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2 - Diseases Of The Human System > Respiratory Medicine - 2 > Flashcards

Respiratory Medicine - 2 Flashcards

1
Q

What are the two diseases that cause COPD?

A

Bronchiectasis & emphysema component - non-reversible

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2
Q

What causes bronchiectasis and what happens to the lungs?

A

recurrent infections
causing consistent damage to the bronchial walls
increased mucus
thickened walls due to scarring

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3
Q

What is the main symptom of bronchiectasis?

A

productive cough with green sputum

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4
Q

What causes emphysema and what happens to the lungs?

A

smoking and exposure to toxic chemicals
* Destruction of alveoli - less alveoli
* dilatation of some sacs to ‘fill space’
less surface area, increased cardiac load

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5
Q

What are the causes of COPD?

A

smoking
air pollutants
genes (AAT deficiency)
age
asthma
chemical exposure

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6
Q

What are the symptoms of COPD?

A

chronic cough
production of mucus
fatigue
shortness of breath
chest tightness

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7
Q

What is the biggest preventative cause of COPD?

A

smoking

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8
Q

What medications can be used to treat COPD?

A

long acting beta agonists = for reversible patients

steriods

oxygen support

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9
Q

What can excerbate COPD?

A

environmental factors
noncompliance with medications
bacterial pathogens
viral infections
atypical bacteria

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10
Q

What can COPD lead to without management?

A

progress to respiratory failure - type 1/2

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11
Q

Type 1 VS Type 2 respiratory failure?

A

Type 1 - hypoxemia
Impaired gas exchange
Normal CO2
Caused by V/Q mismatch, alveoli descruction/ thickening
Treat with oxygen

Type 2 - hypercapnia
Hypoventilation
Normal O2
Caused by muscle disorders, increased airway resistance
Treat with ventilatory support (bronchodilators)

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12
Q

Symptoms of Type 1 VS Type 2

A

Type 1 (blue bloaters)
- cyanosis
- confusion

Type 2 (pink puffers)
- pink skin
- barrel chest
- pursed lips

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13
Q

When should oxygen be used and what should be done during?

A
  • In the acute stage use Oxygen until medical help arises
    Watch - under medical supervision
    respiratory rate
    SaO2
  • In the CHRONIC stage, use oxygen with care – fixed percentage delivery
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14
Q

What is a risk of home oxygen therapy?

A

oxygen can suppress the respiratory drive, leading to lower ventilatory effort and inability to exhale CO2 efficiently

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15
Q

What is the risk of inhaled steriods dentally and what can be used to prevent this?

A

Use of inhaled steroids - candida risk
* rinse mouth after device use
* use spacer device for MDI ‘puffers’

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16
Q

What increased risk do smokers have?

A

oral cancer

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17
Q

In dental surgery, what may a patient that requires home oxygen need?

A

supplemental oxygen during treatment

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18
Q

What type of disease is cystic fibrosis?

A

genetic disease

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19
Q

What is the systemic failure in cystic fibrosis?

A

inherited defect in cell chloride channels
produces excess mucous in all body systems

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20
Q

Which organs are mostly affected by cystic fibrosis?

A

lung and pancreas

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21
Q

What gene does the cystic fibrosis mutation occur in?

A

CFTR gene (cystic fibrosis transmembrane conductance regulator)
chromosome 7

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22
Q

What type of gene is the CFTR mutation?

A

recessive
both parents need to have the gene

23
Q

What mutation is the commnest defect?

A

F508del

24
Q

How is cystic fibrosis diagnosed?

A
  • Prenatal screening - sibling has it
  • Perinatal testing - ALL children now screened at day 5 – blood spot test
  • ‘Sweat test - greater salt in CF patients
  • CTFR Gene testing
25
Q

Why is diabetes a symptom of CF?

A

build up causes inflammation and damage to B cells in pancreas

26
Q

What are the main symptoms of CF in children?

A
  • Troublesome cough
  • Repeated Chest infections
  • Pseudomonas, Staphylococci
  • Prolonged Diarrhoea
  • Poor weight gain
27
Q

What are the consequences of CF?

