alveoli

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15
Q

what are the two types of emphysema? describe the difference.

A

centriacinar emphysema
- if the emphysema occurs further up the bronchiole, next to respiratory bronchiole

panacinar emphysema
- if the emphysema occurs terminal to alveolus

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16
Q

describe the aetiology of COPD

A

aetiology
- smoking
- obstructive lung disease
- reduced expiratory flow

17
Q

describe the 9 clinical features of chronic bronchitis

A

described as blue bloaters:
- larger people
- mild dyspnoea
- cough/wheeze due to mucous hypersecretion

cyanotic - from less o2 and more co2

hypoxic drive
- because theres so much co2
- become co2 tolerant
- rely on low o2 for respiration
- if you give patient o2, body cannot respire it and become stimulated
- can fall into type 2 respiratory failure

polycythaemia - due to low o2, tries to compensate by producing lots of RBC = blood more viscous

right heart failure - from pulmonary hypertension from pulmonary vasoconstriction and polycythaemia

oadematous - fluid retention = bloating

18
Q

describe the 5 clinical features of emphysema

A

described as pink puffers
-thinner people

pursed lips
- alveolar air trapped in the acini
- loss of elastic recoil
- pursed lips to try create pressure in the lungs

severe dyspnoea and cachetic
- cachetic = weak and wasting away
- hyperventilation to maintain oxygenation

barrel chested
- use accessory muscles in the chest to help with respiration
- large end expiratory volume

19
Q

how may you manage patients with COPD?

A
  • beta-antagonists
  • muscarinic antagonists - block ach from proliferating fibroblasts
  • steroids
  • oxygen - be careful with hypoxic drive
  • smoking cessation
20
Q

define tuberculosis

A

an infectious disease caused by mycobacterium tuberculosis

21
Q

describe the two types of tuberculosis

A

primary tuberculosis
- unexposed
- non-immune host
- 95% asymptomatic

secondary tuberculosis
- from prev exposure
- immune host
- latent state
- reactivates

22
Q

what is it called when TB spreads to the rest of the body?

A

miliary tb
- spreads from lungs to liver, spleen etc

23
Q

describe the clinical features of tuberculosis

A

cough
malaise
weight loss
fever
haemoptysis
night sweat
pain on breathing
lymphadenopathy
back pain
heart failure
neurological symptoms

24
Q

how is TB diagnosed and treated?

A

Mantoux test - skin prick test
histology
microbiology

treated with antimicrobial therapy

25
Q

what are the relevant clinical guidelines of dental treatment in patients with COPD?

A
  • keep upright
  • avoid rubber dam
  • avoid sedation
  • monitor oxygen - saturation should be 88-92%
  • if in respiratory distress, give high flow oxygen and adjust
26
Q

what are the clinical guidelines for patients with asthma?

A
  • always ensure patient has inhaler, ideally with spacer
  • dont hesitate to ring 999
  • sit upright, slow steady breaths
  • appointment times later in the day for those worse in the morning
  • avoid aspirin
27
Q

does asthma increase risk for caries?

A

yes, by double

28
Q

what are the dental considerations with TB?

A

vaccination against TB
infection control

YR 3 - Illness and Wellbeing (31 decks)

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