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3rd yr- IWB- Pathology > Respiratory disorders > Flashcards

Respiratory disorders Flashcards

1
Q

How can non infectious chronic lung diseases be classified?

A

Obstructive or restrictive

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2
Q

How do we distinguish between different types of chronic lung diseases?

A
  1. FEV1 (Forced expiratory volume in 1 sec)

2. FVC (Forced vital capacity)

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3
Q

What does FEV1 stand for

A

Forced expiratory volume in 1 sec

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4
Q

What does FVC stand for?

A

Forced vital capacity

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5
Q

State the normal FEV1: FVC ratio

A

0.75 - 0.8

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6
Q

What would a FEV1: FVC < 0.7 mean

A

Obstructive

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7
Q

What would a FEV1: FVC > 0.85 mean

A

Restrictive

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8
Q

Give examples of obstructive lung diseases

A
  1. Emphysema
  2. Chronic bronchitis
  3. Asthma
  4. Small airway disease
  5. Bronchiectasis
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9
Q

Which 2 lung diseases fall under chronic obstructive pulmonary diseases

A
  1. Emphysema

2. Chronic bronchitis

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10
Q

What is chronic obstructive pulmonary disease (COPD)

A

A clinical syndrome- chronic bronchitis and emphysema

Characterised by obstructive lung FTs and reduced expiratory flow

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11
Q

How many people in the uK suffer from COPD

A

1.2 million

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12
Q

Name the most common lung disease in the uK

A

Asthma (followed by COPD)

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13
Q

What would the FEV1:FVC ratio of a person with COPD be

A

<0.7

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14
Q

Why are Emphysema and Chronic bronchitis grouped together?

A

Both diseases are characterised by airflow restriction and therefor most patients have a mixture of both
They share similar aetiology (smoking)

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15
Q

Define chronic bronchitis

A
  1. Persistent cough with sputum production
  2. Cough present for at least 3 month over at least 2 Years
  3. Absence of any other identifiable cause
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16
Q

What is the pathogenesis of chronic bronchitis

A
  1. Chronic airway irritation leading to epithelial/ cililary dysfunction
  2. Mucous hyper secretion/ mucous gland hypertrophy
  3. Chronic inflammation leading to fibrosis and small airway obstruction
  4. Airway obstruction and mucous hyper secretion leading to alveolar hypoxia
  5. Alveolar hypoxia leading to V:Q mismatch and pulmonary vasoconstriction
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17
Q

What are the overall affects of chronic bronchitis

A
  1. Hypoxaemia
  2. Hypercapnia
  3. Pulmonary hypertension
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18
Q

Define emphysema

A

Irreversible abnormal enlargement of airspaces distal to the terminal bronchioles
This leads to alveolar wall and capillary destruction

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19
Q

How does emphysema lead to airway obstruction?

A

Abnormal enlargement occurs that leads to loss of recoil and bronchiole collapse
This leads to airway obstruction

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20
Q

Describe the pathogenesis of emphysema

A
  1. Inflammatory stimulus such as cytokines and proteases
  2. Alveolar connective tissue is broken down
  3. This affecters the central acinus bronchioles and spare distal alveoli
  4. This affects the entire acinus bronchioles and alveoli
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21
Q

What is another term for chronic bronchitis

A

Blue bloaters

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22
Q

Describe patients with blue bloaters

A

They have a large, oedematous cyanotic with mild dyspnoea

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23
Q

Give some symptoms of chronic bronchitis

A
  1. Cough/ wheeze (due to mucous hypersecretion and airway obstruction)
  2. Cyanotic blue colour (drew to impaired alveolar oxygenation)
  3. Often obese
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24
Q

Why do some patients with chronic bronchitis turn cyanotic

A

They have an impaired oxygenation leading ro decreased levels of oxygen and increased CO2 in the alveolus
This leads to hypoxaemia, hypercapnia and polycythaemia giving patients a blue hue

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25
Q

What is polycythaemia?

A

Increased production of red blood cells in response to hypoxia

26
Q

What can some patients with COPD become resistant or tolerant to?

A

CO2

27
Q

Which side of red heart can fail in a patient with chronic bronchitis? Why?

A

Right heart failure can occur die to pulmonary vascular vasoconstriction leading to pulmonary hypertension

28
Q

Why can oedemas form in patients with chronic bronchitis

A

Due to fluid retention

29
Q

What is another term for emphysema

A

Pink puffers

30
Q

Describe patients with Pink puffers

A

Thin, cachectic with severe dysnopea

31
Q

Why are patients with emphysema sometimes described as pink puffers?

