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Respiratory System > Why is studying Lung disease important > Flashcards

Why is studying Lung disease important Flashcards

1
Q

What does a healthy lung look like

A

Pink

Clearly defined edges

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2
Q

What does an unhealthy lung look like

A

Ragged edges

Degradation due to proteolytic enzymes

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3
Q

Are all symptoms specific to lung disease

A

NO

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4
Q

Why is the data not always extrapable

A

Different burdens in different areas

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5
Q

What is meant by endentulism

A

No teeth

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6
Q

What is the respiratory system/disease concerned with

A

Concerned with function and dysfunction of the lungs and structures around the lungs (pleura, chest wall and respiratory muscles), and the pulmonary vasculature

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7
Q

Which parameters are used to measure the burden of lung disease

A

Mortality
Morbidity: Hospital admissions, GP consultation rates, time off work or school
Morbidity: Years lived with disability (YLDs)
and relative rankings, depends upon the parameter studied and the population studied

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8
Q

What is meant by ‘Winter Pressures’

A

Respiratory disease- massive peak in winter for burden on health services due to exacerbations of asthma, COPD and infections

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9
Q

When is COPD often diagnosed

A

COPD often diagnosed with severe acute episodes- unnecessary morbidity- could have been picked up or intervened earlier

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10
Q

What can flow-volume loops be used for

A

To diagnose different lung diseases

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11
Q

How much does lung disease in the UK cost society

A

Lung disease in UK costs society £11 billion per annum

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12
Q

Describe the scale of the problem associated with lung disease

A

Lung conditions, including lung cancer, are estimated to cost wider society around £9.9 billion each year.
Respiratory disease affects one in five people in England and is the third biggest cause of death
Hospital admissions for lung disease have risen over the past seven years at three times the rate of all admissions

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13
Q

How many people present with a COPD exacerbation but have not been diagnosed previously

A

Currently around a third of people with a first hospital admission for a COPD exacerbation have not been previously diagnosed

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14
Q

What does NHS England says needs doing

A

From 2019 we will build on the existing NHS RightCare programme to reduce variation in the quality of spirometry testing across the country. More staff in primary care will be trained and accredited to provide the specialist input required to interpret spirometry results.
Over the next ten years we will be targeting investment in improved treatment and support for those with respiratory disease, with an ambition to transform our outcomes to be equal, or better, than our international counterparts.

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15
Q

What increases the burden of lung disease

A

60% of patients with obstructive airways disease received no bronchodilators
only a minority of people with mild obstructive lung disease are detected- no treatment given- increasing the burden

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16
Q

Describe some trends associated with lung disease

A

Decline in respiratory mortality not seen in females

uk not producing better outcomes compared to similar EU countries (less steep decreases in death)

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17
Q

List the most common numbers of lung disease (in terms of people living with a diagnosis in Jan 2013)

A
  1. Asthma
  2. COPD
  3. Bronchiectasis
  4. Obstructive sleep Apnea
  5. Sarcoidosis
  6. Lung cancer
  7. IPF
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18
Q

Describe the deaths from different cancers

A

Lung cancer is the biggest cancer killer in the UK

Lung cancer kills more women in the UK than breast cancer

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19
Q

Describe the 5 year cancer survival rates associated with lung cancer

A

2nd lowest- to pancreas

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20
Q

Describe lung cancer in the UK

A

46,000 new cases per year in the UK
Over 35,900 deaths per year in the UK
ie 98 deaths every day
Less than 5% of patients with lung cancer survive more than 10 years
rate identical to rate in 1970
86% preventable

21
Q

Describe the improvements associated with lung cancer

A

One and two year survival rates are improving

Mortality rates for lung cancer are projected to fall by 21% in the UK between 2014 and 2035, to 58 deaths per 100,000 people by 2035.

Reflecting reduced rates of smoking, earlier diagnosis, better treatments

22
Q

Describe the trends associated with smoking

A

In 2014, 19% of adults in Great Britain currently smoked, down from a peak of 46% in 1974. Average consumption among smokers was 11 cigarettes a day – the lowest daily cigarette consumption for years

23
Q

Describe the classifications of lung diseases

A

Spirometry distinguishes between airway diseases and small lung disorders
Restrictive- small lung diseases
once spirometry confirms this- is it disease inside or outside the lung

24
Q

What are the different types of airway diseases

A

localised obstruction

generalised obstruction

25
Q

Give some examples of diseases due to localised obstruction

A 
Obstructive sleep apnoea syndrome
Upper airway tumours
Thyroid enlargement 
Vocal cord dysfunction 
Relapsing Polychondritis 
Tumours (eg Lung Cancer)
Post tracheostomy stenosis 
Foreign bodies 
Bronchopulmonary dysplasia
26
Q

