Respiratory system in health and disease Flashcards

ILO 4.5b: be competent at he recognition of medical problems that impact on fitness for routine dentistry

1
Q

what is the definition of respiratory?

A

designating, relating to, or affecting the organs involved in respiration

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2
Q

what is the definition of respiration?

A

the exchange of oxygen and carbond dioxide between an organism or cell and the environment

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3
Q

what is the definition of disease?

A

sickness; disturbance or impairment of the function and structure of the body, a part of the body, or the mind

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4
Q

what is the normal respiratory rate of an: adult, new born and toddler?

A

adult: 12-20bpm
new born: 30-40bpm
toddler: 20-30bpm

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5
Q

what is the ideal range for oxygen saturation?

A

96-100%

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6
Q

what is FEV1? and what are the normal values for healthy adult males and females?

A

volume of air forcibly expired in first second after a full inhalation (forced expiratory volume in 1s)
* healty adult male >3.5L
* healthy adult female >2.5L

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7
Q

what is FVC?

A

forced vital capacity - max volume of air that can be expressed from lungs forcibly

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8
Q

give examples of rheumtological conditions

A

rheumatoid arthritis
systemic sclerosis
myositis
systemic lupus erythematosis

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9
Q

what is obstructed sleep apnoea (OSA)?

A

upper airway obstruction, but movement of the chest wall persists

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10
Q

what are the symptoms of obstructed sleep apnoea (OSA)?

8

A

snoring
apnoea periods - temporary pause in breathing
dry mouth
daytime fatigue
daytime somnolence (sleepiness)
poor concentration
headaches
depression

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11
Q

what are the risk factors of obstructed sleep apnoea (OSA)?

9

A

male
obesity
type 2 diabetes
smoking
alcohol
down’s syndrome
craniofacial abnomalities
hypothyroidism
acromegaly (excess growth hormone)

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12
Q

what are the treatments for obstructed sleep apnoea (OSA)?

3

A

lifestyle chnages
continuous positive airway pressure (CPAP)
mandibular advancement devices

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13
Q

what viruses cause the common cold?

4

A

influenza, parainfluenza, respiratory syncytial viruses and adenoviruses

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14
Q

what is epiglottitis? what does it obstruct?

A

localised swelling of the epiglottis caused by infection
obstructs the laryngeal inlet

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15
Q

what can be identified on examination with a patient with epiglottitis?

5

A

muffled voice
increasing dysphagia
drooling
stridor (vibrating noise when breathing)
if child coughs, it may sound like a quack

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16
Q

what do patients complain of with tonsillitis?

3

A

sore throat
otalgia (ear pain)
headache or malaise

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17
Q

what can be identified on examination with a patient with tonsillitis?

4

A

pyrexia (high temperature)
tonsils are enlarged and may exude pus
lymph nodes are enlarged and tender
foetar oris (bad breath)

18
Q

how do you manage tonsillitis? when do you refer to ENT?

4

A

analgesia - paracetamol
soft diet
if difficulty swallowing or unilateral, refer to ENT urgently
if recurrent symptoms, refer to ENT urgently

19
Q

what is chronic obstructive pulmonary disease (COPD)?

A

group of lung conditions that cause breathing difficulties due to chronic inflammation

20
Q

what are the two main types of COPD?

A

chronic bronchitis
emphysema

21
Q

what is chronic bronchitis?

3

A

inflammation of bronchi
excess mucus
chronic productive cough for >3months in 2 consecutive years

22
Q

what is emphysema?

2

A

alveolar membrane degradation
recurrent inflammation, scarring and loss of parenchymal luncg texture

23
Q

what is an exacerbation of COPD and what is it caused by?

2

A

symptoms beyond the normal expected symptoms of a disease
caused by acute inflammation or infections

24
Q

what is the pathology of COPD?

5

A

mucous hypersecretion
ciliary dysfunction
airflow obstruction and hyperinflation/air trapping
gas exchange abnormalities
pulmonary hypertension

25
what are the symptoms of COPD? | 6
chronic cough fatigue dyspnoea (difficult breathing) excess mucus shortness of breath chest discomfort
26
what are the causes of COPD? | 6
smoking pollution occupational exposure genetics (alpha-1-antitrypsin deficiency) lung development asthma
27
how do you diagnose COPD? | 4
history spirometry (monitors disease progression) cheset radiograph (to exclude other pathologies) full blood count (to identify anaemia or polycythaemia)
28
what is the sequale for COPD? | 8
reduced QoL - quality of life Cor Pulmonale - right ventricle enlarges frequent lower respiratory tract infection (LRTI) secondary polycythaemia pneumothorax - collapsed lung respiratory failure lung cancer muscle wasting and cachexia
29
what is the treatment for COPD? | 7
aim to prevent COPD sequale minimise progression of disease minimise exacerbations lifestyle measures smoking cessation exercise end-stage = oxygen therapy
30
what is the difference between type 1 and type 2 respiratory failure?
* type 1: **hypoxemic** - body does not have enough oxygen and CO2 levels are **normal/low** * type 2: **hypercapnic** - body does not have enough oxygen and CO2 levels are **high**
31
what is asthma?
chronic respiratory condition associated with airway inflammation and hyper-responsiveness
32
what is the pathology of asthma? what do the pathologies lead to? | 2,3
atopy - genetic predisposition as produce large amounts of IgE to allergens airway hypersensitivity - increased responsiveness of the airways to non-specific stimuli which may be due to bronchus inflammation atopy and airway hypersensitivity lead to: * bronchoconstriction * mucosal oedema * increased secretion of tenacious mucus
33
what is late onset (intrinsic) asthma? | 3
the late development of asthma symptoms - not related to atopic conditions - no evidence of IgE medication - no seasonal variation - pathology relatively unknown
34
what are the symptoms of asthma? | 5
cough wheeze chest tightness shortness of breath variable expiratory airflow limitation | varies over time and in intensity
35
what are the triggers of asthma? | 6
exercise allergen or irritant exposure changes in weather viral respiratory infections NSAIDS beta blockers
36
how do you diagnose asthma? | 4
history peak flow trial SABA blood tests - IgE
37
what is the sequalae for asthma? | 3
death respiratory complications (pneumonia, pulmonary collapse, pneumothorax, status asthmaticus) impaired QoL - fatigue
38
how do you control asthma? | 1
avoid exacerbations
39
what does complete control of asthma look like? | 7
no daytime symptoms no night-time awakening due to asthma no need for rescue medication no exacerbations no limitations on activity including exercise normal lung function minimal side effects from medication
40
what medications are used for asthma? | 2
controllers * sytemic corticosteroids * inhaled corticosteroids * methotrexate * leukotriene antagonists * LABA - long-acting-beta-2-agonists relievers * SABA - short-acting-beta-2-agonists * short acting theophylline * inhaled anticholinergics