Topic 3. Chronic Respiratory Diseases

Chronic Respiratory Diseases

long-term, non-curable conditions that mainly affect the respiratory airways and the lung structures

Asthma, Chronic Obstructive Pulmonary Disorder (COPD), Chronic Bronchitis, and Pulmonary Hypertension

Chronic Respiratory Diseases include:

sixth

According to the WHO European Region, CDRs remain the a._____ leading cause of death globally with almost b._____ deaths every year

a = ?

400,000

According to the WHO European Region, CDRs remain the a._____ leading cause of death globally with almost b._____ deaths every year

b = ?

pneumonia

In the country, CDRs, more specifically, a._________, are ranked as the b.____ leading cause of death in the Philippines, with over c.___________ cases as of March 2025.

a = ?

fourth

In the country, CDRs, more specifically, a._________, are ranked as the b.____ leading cause of death in the Philippines, with over c.___________ cases as of March 2025.

b = ?

33,050

In the country, CDRs, more specifically, a._________, are ranked as the b.____ leading cause of death in the Philippines, with over c.___________ cases as of March 2025.

c = ?

4.1%

The most common CRD globally with a worldwide prevalence of a.__ is b._____.

a = ?

Asthma

The most common CRD globally with a worldwide prevalence of a.__ is b._____.

b = ?

Asthma

long-term condition where the airways swell, narrow, and produce excess mucus, making it difficult to breathe.

Genetic Factors

Risk Factors of Asthma:

a. includes family history

b. includes smoke, pollution, or childhood respiratory infections

a = ?

Environmental Exposures

Risk Factors of Asthma:

a. includes family history

b. includes smoke, pollution, or childhood respiratory infections

b = ?

Wheezing Shortness of Breath, Chest Tightness, Persistent Cough

Symptoms of Asthma

no treatment

Treatment for asthma

Trigger

Prevention of Asthma:

a. _________ avoidance

b. Use of ________________________

a = ?

Maintenance or Rescue Inhalers

Prevention of Asthma:

a. _________ avoidance

b. Use of ________________________

b = ?

COPD

In the Philippines, a._____ remains the most prevalent CRD especially in b.___ areas where c.______________ is present.

a = ?

urban

In the Philippines, a._____ remains the most prevalent CRD especially in b.___ areas where c.______________ is present.

b = ?

high levels of air pollution

In the Philippines, a._____ remains the most prevalent CRD especially in b.___ areas where c.______________ is present.

c = ?

Chronic Obstructive Pulmonary Disease (COPD)

significant respiratory challenge characterized by long-term airflow blockage and breathing-related issues.

lung irritants

Causes of COPD:

a. long-term exposure to ________________, most commonly:

1. _______ smoke

2. indoor/outdoor ___________

3. occupational ________________

b. _______ factors

a = ?

tobacco

Causes of COPD:

a. long-term exposure to ________________, most commonly:

1. _______ smoke

2. indoor/outdoor ___________

3. occupational ________________

b. _______ factors

a.1. = ?

air pollution

Causes of COPD:

a. long-term exposure to ________________, most commonly:

1. _______ smoke

2. indoor/outdoor ___________

3. occupational ________________

b. _______ factors

a.2. = ?

dust or chemicals

Causes of COPD:

a. long-term exposure to ________________, most commonly:

1. _______ smoke

2. indoor/outdoor ___________

3. occupational ________________

b. _______ factors

a.3. = ?

genetic

Causes of COPD:

a. long-term exposure to ________________, most commonly:

1. _______ smoke

2. indoor/outdoor ___________

3. occupational ________________

b. _______ factors

b = ?

Persistent, Phlegm-producing Cough, Wheezing, and progressive shortness of breath

Symptoms of COPD

no treatment

Treatment of COPD

smoking cessation

Public Health Factors regarding COPD:

a. emphasize ________________

b. improve _____________

c. implement ______________________ to reduce disease prevalence

a = ?

air quality

Public Health Factors regarding COPD:

a. emphasize ________________

b. improve _____________

c. implement ______________________ to reduce disease prevalence

b = ?

smoke-free campaigns

Public Health Factors regarding COPD:

a. emphasize ________________

b. improve _____________

c. implement ______________________ to reduce disease prevalence

c = ?

