Respiratory Diseases

Common symptoms of respiratory disease

Common symptoms of respiratory disease

Chest pain, dyspnea, wheezing, coughing (productive+acute), hemoptysis, fatigue (low O2), fever, dysphonia, cyanosis, sinus and nasal drainage, clubbed fingers and toes (oedema), tachypnea, abnormal breath sounds

MRC Dyspnea Scale

Ranks the ability to breath during movement/excercise in 5 grades. Grade 1 is breathless during strenous excercise and grade 5 is too breathless to leave the house or dress themselves

Diagnose respiratory

Auscultation, percssion, tests to check pulmonary function, sputum analysis, biopsy and imaging

Auscultation process

Listen for bronchial sounds and vesicular breathing. Eg bibasal crepitations

Percussion

Physical examination to check proportion of air to solid tissue and if there is any fluid

Pulmonary function tests

Spirometer, peak flow meter, Arterial blood gases ABG, pulse oximeter, bronchial challenge

Biopsy and imaging

Bronchoscopy, larygoscopy, X-rays. CT. MRI

Exampls of upper respiratory diseases

Common cold, allergic rhinitits, sinusitis, tonsilitis, pharyngitis, laryngiitis

Common cold

Inflammation of mucus membranes of nose, throat, eyes, Eustachian tubes with watery and purulent/pus discharge

At risk for Common cold

Preschool children, exposure to infec ted, immunocompromised, and time of year (Winter and Fall)

Etiology Common Cold

More than 200 viruses, rhinoviruses, and coronavirus. Transmitted by respiratory droplets released through coughs and sneezes, and touching eyes with contaminated hands.

Common Cold Key signs

Sore throat, runny nose, sneeezing, and cough only. Treatment is symptomatic and can heal in around 7 to 10 days. Decongestants, antihistamines, cough supressants, and pain relief

Allergic Rhinitis

Inflamation of mucus membrane of the nasal cavity

Etiology Allergic Rhinitis and Risk

Airbone allergens. Family history, other allergies, and long exposure to airbone particles. Causes the B cell to react to the allergen like an antigen and produce IgE antibodies. The IgE Antibodies attach to mast cells. Mast cells release mediators like histamine and cytokines to create the allergic reaction.

Allergic Rhinitis Sign

Eyes and nose only. Runny nose congestion wattery eyes, and sneezing

Treatment Allergic Rhinitis

Avoid, nasal steroids, allergy shots to reduce sensitivity

Sinusitis

Inflmaation of mucus membrane of sinuses

Etiology and signs Sinusitis

viral infection (like common cold), facial pain, pressure, nasal stuffiness, nasal discharge, loss of smell, cough, congestion.

Diagnosis sinusitis

Nasal endoscopy, imaging tests, nasal and sinus culture, allergy testing, medical history, physical examination

Sinusitis treatment

Symptomatic. Saline nasal spray to flush away, nasal corticosteroid, decongestant, pain releif

Sinusitis prevention

avoid having many upper resp. infection, manage allergies, avoid smoke and pollutants, keep sinus moist (humidifier)

Tonsilitis

Infection inflammation of tonsils

Tonsilitis cause

Bacterial andviral infection like streptococccus Risk with kids, and exposure to infected people.

Tonsilitis signs and diagnosis

Severe sore throat, visible and red swollen tonsils, difficulty swallowing, white or yellow patches on tonsil and fever. Diagnosed by visual examinaiotion and rapid strep test or throat culture

Tonslitis treatment

Depend on cause. Bacteria: antibiotics. Viral: symptomatic treatment. Severe and recurrent inflammation can lead to surgical removal instead

Tonsilitis preventino

Avoid close contact with infected, proper hygene, and handwashing

Pharyngitis

Inflammation of pharynx

Pharyngitis Causes and Risks

Viral infection and bacterial infection. Risk closecontact, immunocompromised, diabetes mellitus, smoking, secondhand smoke.

