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
what is the definition of respiratory?
designating, relating to, or affecting the organs involved in respiration
what is the definition of respiration?
the exchange of oxygen and carbond dioxide between an organism or cell and the environment
what is the definition of disease?
sickness; disturbance or impairment of the function and structure of the body, a part of the body, or the mind
what is the normal respiratory rate of an: adult, new born and toddler?
adult: 12-20bpm
new born: 30-40bpm
toddler: 20-30bpm
what is the ideal range for oxygen saturation?
96-100%
what is FEV1? and what are the normal values for healthy adult males and females?
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
what is FVC?
forced vital capacity - max volume of air that can be expressed from lungs forcibly
give examples of rheumtological conditions
rheumatoid arthritis
systemic sclerosis
myositis
systemic lupus erythematosis
what is obstructed sleep apnoea (OSA)?
upper airway obstruction, but movement of the chest wall persists
what are the symptoms of obstructed sleep apnoea (OSA)?
8
snoring
apnoea periods
dry mouth
daytime fatigue
daytime somnolence (sleepiness)
poor concentration
headaches
depression
what are the risk factors of obstructed sleep apnoea (OSA)?
9
male
obesity
type 2 diabetes
smoking
alcohol
down’s syndrome
craniofacial abnomalities
hypothyroidism
acromegaly (excess growth hormone)
what are the treatments for obstructed sleep apnoea (OSA)?
3
lifestyle chnages
continuous positive airway pressure (CPAP)
mandibular advancement devices
what viruses cause the common cold?
4
influenza, parainfluenza, respiratory syncytial viruses and adenoviruses
what is epiglottitis? what does it obstruct?
localised swelling of the epiglottis caused by infection
obstructs the laryngeal inlet
what can be identified on examination with a patient with epiglottitis?
6
unwell, scared patient
muffled voice
if child coughs, it may sound like a quack
increasing dysphagia
drooling
stridor (vibrating noise when breathing)
what do patients complain of with tonsillitis?
3
sore throat
otalgia (ear pain)
headache or malaise
what can be identified on examination with a patient with tonsillitis?
4
pyrexia (high temperature)
tonsils are enlarged and may exude pus
lymph nodes are enlarged and tender
foetar oris (bad breath)
how do you manage tonsillitis? when do you refer to ENT?
4
analgesia - paracetamol
soft diet
if difficulty swallowing or unilateral, refer to ENT urgently
if recurrent symptoms, refer to ENT urgently
what is chronic obstructive pulmonary disease (COPD)?
group of lung conditions that cause breathing difficulties due to chronic inflammation
what are the two main types of COPD?
chronic bronchitis
emphysema
what is chronic bronchitis?
3
inflammation of bronchi
excess mucus
chronic productive cough for >3months in 2 consecutive years
what is emphysema?
2
alveolar membrane degradation
recurrent inflammation, scarring and loss of parenchymal luncg texture
what is an exacerbation of COPD and what is it caused by?
2
symptoms beyond the normal expected symptoms of a disease
caused by acute inflammation or infections
what is the pathology of COPD?
5
mucous hypersecretion
ciliary dysfunction
airflow obstruction and hyperinflation/air trapping
gas exchange abnormalities
pulmonary hypertension
what are the symptoms of COPD?
6
chronic cough
fatigue
dyspnoea (difficult breathing)
excess mucus
shortness of breath
chest discomfort
what are the causes of COPD?
6
smoking
pollution
occupational exposure
genetics (alpha-1-antitrypsin deficiency)
lung development
asthma
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)
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
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
what is asthma?
chronic respiratory condition associated with airway inflammation and hyper-responsiveness
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
what is late onset (intrinsic) asthma?
4
not related to atopic conditions
no evidence of IgE medication
no seasonal variation
pathology relatively unknown
what are the symptoms of asthma?
5
cough
wheeze
chest tightness
shortness of breath
variable expiratory airflow limitation
varies over time and in intensity
what are the triggers of asthma?
6
exercise
allergen or irritant exposure
changes in weather
viral respiratory infections
NSAIDS
beta blockers
how do you diagnose asthma?
4
history
peak flow
trial SABA
blood tests - IgE
what is the sequalae for asthma?
3
death
respiratory complications (pneumonia, pulmonary collapse, pneumothorax, status asthmaticus)
impaired QoL - fatigue
how do you control asthma?
2
avoid exacerbations
reduce risk of morbidity and mortality
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
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