Pneumonia

Acute Respiratory Diseases include:

Asthma and COPD

Chronic Respiratory Diseases

Breathing, Oxygen Exchange, and Overall Health

Respiratory Diseases affect:

Infectious

Respiratory Diseases can be:

a. caused by pathogens

b. due to environment/lifestyle

a = ?

Non-Infectious

Respiratory Diseases can be:

a. caused by pathogens

b. due to environment/lifestyle

b = ?

Bacteria

Pathogens of Respiratory Diseases

a. can cause pneumonia and TB

b. can cause influenza

c. less common causative agent

a = ?

Influenza

Pathogens of Respiratory Diseases

a. can cause pneumonia and TB

b. can cause influenza

c. less common causative agent

b = ?

Fungi

Pathogens of Respiratory Diseases

a. can cause pneumonia and TB

b. can cause influenza

c. less common causative agent

c = ?

1-3 days

Incubation Period:

a. Bacteria

b. TB

c. Influenza

a = ?

2-4 months

Incubation Period:

a. Bacteria

b. TB

c. Influenza

b = ?

1-4 days

Incubation Period:

a. Bacteria

b. TB

c. Influenza

c = ?

inflammation of the airways or the narrowing of the air passages

Mechanism of Infectivity:

a. Infection or irritation that leads to the _______________________________.

b. Increased ________________________

c. Impaired _____________ in the lungs

a = ?

mucus production

Mechanism of Infectivity:

a. Infection or irritation that leads to the _______________________________.

b. Increased ________________________

c. Impaired _____________ in the lungs

b = ?

gas exchange

Mechanism of Infectivity:

a. Infection or irritation that leads to the _______________________________.

b. Increased ________________________

c. Impaired _____________ in the lungs

c = ?

Airborne Droplets

Mode of Transmission:

1. includes coughing and sneezing

2. _____ contact

3. ________________ exposure

4. is not involved

1 = ?

Direct

Mode of Transmission:

1. includes coughing and sneezing

2. _____ contact

3. ________________ exposure

4. is not involved

2 = ?

Environmental

Mode of Transmission:

1. includes coughing and sneezing

2. _____ contact

3. ________________ exposure

4. is not involved

3 = ?

Vectors

Mode of Transmission:

1. includes coughing and sneezing

2. _____ contact

3. ________________ exposure

4. is not involved

4 = ?

Biological Factors

Disease Risk Factors:

1. includes age, weak immune system, and pre-existing diseases

2. includes smoking (1st or 2nd hand), poor nutrition, and lack of physical activity

3. includes air pollution (indoor and outdoor) and poor ventilation

4. includes overcrowding, and limited access to healthcare (impoverished areas)

1 = ?

Lifestyle Factors

Disease Risk Factors:

1. includes age, weak immune system, and pre-existing diseases

2. includes smoking (1st or 2nd hand), poor nutrition, and lack of physical activity

3. includes air pollution (indoor and outdoor) and poor ventilation

4. includes overcrowding, and limited access to healthcare (impoverished areas)

2 = ?

Environmental Factors

Disease Risk Factors:

1. includes age, weak immune system, and pre-existing diseases

2. includes smoking (1st or 2nd hand), poor nutrition, and lack of physical activity

3. includes air pollution (indoor and outdoor) and poor ventilation

4. includes overcrowding, and limited access to healthcare (impoverished areas)

3 = ?

Socioeconomic Factors

Disease Risk Factors:

1. includes age, weak immune system, and pre-existing diseases

2. includes smoking (1st or 2nd hand), poor nutrition, and lack of physical activity

3. includes air pollution (indoor and outdoor) and poor ventilation

4. includes overcrowding, and limited access to healthcare (impoverished areas)

4 = ?

