Respiratory Pathologies Flashcards
Define Rhinitis
Rhinitis is an inflammation of the nasal mucosa
What happens in Rhinitis
Inflammation leads to swelling and an increase in volume and viscosity of nasal secretions (mucous)
What are the 3 causes of Rhinitis
Immune compromise - leading to viral/bacterial/fungal infections i.e due to emotional stress medications diet etc
Allergic Rhinitis - true allergic response to the likes of pollen. We create antibodies in response to an allergic reaction, these antibodies are called IgE (Immunoglobin) which stimulates mast cells to secrete Histamine
Non Allergic Rhinitis - associated with environment, lifestyle diet drugs such as NSAID’s, stress
What are the main signs and symptoms of Rhinitis
Itchy runny nose, stuffy nose, loss of smell and sneezing
What are the complications of Rhinitis
Nasal Polyps, ear infections and loss of smell
What is the Allopathic treatment for Rhinitis
Steroid nasal sprays, decongestants and Anti histamines
Define the common cold
Infection of the upper respiratory tract
Who tends to become infected with the common cold
Those with low immunity
What are the signs and symptoms of the common cold
signs - gradual onset lasting between 2-7 days
Symptoms - Rhinorrhoea - runny nose, sneezing, sore throat and mild fever
What is the Allopathic treatment for a common cold
Painkillers decongestants
What is the differences between the common cold and influenza in the following:
Onset
Symptom distribution
Duration
Cause
Headache
Runny nose
Complications
- Cold = gradual Flu - Rapid
- Cold = localised upper Respiratory Tract Flu - Systemic body/joint aches
- Cold = 2 -7 days Flu - 7-14
- Cold = Rhinovirus Flu - influenza virus
- Cold = Rare Flu - Common
- Cold = Common Flu - Sometimes
- Cold = Less Likely Flu - more serious
Define Influenza
Influenza is an acute respiratory disease, associated with various strains of the flu virus
What is the incubation period for flu
1-4 days from exposure and first symptoms
How are the symptoms of flu different to a common cold
Symptoms tend to be systemic more severe and last for longer
What are the signs and symptoms of Influenza
Sudden onset: Fever and shivering, malaise, muscle and joint pain, rhinitis, sore throat
What is the allopathic treatment for Influenza
Antiviral drugs - reduces viral shredding needs to be taken within 48 hours poor effectiveness.
Antibiotics - to prevent secondary bacterial infection (adverse effects - lowered immunity, thrush diarrhoea and poor digestion.
Flu vaccine
What are the 4 Flu complications
Secondary infections - while the immune system is already depleted.
Chronic fatigue syndrome - post viral syndrome following a compromised immune system.
Morbidity/mortality
Pigs - mixing reservoirs as they can host both human and non human viruses potentially allowing the mixing of viral genes creating new viruses.
Define Sinusitis
It is inflammation of the membranous lining of one or more of the sinuses known as Rhinosinusitis.
Is sinusitis acute or chronic
It can be acute or chronic if chronic would be more than 3 months
What are the signs and symptoms of sinusitis
Pain in the affected sinus and congestion
Headache
fever, reduced resonance in voice, reduced smell nasal drip
What is the allopathic treatment for sinusitis
Decongestants and painkillers
What is the name given to swelling with fluid
Oedematous - Odema 2
Define nasal Polyps
Nasal Polyps are soft benign masses of oedematous nasal mucosa
What are the causes of Polyps
The end result of chronic inflammation from a viral, bacterial or fungal infection.
Allergies: Chronic Rhinitis
What is the Pathophysiology of nasal polyps
Chronic inflammation causes the blood vessels in the lining of the nose to become more permable allowing water to accumulate in the cells. Over time, gravity pulls on the waterlogged cells and they can become polyps
What are the signs and symptoms of Polyps
Difficulty breathing, persistent stuffiness runny nose, chronic rhinitis, headache reduced sense of smell and snoring
Sleep apnoea
What is the allopathic treatment for Polyps
Intranasal steroids
Anti-histamines, anti fungals or sometimes surgery
What is tonsillitis
Inflammation of the tonsils
What are the tonsils
They are immune lymphoid tissue in the oral and nasal passageway and act as our first line of defence
Tonsillitis can be viral or bacterial what is the name of the bacteria
Streptococci (Strep tu coxi)
What individuals is tonsillitis more common in
Children aged 5-10 years and 15-25 years
How long is the incubation period for tonsillitis
Short
What are the signs and symptoms of tonsillitis
Sore throat that becomes worse when swallowing
Fever over 38 degrees
Coughing/headache and red inflamed tonsils
What are the complications from tonsillitis
Middle ear infection or Quinsy (abcess)
Define a Quinsy
An abscess that has formed around the tonsils, occurring as a result of tonsillitis
What are the signs and symptoms of a Quinsy
Severe unilateral throat pain, Dysphagia (difficulty swallowing) Dis fay jee uh
Unilateral earache, Trismus - Trizmus (limited opening of the mouth, fever and swollen lymph nodes.