A
  • Liver dysfunction in some
  • Prone to osteoporosis
  • Diabetes symptoms
  • Prolonged pancreas disease
  • Reduced fertility (mainly male)
28
Q

How is physiotherapy used to treat CF?

A
  • Used to help remove the mucous secretions from the lungs
  • Performed at home by parents
29
Q

What medications are used to treat CF in lungs?

A
  • Bronchodilators to open the airways
  • Antibiotics to reduce Chest infection frequency
  • Steroids to reduce airway inflammation
30
Q

What can resistance to antibiotics cause?

A

pneumonia leading to respiratory failure (1)

31
Q

What medications are used to treat CF in the digestive system?

A
  • Pancreatic Enzyme replacement
  • Nutritional Supplements
32
Q

What full body system medications can also be used to treat CF?

A
  • CFTR Modulators
  • Stem Cell treatments
33
Q

What are example of CFTR moedulators and what mutation are they used for?

for F508del patients

A
  • ivacaftor, tezacaftor and elexacaftor
  • triple-combination therapy
34
Q

What can taking CFTR modulators from an early age do?

A

allows patient to produce a more normal secretion for a larger part of their life avoiding much damage

35
Q

How is stem cell therapy used to treat CR and what is the different between adult and immature stem cells?

A
  • Replace the bad gene with a new copy
  • If given to stable cells (‘adult’ cells) the therapy needs repeated every time the cells are replaced
  • If given to Stem Cells then ‘adult’ cells will all be made with the correct gene = cure
36
Q

Why is exercise important for CF?

A
  • Necessary to keep lung function optimal
  • Necessary to build physical bulk & strength
37
Q

What is tranplantation used for in CF?

A
  • Not a cure!
  • End stage lung disease
  • Also affects heart (cor pulmonale)
  • Heart-lung transplant
  • Not much survival after due to immunosuppressive drugs
38
Q

What is the location of a visible mass in the lungs usually?

A

periphery

39
Q

What happens if the mass is more central and blocks the bronchus?

A

allows secretions to build up leading to infection such as pneumonia causing occlusion of the lung

40
Q

What is the biggest cause of lung cancer?

A

smoking

41
Q

What are causes of lung cancer? (not smoking)

A

radon
workplace chemicals (asbestos, arsenic, nickel)
air pollution
genetics
radiation therapy
other lung diseases (COPD, fiborosis)

42
Q

What are the two groups of lung tumours?

A

small cell (25%)
non-small cell (75%)

43
Q

What are the 3 types of non-small cell lung tumors?

A
  • Squamous Cell carcinoma - most common, central location
  • Large cell
  • Adenocarcinoma
44
Q

What are the signs and symptoms of lung tumours?

A
  • Cough
  • Haemoptysis (blood stained sputum)
  • Pneumonia
  • Obstruction of structures near lungs
45
Q

What are biomarkers and what do they allow?

A

genetic mutations the tumour has
they allow physicians to classify patients by their probable diseases, prognosis and their response to treatment

46
Q

In locally advanced NSCLC, what are the treatment steps?

A

chemoradiation
watch and wait

47
Q

What is the role of the dentist in cancer?

A

ask about smoking
advise on quitting
act on patient’s response (refer, build confidence)

48
Q

What is sleep apnoea?

A
  • Airway obstruction whilst asleep (blocked preventing patient from breathing normally)
  • 10 secs or more duration
  • Airway muscle tone drops (causes tongue to fall back and occlude the airway)
49
Q

What can sleep apnoea cause?

A

Daytime sleepiness/drowsiness (dangerous while driving)
Higher risk of heart disease/stroke due to low oxygen

50
Q

What are the two types of sleep apnoea?

A

obstructive sleep apnoea (most common)
central sleep apnoea

51
Q

How is the severity of sleep apnoea measured?

A

via apnoea/hypopnoea index (AHI)

52
Q

What score and less indicates few problems in AHI?

A

<10

53
Q

What are the two treatments for OSA and how do they work?

A

Mandibular Advancement Devices
Oral appliance that pulls jaw forward to open airway

Continuous Positive Airway Pressure (CPAP)
Machine providing constant air pressure to splint airway open

54
Q

What is positional therapy used for in sleep apnoea?

A

prevent patient sleeping on their back

2 - Diseases Of The Human System (19 decks)

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