Home Environment

ENVIRONMENT:

• areas near a person’s living quarters may have bad air quality, which may lead to indoor air pollution (from cooking, smoking, and tobacco)

• include poor ventilation and overcrowding

Community Environment

ENVIRONMENT:

• areas may have high levels of air pollution due to traffic emissions or industrial pollution from nearby factories such as sugar and plastic factories

Work Environment

ENVIRONMENT:

• dust from construction or mining and chemical/microbiological contamination

vehicle emissions and poor sanitation

ENVIRONMENT:

• In the Philippine Context, there are high levels of ____________________

40 years old

INTRINSIC (BIOLOGICAL) HOST FACTORS:

a. AGE: Risk increases significantly after ____________ because lung function naturally declines with age

b. SE X: Higher susceptibility in ________ are due to smoking the other se x’s susceptibility is rising sharply in the Philippines due to exposure.

c. GENETICS: Conditions such as ___________________________ increased susceptibility to COPD

d. HISTORY OF PULMONARY TB: A major biological host factor as post-TB lung damage makes host highly vulnerable to ___________________________.

e. COMORBIDITIES: ____________________________________________ may worsen respiratory problems.

a = ?

males

INTRINSIC (BIOLOGICAL) HOST FACTORS:

a. AGE: Risk increases significantly after ____________ because lung function naturally declines with age

b. SE X: Higher susceptibility in ________ are due to smoking the other se x’s susceptibility is rising sharply in the Philippines due to exposure.

c. GENETICS: Conditions such as ___________________________ increased susceptibility to COPD

d. HISTORY OF PULMONARY TB: A major biological host factor as post-TB lung damage makes host highly vulnerable to ___________________________.

e. COMORBIDITIES: ____________________________________________ may worsen respiratory problems.

b = ?

alpha-1 antitrypsin deficiency

INTRINSIC (BIOLOGICAL) HOST FACTORS:

a. AGE: Risk increases significantly after ____________ because lung function naturally declines with age

b. SE X: Higher susceptibility in ________ are due to smoking the other se x’s susceptibility is rising sharply in the Philippines due to exposure.

c. GENETICS: Conditions such as ___________________________ increased susceptibility to COPD

d. HISTORY OF PULMONARY TB: A major biological host factor as post-TB lung damage makes host highly vulnerable to ___________________________.

e. COMORBIDITIES: ____________________________________________ may worsen respiratory problems.

c = ?

chronic airflow obstruction

INTRINSIC (BIOLOGICAL) HOST FACTORS:

a. AGE: Risk increases significantly after ____________ because lung function naturally declines with age

b. SE X: Higher susceptibility in ________ are due to smoking the other se x’s susceptibility is rising sharply in the Philippines due to exposure.

c. GENETICS: Conditions such as ___________________________ increased susceptibility to COPD

d. HISTORY OF PULMONARY TB: A major biological host factor as post-TB lung damage makes host highly vulnerable to ___________________________.

e. COMORBIDITIES: ____________________________________________ may worsen respiratory problems.

d = ?

Cardiovascular diseases, asthma, and diabetes

INTRINSIC (BIOLOGICAL) HOST FACTORS:

a. AGE: Risk increases significantly after ____________ because lung function naturally declines with age

b. SE X: Higher susceptibility in ________ are due to smoking the other se x’s susceptibility is rising sharply in the Philippines due to exposure.

c. GENETICS: Conditions such as ___________________________ increased susceptibility to COPD

d. HISTORY OF PULMONARY TB: A major biological host factor as post-TB lung damage makes host highly vulnerable to ___________________________.

e. COMORBIDITIES: ____________________________________________ may worsen respiratory problems.

e = ?

Tobacco Consumption

BEHAVIORAL AND LIFESTYLE HOST FACTORS:

a. the most significant behavioral factor; susceptibility is dose-dependent and can be based on cumulative “pack-years” (ex: smoking 1 pack/day for 20 days)

b. those who are underweight with BMI < 18.5 have weakened respiratory muscle strength and immune function, speeding up progress of the disease

c. most common in populated and dense households

a = ?

Nutritional Status

BEHAVIORAL AND LIFESTYLE HOST FACTORS:

a. the most significant behavioral factor; susceptibility is dose-dependent and can be based on cumulative “pack-years” (ex: smoking 1 pack/day for 20 days)

b. those who are underweight with BMI < 18.5 have weakened respiratory muscle strength and immune function, speeding up progress of the disease

c. most common in populated and dense households

b = ?

Secondhand Smoke Exposure

BEHAVIORAL AND LIFESTYLE HOST FACTORS:

a. the most significant behavioral factor; susceptibility is dose-dependent and can be based on cumulative “pack-years” (ex: smoking 1 pack/day for 20 days)

b. those who are underweight with BMI < 18.5 have weakened respiratory muscle strength and immune function, speeding up progress of the disease

c. most common in populated and dense households

c = ?