What is the allopathic treatment for Quinsy
Antibiotics, pus drainage and sometimes surgery
What is Pharyngitis
An acute inflammation of the mucous membrane of the Pharynx
What is Pharyngitis usually accompanied by
Colds and tonsillitis and often swollen lymphnodes
What is the allopathic treatment for Pharyngitis
Painkillers and antibiotics
Describe Laryngitis
Inflammation of the Larynx
What is acute Laryngitis due to
Viral or bacterial infection
What is chronic laryngitis due to
Overuse, irritation from smoke or fumes. Acid reflux
What are the signs and symptoms of Laryngitis
Hoarseness, weak voice or loss of voice
Sore dry tickly throat dry cough and in children difficulty breathing.
What is the allopathic treatment for Laryngitis
Antibiotics and avoid smoking and maintain oral hygiene
Define asthma
Is a chronic airway disease with reversible narrowing of the Bronchi and Bronchioles
Describe Asthma
It is an inflammatory condition combined with bronchial hyper responsiveness with varying degrees of of immune cell infiltration.
What causes problems exhaling in Asthma
Airflow obstruction due to Oedema, mucus build up and smooth muscle proliferation causes problems exhaling
What age does asthma usually develop
Before the age of 10 and then again in the elderly
What is the key chemical inflammatory mediator in Asthma and what do they do.
Leukotrienes which are bronchoconstrictors
Give 4 reasons why the prevalence of Asthma is increasing
Weaning to early
Sterile environments
Inherited dysbiosis
Food additives
Leaky gut
Nutritional deficiencies i.e C D E And magnesium
What is Extrinsic (or atopic) Asthma
Typically effects children, immunologically mediated with an increase in IgE antibodies. Brought on due to exposure of pollen, dust and animal dander
What is Intrinsic Asthma
Bronchial reaction that is not due to antigen- antibody stimulation usually adult onset
Common triggers stress, anxiety chemicals cold air drugs (NSAID’s betablockers) dust etc
What are the signs and symptoms of Asthma
Recurrent episodes of breathlessness and chest tightness
Wheezing on exhaling
Nocturnal coughing (occasionally with a thick yellow sputum)
Accessory muscles of ventilation are overused and cause aching in the back and upper neck
How do we diagnose Asthma
Based on signs/symptoms and history
Spirometry - test breathing through a tube
Peak flow meter
What are the pathological changes that happen in Asthma
Smooth muscle contracts and immune cells infiltrate the bronchioles as part of the inflammatory process which obstructs the airways.
What is the Atopic Triad and what conditions does it include
A group of conditions that are associate with the same features. (all allergy mediated)
Eczema, Hayfever (allergic Rhinitis) and Asthma
What should you do if someone is having an asthma attack
Call for help:
If patient cannot speak in sentences and has more than 25 breaths per minute
encourage the patient to sit not lie down.
use inhaler (usually blue bronchodilator every 30-60 seconds up to a maximum of 10 puffs
What is the Allopathic treatment for Asthma
Bronchodilators - blue inhalor (relieve symptoms)
Corticosteriods - Brown inhaler (prevention)
What are the side effects of the corticosteriod inhaler
Oral thrush, gingivitis
Why is magnesium a good natural treatment for asthma
It is a bronchodilator
What is a fast heartbeat called in medicine
Tachycardia
What is rapid shallow breathing called in medicine
Tachypnoea - Ta Kip Knee ah
What is auscultation
Listening to sounds from the lungs/heart and other organs using a stethoscope
Describe Bronchitis
Is an inflammation of the Bronchial tubes it can be acute or chronic
How do we develop bronchitis
Following a viral or bacterial infection from a cold or can be associated with environmental irritants.
When an irritant enters the airways xxxxx cells secrete mucus to flush it out. If xxxxx is overproduced the respiratory system struggles to clear it.
This can xxxx xxxxx resistance and hence breathing difficulties
Goblet cells
Mucus
Increase airway resistance
Define COPD
COPD causes airflow limitation that is progressive and not fully reversible. The airflow limitation is due to airway and functional tissue damage. Is is a chronic inflammatory response of the lungs (usually from inhaled toxins)
Describe Chronic Bronchitis and key symptoms.
Inflammation and thickening of the bronchial lining with mucus hyper-secretion
Key symptoms - Cough and wheezing
What are the 2 main pathologies that COPD make up. Describe each.
