Respiratory System and Diseases 1

Question 1

What is a Common cold?

Answer 1

A catarrhal disorder of upper respiratory tract, very common

Question 2

What type of virus is the common cold normally?

Answer 2

Mainly by rhinoviruses (picornavirus group, over 100 strains
- vaccination impracticable)

Question 3

How is the common cold spread?

Answer 3

Spread by close personal contact, droplets

Question 4

Common cold pathology

Answer 4

inflamed mucosal membrane of the nose

Question 5

What virus is Influenza caused by?

Answer 5

Influenza virus (orthomyxovirus), main forms A, B−type A: cause for pandemics

Question 6

Influenza antigens

Answer 6

• Haemagglutinin (H) – cell attachment
• Neuraminidase (N) – cell penetration
• H1-H3 and N1&N2 subtypes have established stable lineage in human population

Question 7

Genetic variations of influenza virus - major and minor antigenic

Answer 7

−Major antigenic shift= pandemics

−Minor antigenic drift= less severe epidemics

Question 8

Influenza spread

Answer 8

By droplets and fomites

Question 9

Influenza incubation

Answer 9

1-3 days

Question 10

Influenza Symptoms

Answer 10

Fever, shivering, generalised aching (limbs)−Severe headache, sore throat, persistent dry cough

Question 11

Influenza Prophylaxis

Answer 11

Influenza vaccines; recent advance:M2-protein based multi- strain vaccine; universal vaccine targeting core proteins on trial

Question 12

Pneumonia

Answer 12

Inflammation of alveoli, usually caused by bacteria

Question 13

Pneumonia Classifications - Anatomica

Answer 13

Lobar pneumonia (whole of one lobe)

Question 14

Pneumonia Classifications - Aetiological

Answer 14

Bacterial, Viral, Other

Question 15

Pneumonia bacteria

Answer 15

Streptococcus pneumoniae

Bronchopneumonia

Lobar pneumonia

Question 16

Pneumonia bacteria explained

Answer 16

• Streptococcus pneumoniae: Common cause of community -acquired acute pneumonia
• Bronchopneumonia:−Most commonly in old age, infancy and patients with debilitating diseases
• Lobar pneumonia:−Typically healthy adults between 20-50 yrs

Question 17

Pneumonia Pathology

Answer 17

• Alveolar inflammation
• Protein-rich exudate
• Bronchopneumonia: - foca; inflammation along the airways (patchy consolidation); often bilateral of the lung
• Lobar pneumonia: –Diffuse inflammation affecting the entire lobe; pleural exudate common

Question 18

Clinical features of pneumonia

Signs

Answer 18

• Consolidationof lung with disease
• Pleural friction rub
• Elderly patients often have fewer symptoms

Question 19

Clinical features of pneumonia - respiratory and systemic symptoms

Answer 19

• Respiratory symptoms:Cough, Purulent or “rusty” sputum Dyspnoea
• Systemic symptom: Pyrexia (fever)

Question 20

Pneumonia Investigations

Answer 20

• Chest X-ray
• Blood cell count:
  −WBC count >15x109 /L - bacterial infection
• Sputum:−Gram stain, culture & sensitivity tests
• Other specific tests−Myoplasma, legionella

Question 21

Management of Pneumonia

Answer 21

• Community-acquired:

−Antibioticsimmediately without waiting for microbial results

• Hospital-acquired:−Often Gram-negative organisms; different antibiotics
• Treatment should be modified -culture and sensitivity results

Question 22

Pneumonia specific measures

Answer 22

−Analgesia (pleuritic pain)

−O2therapy (hypoxaemia)

−Intensive care (severe pneumonia)

Question 23

Pneumonia Complications

Answer 23

• lung abscess
• empyema - pus in the pleural cavity

Question 24

Tuberculosis

Answer 24

• Major cause of death/morbidity in developing countries
• Prevalenceon the increasein developed countries
• Lung – the commonest site

Question 25

Tuberculosis - Aetiology, transmission & risk factors

Answer 25

• Caused mainly by:−Mycobacterium tuberculosis
• Transmission:−Through the air, or from direct contact
• Predisposing factors:−Alcohol, diabetes, immunosuppression

Question 26

Tuberculosis Pathology - Primary

Answer 26

Small granulomas in lobes (Ghon complex); often resolves

Question 27

Miliary tuberculosis

Answer 27

Disseminated(spread) granulomas in many organs

Question 28

Tuberculosis Pathology - Secondary

Answer 28

Reactivation

lesions in apices:
-caseous necrosis ingranulomas
- convert to fibrocalcific scars

Question 29

Tuberculosis - clinical features- symptoms

Answer 29

Primary TB: usually asymptomatic Cough, chest pain, and fever Purulent sputum

Question 30

Tuberculosis - Diagnosis

Answer 30

Chest X-ray: Upper zone shadows, fibrosis–Sputum samples: Stain & culture

Question 31

Prevention & treatment of Tuberculosis

Answer 31

3 or 4 different kinds of antibiotics in combination over six to nine months