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Body Systems > When Things Go Wrong In The Respiratory System > Flashcards

When Things Go Wrong In The Respiratory System Flashcards

1
Q

What is the primary focus of obstructive respiratory diseases?

A

Conditions which impede the rate of flow into and out of the lungs.

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2
Q

What are the main types of respiratory diseases?

A
  • Obstructive
  • Restrictive
  • Infection & inflammation
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3
Q

What is a key characteristic of obstructive respiratory disease?

A

Increased airway resistance (due to narrowing of airways)

Outflow pressure reduced (due to loss of elastic recoil in the lungs = can’t exhale as much air)

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4
Q

What does reduced compliance in restrictive lung disease indicate?

A

Decreased lung volume and reduced vital capacity (VC)

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5
Q

What is Forced Expiratory Volume in 1 second (FEV1)?

A

A measure of airway resistance using spirometry.

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6
Q

What percentage of vital capacity does FEV1 normally represent?

A

Approximately 80%.

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7
Q

What are the two main diseases classified under Chronic Obstructive Pulmonary Disease (COPD)?

A
  • Chronic bronchitis (narrowing of airways)
  • Emphysema (loss of recoil)
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8
Q

What is the global impact of COPD as of 2021?

A

Approximately 3.5 million deaths globally (5% of all global deaths).

4th leading cause of deaths worldwide

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9
Q

What is the primary cause of chronic bronchitis?

A

Due to smoking (80% of time) and environmental irritants

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10
Q

How long must chronic bronchitis last to be diagnosed?

A

At least 3 consecutive months in 2 consecutive years.

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11
Q

What are common treatments for chronic bronchitis?

A
  • Stop smoking
  • Bronchodilators (opens airways)
  • Antibiotics
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12
Q

What is the mechanism of damage in emphysema?

A
  • smoking
  • neutrophils & macrophages release elastase
  • elastase destroys alveolar walls (so poor gas exchange)
  • emphysema is developed

Elastase normally inactivated by a1 antitrypsin
Genetic a1 antitrypsin deficiency (in 2% of COPD patients) also causes emphysema as elastase is secreted

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13
Q

What is are significant symptoms of emphysema?

A

Shortness of breath on exertion
Hyperventilation (to remove CO2)
Expanded chest

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14
Q

What is the main treatment for asthma?

A
  • Short term = Bronchodilators e.g. salbutamol reliever inhaler (B2 adrenoreceptor antagonists = work against bronchoconstriction)
  • Long term = Anti-inflammatories e.g. preventer inhaler (for mild to medium asthma)
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15
Q

What are the key causes of asthma?

A
  • Hypersensitivity to allergens
  • Air pollution
  • Exercise and cold air
  • Emotional stress
  • Genetics?
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16
Q

What is the primary characteristic of restrictive lung disease?

A

Decreased lung compliance.

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17
Q

What is a common cause of intrinsic restrictive lung disease?

A

Long-term exposure to dust (e.g., pneumoconiosis)
Drugs (e.g. methotrexate)
Rheumatoid arthritis (inflammatory condition)
ARDS & IRDS
Or may be idiopathic (no cause, just develops)

18
Q

What is the effect of fibrosis on lung compliance?

A

It causes a decrease in lung compliance.

19
Q

What are upper respiratory tract infections commonly caused by?

A

Minor infections such as the common cold.

20
Q

What bacterium is commonly responsible for pneumonia?

A
  • Streptococcus pneumoniae
  • Staphylococcus aureus
  • Klebsiella pneumoniae
21
Q

What is tuberculosis caused by?

A

Inhalation of Mycobacterium tuberculosis.

Highly contagious

22
Q

What are the two phases of tuberculosis?

A
  • Latent - asymptomatic, non-infectious, granuloma in lung tissue
  • Active - spreads to bronchioles and circulation = becomes contagious
23
Q

What is the primary target of the COVID-19 virus?

A

Lung epithelial cells.

24
Q

What receptor does SARS-CoV-2 bind to for infection?

A

Angiotensin-converting enzyme 2 (ACE2) receptor.

25
Q

What is the significance of the Omicron variant of COVID-19?

A

It represented over 98% of sequenced samples as of February 2022.

26
Q

What is a common misconception about COVID-19 vaccines?

A

Vaccines are only for high-risk groups.

27
Q

What is the average number of upper respiratory tract infections an adult experiences per year?

A

2-4 URTI/year.

28
Q

What is COPD characterised by?

A
  • Narrowing of airways —> increases airway resistance
  • Elastic recoil of lungs is lost —> reduced outflow pressure
  • Thus decreased FEV1
  • Increased residual volume (RV) —> appearance of chest over-inflation (due to retention of air)
29
Q

What causes bronchitis?

A

Inflammation of the bronchi - mucus hypersecretion

30
Q

What causes acute bronchitis?

A

Bacteria/ virus

Lasts days/ weeks

31
Q

What happens in chronic bronchitis?

A
  • irritants cause inflammation in bronchi
  • abnormal mucus secretion (causes inflammation)
  • plugs airways
  • prone to infection
  • further inflammation
32
Q

What are symptoms of chronic bronchitis?

A
  • airway obstruction
  • shortness of breath / wheezing (due to obstruction)
  • chest pain, chronic cough (in attempt to clear airway of mucus)
33
Q

What happens to compliance in emphysema?

A

Significantly above normal
SO
Increased residual volume (RV) —> increased functional residual capacity (FRC) = chronically over-inflated lung

34
Q

What causes emphysema?

A

20% of smokers develop COPD
Lifelong smokers

Loss of alveoli is permanent and irreversible

Treatment:
- stop smoking
- supplement O2
- lung transplant
- enzyme supplements in a1 antitrypsin deficiency

35
Q

What are the symptoms of asthma?

A
  • Bronchconstriction
  • Oedema of airway mucosa
  • Mucus secretion

All these increase airway resistance

36
Q

What is the mechanism of asthma?

A
  • Mast cell activation
  • Histamine (causes allergic response) and cytokine (causes inflammation) release
  • Oedema, mucus, smooth muscle contraction = bronchoconstriction
37
Q

What is extrinsic cause of restrictive lung disease?

A

Non-muscular disease of upper thorax

38
Q

What is fibrosis in restrictive lung disease?

A

Fibrosis is development of excess connective tissue

  • Alveoli are replaced by fibrotic tissue = harden & become stiffer
  • Decreased lung compliance
  • Irreversible decrease in oxygen diffusion capacity
39
Q

What causes fibrosis?

A
  • Inhaled environmental and occupational pollutants
  • Cigarette smoke
  • Autoimmune disease

No effective treatments for fibrosis

40
Q

What are respiratory tract infections caused by?

A

Upper respiratory tract infections
- common but minor
- average adult has 2-4 URTI/year

Lower respiratory tract infections
- less common but serious
- e.g. bronchitis, pneumonia, tuberculosis…

41
Q

How does pneumonia affect the lungs?

A
  • Affects bronchi and alveoli
  • Inflammatory exudate (liquid) fills alveoli
  • Leads to ‘consolidation’
  • Lung tissues become firm and airless
42
Q

Describe the mechanism of tuberculosis

A
  • Replicate in alveolar macrophage
  • This is know as Ghon focus = site of primary infection (latent phase)
  • Initial infection has ineffective immune response
  • Bacteria moved to lymph nodes so can spread to the body
  • Collagen deposited around bacteria = can break down lung structure
  • Lymph nodes erode releasing bacteria into: bronchioles or blood vessels
  • Destruction of alveoli

Treatment of tuberculosis is difficult due to antibiotic resistance

Body Systems (19 decks)

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