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Respiratory system > why study lung disease > Flashcards

why study lung disease Flashcards

1
Q

what is the study of lung disease

A

concerned with function and dysfunction of lungs and structures around the lungs and pulmonary vasculature

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2
Q

parameters of burden

A

mortality
morbidity - hospital admissions, GP consultation rates, time off
morbidity - years lived with disability (as in a study)
is it generalisable

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3
Q

change in levels of diabetes and alzheimers

A

increase

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4
Q

change in level of diarrhoeal illness

A

decrease

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5
Q

burden of lung disease

A 
£11 billion annum
£9.9billion for england alone 
1 in 5 people in England affected 
3rd biggest cause of death 
hospitalisations risen over 7 years 3x rate of all admissions - better at keping people out of hospital for different things
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6
Q

cause of increased burden of lung disease in september

A

asthma

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7
Q

cause of increased burden of lung disease in oct-feb

A

COPD and pneumonia exacpeated

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8
Q

how many people with COPD exacerbation have not been previously diagnosed

A

1/3

missed opportunity for prevention

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9
Q

NHS england view

A

reduce variation in spirometry tetsing across teh country

more staff in primary care trained to provide specialist input to interpret results

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10
Q

results of secret spirometry study

A

only a few people noticed when there was severe obstructive lung disease
60% people with obstructive airways didnt receive bronchodilators
very easy to overlook disase if you dont do the test
1/3 people on drugs found not to have disease - waste of money

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11
Q

UK’s respiratory mortality in comparision to other places

A

worse

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12
Q

regional variation of lung disease

A

different diagnostic rate of sleep apnea

5/6 fold difference in asthma hospitalisation rate - not on optimal treatment

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13
Q

commonest lung disease in order

A 
asthma 
COPD 
bronchiolitis 
obstructive sleep apnoea 
sarcoidosis 
lung cancer 
idiopathic pulmonary fibrosis
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14
Q

respiratory death in UK

A

kills 1 in 5 people

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15
Q

asthma mortality and prevalence

A 
high prevalence 
low mortality (it should be even lower with the treatment available)
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16
Q

mortality of COPD and lung cancer from 1990 to 2020

A

increasing

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17
Q

death from lung cancer

A

biggest cancer killer
awful 5yr survival rate
even though more people have breast cancer

18
Q

lung cancer in the UK

A 
46000 new cases a year 
35900 deaths yr - 98 daily 
<5% survive 10yrs 
86% preventable 
some have it and dont smoke
19
Q

one and 2 year survival of lung cancer

A

improving

20
Q

lung cancer prediction for 2035

A

fall by 21% to 58deaths per 100000 people by 2035

because of reduced rates of smoking, earlier diagnosis and better treatment

21
Q

smoking prevalence

A

from 46% in 1974 to 19% in 2014

average consumption 11 a day = lowest for years

22
Q

what are restrictive disorders

A

small lungs

disease in or out of the lung

23
Q

order of thought when suspect lung disease

A

infection
pul vascular disorder - spirometry distinguish from infections
then is it restrictive disorder or an airway disease (obstruction)

24
Q

what is happening with mesothelioma now

A

epidemic
asbestos related malignancy terrible prognosis of lining off lungs
reflect exposue to asbestos years ago

25
Q

pulmonary embolism

A

biggest cause of death in childbirth
vessel obstructed
complicate immobility

26
Q

obesity

A

restrict size of the lung

causes increased respiratory workload, respiratory dysfunction, and risk of asthma and sleep related breathing disorders

27
Q

idiopathic pulmonary fibrosis

A

35% increase in diagnosis between 2000 and 2008
median survival 3 yrs from diagnosis - more people know about it
poor prognosis than colon, breast or ovary cancer
need more research

28
Q

sleep apnoea

A

6x normal risk of having car crash
public health concern - interfere with the ability to work
recession of the ribcage - muscle moves in and causes obstruction of the airways
every 45s
big tongue, obese, receding jaw - obese are the biggest group

29
Q

symptoms of lung disease

A 
breathlessness
cough
sputum production
haemoptysis
chest discomfort 
wheeze or musical breathing
stridor 
hoarseness 
snoring history/daytime sleepiness 
weight loss
anorexia 
fever
30
Q

what is breathlessness

A

dyspnoea

sensation of difficult, uncomfortable or laboured breathing

31
Q

cause of breathlessness

A

lung disease
heart disease
pulmonary vascular disease
neuromuscular disease - eg diaphragm weakness, bowel push up diaphragm - cant breath properly when lying down
systemic disorders - anaemia, hyperthyroidism, obesity

32
Q

when do you check the causes of breathlessness

A

always, even if already have one of these diagnoses- might be a different one this time

33
Q

function of lungs

A

get O2 into the body and CO2 out

34
Q

why cant we use diffusion

A

resting adult needs 250ml O2/min

more than can get from diffusion

35
Q

describe gas exchange

A

the airway branch to gas exchange surfaces
action of breathing delivers warm, humidified air to gas exchange surfaces
heart delivers deox blood to pul capillaries
GE occurs by diffusion

36
Q

effect of COPD on GE

A

damaged respiratory mucosa
ciliotoxic
more mucous - it is over produced and because ciliotoxic it cannot be removed as well
excess mucous obstruct airways
mucous gland hyperplasia - wall is cartilaginous so cant expand so restrict the lumen
radial refraction of elastic tissue

37
Q

effect of lung damage on the airways

A

the walls are thicker - mucous

38
Q

foreign bodies

A

can cause infection

39
Q

pneumonia

A

airsacs not available because full of neutrophils, inflammatory cells and bacteria,

40
Q

asbestos

A

fibrosis

destroys air sacs

41
Q

first steps in diagnosis

A

take a history and examine the respiratory system

42
Q

bronchiolitis

A

dilatation of bronchi

infection and suppuration

Respiratory system (23 decks)

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