Respiratory Pathology Flashcards
What anatomical structures make up the upper respiratory tract?
Nasal cavity
Sinuses
Mouth
Larynx - throat
What anatomical structures make up the lower respiratory tract?
Trachea
Bronchus
Lungs
Alveoli
What diseases classify as lower respiratory tract infections?
Pulmonary embolism
COPD
Pneumonia
Tuberculosis
What is the differential diagnosis of dyspnoea (SOB)?
Rapid onset - asthma, pulmonary embolus, inhaled foreign bod, pneumothorax
Gradual - obstructive airway disease, malignancy
Orthopnoea - cardiac cause
What are the common symptoms of respiratory diseases?
Cough
Dyspnoea
Wheeze - expiratory, asthma
Stridor - inspiratory, allergic swelling, foreign body
Cyanosis - peripheral then cardiac, central then lungs
Finger clubbing
Cervical lymphadenopathy
Horners syndrome - drooping of eye lid
What diseases classify as upper respiratory tract diseases?
Inhaled foreign body
Common cold
Influenza
Rhinitis
Sinusitis
What is the pathology following an inhaled foreign body?
Goes down pharynx to right main bronchus and lower lobe of lung
Risk of abscess and pneumonia
Obstruct airflow - cough, stridor, wheeze
What is the treatment for an inhaled foreign body?
Cough and turn head to the side
Heimlich manoeuvre
Suction, forceps and good lighting
Bronchoscope
High flow oxygen
What are dental ways of preventing an inhaled foreign body?
Rubber dam
Pharyngeal sponges
Restraining cords
What is the common cold virus?
Rhinovirus
What is influenza virus coated with?
Haemagglutinin
Neuraminidase
What is the difference between antigenic shift and drift?
Shift - major change in sequences
Drift - minor change in genomic sequences - influenza
What is the treatment for influenza?
Aspirin
Neuraminidase inhibitors
Antibiotics for those with bronchitis
Vaccine
What is rhinitis?
Caused by allergen
Can be seasonal
What is the treatment for rhinitis?
Antihistamines
What is sinusitis?
Bacterial Infection of paranasal sinus
What is sinusitis caused by?
Strep. Pneumonia
Haemophilius influenza
Follows a viral infection
What is the dental relevance of sinusitis?
Can appear as toothache in the upper molar teeth - due to alveolar nerve
Thickening of lining mucosa opaque of radiograph
What is the treatment for sinusitis?
Antibiotics - cefaclor
What is acute pharyngitis caused by?
Virus
May lead to bacterial infection
Feature of glandular fever
What is laryngo-tracheo-bronchitis?
Croup
Infection with measles virus or influenza virus
Inflammatory oedema in larynx
What is the treatment for laryngo tracheo bronchitis (croup)?
Oxygen
Inhaled steam
Tracheostomy
What is COPD?
Diseases that lead to damage of lung tissue
Chronic bronchitis
Ephysema
What is seen in chronic bronchitis?
Airway obstruction limits airflow - decreased ventilation
Excessive mucus production
Chronic inflammation bronchi
What is the other name for chronic bronchitis and why?
Blue bloaters
Blue - hypoxia and polycythaemia
Obese and water retention
Bloating - residual lung volume increases
What is seen in emphysema?
Destruction of airways
Loss of elastic recoil
Expiratory airflow limited and collapse
What is the other name for emphysema and why?
Pink puffers
Decreased ability to oxygenate blood
Less SA for gas exchange - hyperventilate
What is the cause of COPD?
Smoking
Pollution
Infection
Antitrypsin deficiency
What damage follows COPD?
Respiratory epithelium ulcers
Excess mucus
Airway narrowing
What is the treatment of COPD?
Cessation
Antibiotics
Bronchodilators
Steroids
Influenza vaccine
Emergency - use 100% oxygen
What is the dental relevance of COPD?
Rubber dam difficulty breathing
Candida infection - steroids
Do not sedate
What are the main causes of asthma?
Lifestyle
Pollen, allergies
Raised IgE levels
Asthma gene
Bronchial hyper-reactivity
What pathology follows asthma?
Oedema
Bronchi-constriction
Mucous secretions plug bronchioles
What is the pathology of asthma caused by?
Mast cell degranulation
Release of histamine and prostaglandin
Lymphocytes active eosinophils - shed epithelium
What is the treatment for asthma?
Beta 2 agonist - salbutamol bronchodilator
Inhaled steroid
Long acting beta 2 agonist
Nebulisers
What is the dental relevance of asthma?
Can provoke acute attack
NSAIDS worsen asthma attack - ibuprofen
Inhaled steroids - candiditis
Use inhaler at the beginning
What is a pulmonary embolism caused by?
Emboli released from blood clots in lower limb from DVT
Long rest
Cardiac failure
Surgery
What is the pathology following a pulmonary embolism?
Embolus obstructs pulmonary arterial circulation
Collapse of alveoli
Decreased efficiency of gas exchange
What are the signs of a pulmonary embolism?
Sudden onset of chest pain
SOB
Coughing up blood
What is the treatment for a pulmonary embolism?
Anticoagulants and thrombolytic drugs
Warfarin
Aspirin
What is the dental relevance for a pulmonary embolism?
Special care before invasive procedures
Weight reductions
Stockings
Elevation of leg
What is the cause of pneumonia?
Lung disease
Smoking
Alcohol
Immunosuppression
What is the treatment for pneumonia?
Amoxicillin 500mg 7 days
What is the main complication of pneumonia?
Lung abscess
Empyema pus in pleural cavity
What causes the infection of pneumonia?
Myobacterium tuberculosis
Viral
What causes the infection of TB?
Myobacterium tuberculosis
What areas of the body does TB mainly affect?
Lungs
Lymph nodes
Gut
What is primary and post primary TB?
Primary - initial infection in lung, symptomless, subpleural
Post primary - re infection, pulmonary, pleural pain
What is used as prevention of TB?
BCG
What is the treatment for TB?
Rifampicin - stains dentures orange
Isoniazid
Ethambutol
What are the two types of lung cancer?
Small cell lung cancer - central, rapid growth, metastasises early, polypeptide hormones
Non-small cell lung cancer - slower growth rate, metastasises later, squamous cell, large cell, adenocarcinoma, alveolar
What is the treatment for lung cancer?
Surgical treatment
Radio and chemotherapy
Analgesia
What is the dental relevance of lung cancer?
Cessation
Cervical lymphadenopathy
Neck veins
Horners syndrome