Emphysema - Dilation of alveolar sacs by destruction of the alveolar wall, leading to collapse Alveoli during expiration.
Chronic Bronchitis - Inflammation and thickening of the bronchial lining with mucus hyper secretion
What are the main causes of COPD
90% smoking
Exposure to lung irritants such as air pollution, industrial chemicals, dusts etc.
Describe the pathology Emphysema and key symptoms
Dilation of Alveolar sacs by destruction of alveolar wall. Leading to collapse of the alveoli during expiration.
Breathlessness
What is the alternative name given to individuals with
- Chronic Bronchitis
- Emphysema
- Blue bloater
- Pink Puffer
What is the Pathophysiology of COPD
Smoking cigarettes and inhaling other irritants leads to high levels of oxidative stress in the respiratory tract.
Oxidative stress damages the delicate cilia and promotes inflammation throughout the respiratory tract.
Cells are damaged and scar. This, as well as excess mucus production leads to airflow obstruction
Signs and symptoms of COPD
Chronic cough with sputum, dyspnoea
Prolonged expiration and wheeze
Frequent infections
Signs - Tachypnoea -
breathlessness on exertion
Patients may lean forward on a table to breath
Pursed lips on breathing
Flapping tremor
Cyanosis - blue hands skin lips
Barrel chest
clubbed nails
What are the complications of COPD
Chronic Hypoxaemia - low levels of Oxygen in the blood
Pulmonary Hypertension - High blood pressure
Respiratory failure
Frequent respiratory infections.
What is pnoea
breathing
What is Tachy
Fast/Rapid
What is Hypo
Below normal
What is the allopathic treatment for COPD
Bronchodilators, smoking cessation, corticosteriods and Oxygen therapy
What is Pneumonia
An infection of the Alveoli and terminal Bronchioles, mostly bacterial. Associated with an infiltration of neutrophils with inflammation and Oedema
What are the signs and symptoms of Pneumonia
Cough and purulent sputum which maybe blood stained.
Breathlessness fever and general malaise
Signs - Tachypnoea, crepitations on auscultation
Define Pulmonary Fibrosis
Gradual replacement of the one-layer-thick epithelial cell lining in alveoli with fibrotic tissue.
What are the causes of Pulmonary Fibrosis
Idiopathic (IPF) unknown, it might be genetic presents around age 70
Smoking, asbestos, radiation some drugs and accompanies some diseases such as RA.
What are the signs and symptoms of Plumonary Fibrosis
Progressive Dyspnoea, chronic cough, fatigue discomfort of the chest, loss of appetite weight loss
What is the Allopathic treatment for Pulmonary Fibrosis
No current effective allopathic treatments
Define Sleep Apnoea
Intermittent and repeated upper airway collapse during sleep leading to interrupted sleep
What are causes/risks for sleep apnoea
Obesity, male gender, middle aged, smokers, alcohol, sedatives nasal obstruction (nasal polyps/Rhinitis)
What is the treatment for sleep apnoea
CPAP Nasal continuous positive airway pressure. this goes over the face when sleeping and helps to keep the pressure consistent in the airways. Lifestyle modification
What are the signs and symptoms of Sleep Apnoea
Loud snoring, day time sleepiness, morning headache, morning drowsiness, nocturnal chocking reduced libido.
How is Obstructive Sleep Apnoea diagnosed.
Polysomonography
Define a Pneumothorax
A Pneumothorax describes air accumulation within the pleural cavity causing all or part of the lung to collapse
How does air enter in a Pneumothorax and what could this be due too?
Air enters via a defect in the visceral or parietal pleura.
What do we base a Pneumothorax on?
A Pneumothorax can be simple (Heart remains central) or tension (unstable - progressive build up of air shifting the heart away)
What are the causes of a Pneumothorax
This can be due to a rib fracture, or spontaneous due to a cyst that has ruptured or associated to another disease such as TB or Cystic Fibrosis
What are the signs of a pneumothorax
Reduced breath sounds, decreased cardiac output
What are the symptoms of a pneumothroax
Dyspnoea and pleuritic (sharp) chest pain
Cyanosis
Loss of conciousness, coma
Define Pleurisy
It is an inflammation of the Pleura
What happens in Pleurisy
The pleural surfaces become coated with inflammatory materials and are hence roughened, producing the friction rub on auscultation.
What are the causes of Pleurisy
Tumour or infection e.g Pneumonia or Pneumothorax
Signs and symptoms of Pleurisy
Dysponea, sharp chest pain while breathing aggravated by inspiration, coughing, sneezing or moving around. May be relieved by shallow breathing.
Dullness with percussion, friction rub on auscultation
What is Cyanosis
Low levels of Oxygen in the blood turning skin a bluey colour
What is Cyanoisis due to
Peripheral heart disease