Pharyngitis Signs

Sore troat, fever, headache, swollen lymph node to reflect infection in pharynx, join pain and muscle aches (common viral infection)

Phrangitis diagnosis

Physical, rapid strep test, and throat culture

Pharyngitis

Depends on pathogen. Bacterial - Antibiotics. Viral - symptomatic. Treat inflammation, flush with salt water, and pain relief

Laryngitis

INflmmation of the larync/voicebox

Laryngitis Causes

Viral and bacterial infection | Risks increase with respiratory infection, exposure to iritiants like smok alchohol, acid , fumes) and oversue of voice.

Laryngitis Signs

Dysphonia, difficulty in swallowing, throat pain amd fever

Laryngitis diagnosis and treatment

Signs, physical, laryngoscopy | Treat the pathogen causing the inflammation, rest the vocal cords, control heartburn, reduce alcohol and smoking. Corticosteroids can be given for inflmmation.

Layrngitis prevention

Good hygene, avoidance of infected, not smoking, and less seconahnd smoke

Upper Respiratory System

Influenza, pneumonia, tuberculosis, COPD, Cystic fibrosis, pheumothorax, pulmonar embolism,lung cancer

Inlfuenza

Acute, contagious respiratory. Caused by influenza virus. High risk for developing flu-rated complications.

Infleunza Risk

Children under 5, Adult over 65, pregnant women, immunocompromised, HIV-AIDS, cancer, or chronic respiratory diseases.

Influenza Signs

Sudden onset. Fever, cough, muscle, body aches, headache, fatigue, chest discomfort. Complications include bacterial pnuemonia, ear infec tion, sinus infections, dehydration, worsening of chronic coniditons

Influenza diagnosis and prevention

Sign and symptomp and diagnostic test for influenza virus. yearly influenza vaccine to anticipate and reduce severity fo infection

Influenza Treatment

Default: 2 weeks. Antiviral medication can be given to help severity, and duration, reduce risk of complication. Symptomatic

Pneumonia

Infection of one or both lungs. Especially in the alveoli as they fill up with pus. Loss of SA for absorption

Pneumonia cases and fatality

3 million cases a year, and 600k/year deaths. Viruses (influenza, parainfluenza, respiratory syncytial viruses) and bacteria (streptococcus pneumonia). Risk increase with age young and old, immune deficiency, chronic diseases, smoking, and dependent on mechanical vantilator

Pneumonia Signs

Cough, fever, chills, dyspnea, chest pain. Auscultation has reducedbreath sounds and presence of crackles, percussion note is dull.

Pneumonia diagnosis

Medical history, physical examination, chest X-ray to show areas of pus, and sputum culture to check what pathogen caused it

Pneumonia treatment

Bacterial: antibiotic Viral: rest, oxygen therapy, more fluids, pain relief

Pneumonia prevention

Yearly vaccinaiton against the flu and pneumococcus. Hygene, no smoking

Tuberculosis

Infection due to mycobacterium tuberculosis. 8.7M cases and 1.4M deaths. Risk increases with immmoncompromised, substance abuse, tobacco, and being in healthcare

Tuberculosis sign and symptom

Latent - asymptomatic. Active - caugh for more than 3 weeks, chest pain, blood or sputum, fatigue, weight loss, no appetite, chills, fever, night sweats. Diminished breath sounds and crackling.

tuberculosis etiology

INhaled bacteria through droplets and infect alveoli. Will take macrophages as host and cause aggregation. INtense inflammation and necorsis in lungs. Making Caseus lesion. Lungs will be fiboritc and calcify to surround bacteria. On X-ray it will show as tubercles.