Give some diseases due to generalised obstruction

A 
Asthma 
C.O.P.D. 
Bronchiectasis 
Cystic Fibrosis
Obliterative Bronchiolitis
Long term effects of prematurity
27
Q

Give some small lung diseases within the lungs

A 
Idiopathic Pulmonary Fibrosis
Sarcoidosis
Hypersensitvity Pneumonitis
Langerhans Cell Histiocytosis
Lymphangioleiomyomatosis
Alveolar Proteinosis
Asbestosis 
Extrinsic Allergic Alveolitis 
Eosinophilic pneumonia
28
Q

Give some small lung diseases outside the lungs

A 
Pleural effusions
Mesothelioma
Pneumothorax
Scoliosis 
Respiratory muscle weakness
Obesity- restricts the size of the lungs- increased risk of sleep apnoea syndrome and asthma
29
Q

Give some diseases due to infections

A

Tuberculosis
Infective bronchitis
Pneumonia / Empyema

30
Q

Give some diseases due to pulmonary vascular disorders

A

Pulmonary emboli

Pulmonary hypertension

31
Q

Describe the trends associated with asbestos

A

Deaths due to asbestos related lung disease increasing significantly (mesothelioma)

32
Q

Describe pulmonary emboli

A

Clots in the lung may complicate immobility and be fatal and for example remain single biggest cause of maternal death associated with childbirth

33
Q

Describe the impact of obesity

A

Increasing prevalence of obesity causes both increased respiratory workload, but also respiratory dysfunction and associated with increased risk of asthma and sleep related breathing disorders

34
Q

Describe idiopathic pulmonary fibrosis

A

35% Increase in diagnosis between 2000 and 2008.

Median survival 3 years from diagnosis (Poorer prognosis than cancer of the colon, breast or ovary)

35
Q

Describe sleep apnoea

A

Obstructive Sleep apnoea syndrome:
Leads to a six times normal
risk of having a road traffic crash

36
Q

List some typical symptoms that reflect lung disease

A 
Breathlessness
Cough
Sputum production
Haemoptysis
Chest discomfort
Wheeze or musical breathing
Stridor
Hoarseness
Snoring history /Daytime sleepiness
(Weight loss. Anorexia, Fever)
37
Q

What is breathlessness?

A

Breathlessness or dyspnoea is a sensation of difficult, laboured or uncomfortable breathing.

38
Q

What are the potential causes of breathlessness

A

Lung Disease
Heart Disease
Pulmonary Vascular Disease
Neuromuscular disease (eg diaphragm weakness)
Systemic Disorders (eg anaemia, hyperthyroidism, obesity)
need to consider them all

39
Q

What can motor neurone disease or M.D present with

A

Diaphragm weakness- even once they have been diagnosed

40
Q

What is the key function of the lung

A

The function of the lung is to get oxygen into the body and carbon dioxide out

41
Q

Why can large animals not meed their demands by oxygen alone

A

A resting adult needs 250 ml oxygen/minute

This is much more than can be acquired by simple diffusion

42
Q

Describe gas exchange

A

The action of breathing delivers warmed, humidified air to specialised gas exchange surfaces
The heart delivers deoxygenated blood to the pulmonary capillaries
Gas exchange between air and blood occurs by diffusion

43
Q

List some scilliotoxic agents

A

Pollution
Smoke
Damage the cilia

44
Q

How does COPD interfere with the process of gas exchange

A

Over production of mucus
Due to overstimulation by particulate matter
Excess mucous obstructs the airways
Damaged respiratory mucosa

45
Q

What happens to the mucous glands in COPD

A

Mucous gland hyperplasia occurs
Increase in thickness as it is cartilaginous
Can’t expand outwards and so it narrows the airways

46
Q

What else can narrow the airways

A

poor elasticity of alveolar tissue- we need to elucidate the mechanism

47
Q

What happens in pneumonia

A

neutrophils fill the alveoli- unable to take part in gas exchange

48
Q

What happens in P.E

A

No deoxygenated blood delivered to the heart for oxygenation

49
Q

Describe a systematic approach for diagnosing lung diseases

A

First question if result of infection or vascular disorders
If not, then must be airways or small lung disorder
Use spirometry to distinguish airways and small lung (restrictive) disease
When determined, ask if localised/generalised for airways and due to disease inside/outside lungs if restrictive

Respiratory System (23 decks)

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