A

As they have pursed lip breathing

32
Q

What causes patients with emphysema to have pursed lips

A

Loss of parenchyma/ loss of elastic recoil
This causes alveolar aid to trap and small airways to collapse
Leading to pursed lips

33
Q

Do patients with emphysema have increased or decreased expiratory volume?

A

Increased

34
Q

Give some symptoms of emphysema

A
  1. Pursed lips
  2. Barrel chested
  3. Dyspnoea/ cachexia
35
Q

Give some of the clinical features of COPD

A
  1. Productive cough
  2. Breathlessness
  3. Respiratory failure
  4. Cor pulmonate
36
Q

How do we manage COPD

A
  1. Beta- agonists
  2. Muscarinic antagonist
  3. Inhaled steroids
  4. Oxygen
  5. Smoking cessation
37
Q

When giving a patient with COPD oxygen what do you need to be careful of?

A

Hypoxic drive

38
Q

What do Emphysema and Chronic bronchitis have in common

A

They are both examples of chronic obstructive pulmonary diseases (COPD)

39
Q

If someone is describes as a pink puffer what might they have?

A

Emphysema

40
Q

If you have a patient with COPD what should you monitor and take into consideration being a dentist?

A
  1. Monitor oxygen
  2. Keep them upright
  3. Avoid rubber dam and sedation
41
Q

State the target saturation in COPD patients

A

88-92%

42
Q

What is asthma

A

Reversible small airway obstruction characterised by bronchospasm, airway inflammation and oedema

43
Q

Is asthma a chronic or acute disorder?

A

Chronic disorder of conducting airways

44
Q

What are the episodic bronchoconstrictions in asthma due to?

A
  1. increased airway sensitivity to stimuli
  2. Inflammation of the bronchial walls
  3. Increased mucus secretion
45
Q

Name the 2 different types of asthma

A
  1. Atopic

2. Non topic

46
Q

What is atopic asthma

A

Allergen sensitisation

47
Q

Give some triggers for asthma

A
  1. Allergens
  2. Chemical irritants
  3. Strong smells
  4. Temperature change
  5. Exertion
  6. Stress
  7. Drugs
48
Q

What causes asthma

A

It is a type 1 hypersensitivity disorder mediated by IgE

  1. When you initially exposed to your trigger IgE is produced
  2. On second re exposure IgE cross linking occurs
  3. This leads to most cell degeneration
  4. Bronchospasm and vascular permeability
  5. This all causes oedema
49
Q

List soem symptoms of asthma

A
  1. Cough
  2. Wheezing
  3. Difficulty creating
  4. Often need to use accessory muscles in upper body
  5. Tight chest feeling
50
Q

How should you manage an acute asthma attack

A
  1. Help the casualty take their reliever (blue inhaler)
  2. Sit the casualty upright and get them breathing normally
  3. Continue to give 2 puffs of reliever inhaler ever 2 minutes if symptoms don’t improve
  4. If symptoms don’t resolve after 10 puffs of inhaler call 999
  5. If casualty feels better after taking their inhaler they can go back to their previous activity
51
Q

What is the relationship between asthma and dentistry

A

Possible increased caries risk in asthmatic patients

52
Q

What considerations should you take as a dentist if your patient is asthmatic

A
  1. Keep their reliever inhaler on hand during the appointment
  2. Keep appointment times later in the day
  3. Avoid aspirins and NSAIDs§
53
Q

What is tuberculosis

A

An infectious disease characterised by caseating granulomatous inflammation

54
Q

How many death annually are caused by tb

A

1.4 million deaths

55
Q

caseating granulomatous

A

A lesion that has a lot of macrophages leading to the formation of a granuloma

56
Q

Why can it be hard to diagnose tb?

A

95% of patients are asymptomatic

57
Q

Name the 2 different types of tb?

A

Primary(non immune host) and secondary (immune host)

58
Q

Give some symptoms of tb

A
  1. Cough
  2. Malaise
  3. Weight loss
  4. Fever
  5. Haemoptysis
  6. Night sweats
  7. Pain on breathing
  8. Back pain
  9. heart failure
  10. Neurological symptoms
59
Q

How do you diagnose tb

A
  1. Mantoux test
  2. Look at histology for caseating granulomata
  3. Look at microbiology
  4. Interferon gamma release assay
60
Q

How is tb treated

A

Treated with a cocktail of antimicrobial therapy for 6 months

61
Q

What is the Mantoux test

A

Tuberculin skin prick test

3rd yr- IWB- Pathology (11 decks)

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