Tuberculosis diagnosis and tests

Meidcal history, physical examination, TB test (blood or Mantoux skin), Chest X-ray, sputum smear

Tuberculosis treatme t

Best with treatment started early to prevent the caseus lesions in the lungs. Treat with 3 antiobiotics at once

Tuberculosis prevention

BCG TB vaccine, Isolation of patients, treat latent infections, good hygene

COPD

Chornic obstructive pulmonary disease 3rd leading death, 53M worldwide Example: Ephysema and chronic bronchitis

COPD Cause

Tobacoo, secondary smoke, air pollution, chemical fumes, dust. Genetics (alpha-1-trypsin deficinecy)

COPD Signs

Dyspnea, coughing, wheezing, tachypnea, chest tightness. Wheezing or crackles, diminsihed breath sound. Percussion hyper-resonance

COPD Diagnosis

Pulmonary function (FVC FEV1) chest x-ray, CT scane, ABG, hisotyr and physcial examination

COPD Treatment

LIfestyle changes (no smoking, dust, pollution) bronchodilators, inhale steroids for inflammation, suplement oxygen, pulmonary rehabilitiation, and lung transplant.

Pure Chronic Bronchitis

Large airways like bornchi and trachea - mucus hypersecretion, inflammation. Small Airways - peribronchiolar fibrosis, airway obstruction, inflammation

Pure Emphysema

Acinus (end of bronchial tree) lose elastic recoil and small alveoli rupture due to stiffness. Become big air pockets

Cystic Fibrosis

Dysfunction or loss of the CFTR channel, causing body wide effects such as in the exocrine glands of lungs and pancreas. Known for excessive thick mucus. 70k children and adults in the world

Cystic Fibrosis causes

Autosomal recessive inherited gene (CFTR ΔF508) and N. European and Central Europe are more likely

Cystic Fibrosis Signs

Salty Skin, dyspnea, wheezing, persistent cough with thick sputum, recurrent lung infection because mucus is full of glycoproteins | Weight loss and malnutrition, and fatty stool

Cystic Fibrosis Diagnosis

Screening blood sample for IRT (Immmunoreactive trypsinogen) . Confirmation: genetic test or sweat test.

Cystic Fibrosis Treatment

Chest physcial theraphy, excercise to loosen mucus, chest ves tto vibrate mucus out, nutrition theraphy, mucus thinning meds, anti-inflammatory, bronchodilators

Pneumothorax

Gas in the chest or pleural space to cause collapse of all or some lobes of lung.

Pneumothorax Causes

Injury, damage via disease, or rupture of blebs. Idiopathic sometimes. Risk inceases by being male, smoking, tall, underweught, history for pneymothorax

Pneumothorax Signs

Suddent shapr pain lung and dyspnea, diminished or absent breath sound, typmanic percussion sound]

Pneumothorax Diagnosis

ABG, Chest x-ray, physical examination

Pneumothroax treatment

If small, monitoring is enough. If large, presssure relieved using needle or tube. Sugery can be used to close leak

Traumatic vs Spontaneous pneumothorax

Penetrating or non penetrating chest injury, but, others can be due to rupture of bleb on surface of lung. Breaking barier between pleural and lungs.

Pneumothorax priamry vs secondary

Primary occurs in healthy people, econdary is collapse due to underlying lung disease lik emphysema (alveoli ruptures)

Pneumothorax simple vs tension

Open vs valvular. Simple is when air is able to move in and out of pleural cavity. Tension is when the intrapleural pressure is more than atmosphirc pressure due to inability to move air out. Pressure compounds causing sustained collapsed

Pulmonary embolism

Blockage of one or more arteries of the lung. 300-600k paitents per year

Pulmonary Embolism Causes and risk

Prolonged immobility, having major surgery, hip or lef fracture, family history for PE, cancer, smoking, obesity, heart attack or stroke, pregnancy, brith control pills, hormone therapy

Pulmoanry embolism signs

Sudden dyspnua, tachypnea, chest pain, coughing that release bloody sputum.

Pulmonary embolism Diagnosis

Medical history, physclal examination, imaging tests. Auscultation craclles and pleural rub at site of embolism

Pulmonary Embolism Treatment

Anticoagulants and thrombolytics drugs. Most severe can have clot dissolvers and surgery

Pulmonary embolism prevention

Avoid being sedentary for long time, be more mobile after surgery, elastic compression stockings, adequote fluid