Occupational Exposure

OCCUPATIONAL AND ENVIRONMENTAL FACTORS:

a. Especially farmers with dust and pesticides, construction workers with cement dust, and transportation workers with vehicle emissions

b. from traffic and urban pollution to biomass fuels (charcoal, firewood) in rural areas

a = ?

Air Pollution

OCCUPATIONAL AND ENVIRONMENTAL FACTORS:

a. Especially farmers with dust and pesticides, construction workers with cement dust, and transportation workers with vehicle emissions

b. from traffic and urban pollution to biomass fuels (charcoal, firewood) in rural areas

b = ?

Barrel Chest

CLINICAL SIGNS:

a. Abnormal round bulging chest shape (Emphysema)

b. Prolonged exhalation, tachypnea, visible use of neck and shoulder muscles to force air in and out

c. Massive drip in exercise tolerance

a = ?

Altered Breathing

CLINICAL SIGNS:

a. Abnormal round bulging chest shape (Emphysema)

b. Prolonged exhalation, tachypnea, visible use of neck and shoulder muscles to force air in and out

c. Massive drip in exercise tolerance

b = ?

Fatigue and Weakness

CLINICAL SIGNS:

a. Abnormal round bulging chest shape (Emphysema)

b. Prolonged exhalation, tachypnea, visible use of neck and shoulder muscles to force air in and out

c. Massive drip in exercise tolerance

c = ?

Chronic Cough

MAJOR SYMPTOMS:

a. often early, ignored as “smoker’s cough”

b. Persistent and frequent in the morning

c. other symptoms

a = ?

Sputum Production

MAJOR SYMPTOMS:

a. often early, ignored as “smoker’s cough”

b. Persistent and frequent in the morning

c. other symptoms

b = ?

Progressive Dyspnea (SOB) and Chest Tightness and Wheezing

MAJOR SYMPTOMS:

a. often early, ignored as “smoker’s cough”

b. Persistent and frequent in the morning

c. other symptoms

c = ?

Cyanosis

Severe and Late-Stage Indicators:

a. Bluish tint to lips and nail beds indicating hypoxemia (low oxygen levels)

b. Severe weight loss and muscle wasting due to massive burning of calories just trying to breathe.

c. Sudden, severe flare-ups of symptoms

a = ?

Pulmonary Cachexia

Severe and Late-Stage Indicators:

a. Bluish tint to lips and nail beds indicating hypoxemia (low oxygen levels)

b. Severe weight loss and muscle wasting due to massive burning of calories just trying to breathe.

c. Sudden, severe flare-ups of symptoms

b = ?

Acute Exacerbations

Severe and Late-Stage Indicators:

a. Bluish tint to lips and nail beds indicating hypoxemia (low oxygen levels)

b. Severe weight loss and muscle wasting due to massive burning of calories just trying to breathe.

c. Sudden, severe flare-ups of symptoms

c = ?

Spirometry

Diagnosis of COPD:

• only definitive, objective test to confirm a diagnosis of Asthma or COPD. A post-bronchodilator FEV1/FVC ratio of less than 0.70 confirms fixed airflow obstruction

Peak Expiratory Flow Rate (PEFR)

Diagnosis of COPD:

• Handheld device that measures how fast a person can exhale. According to local guidelines, a consistently low PEFR (< 350 L/min for males or < 250 L/min for females) is highly suggestive of COPD

disease management

CRDs’ treatment focuses on ________________________

Symptom Management

Management of CRDs:

a. Relieving daily burdens

b. Ensure patients can continue performing daily activities

c. Stopping severe disease flare-ups

a = ?

Improving Quality of Life

Management of CRDs:

a. Relieving daily burdens

b. Ensure patients can continue performing daily activities

c. Stopping severe disease flare-ups

b = ?

Preventing Exacerbations

Management of CRDs:

a. Relieving daily burdens

b. Ensure patients can continue performing daily activities

c. Stopping severe disease flare-ups

c = ?

Bronchodilators, Inhaled Corticosteroids, System Corticosteroids and Antibiotics, and Mucolytics

Pharmacological Treatments

Smoking Cessation, Pulmonary Rehabilitation, Vaccinations, Long-Term Oxygen Therapy, and Nutritional Support

Non-Pharmacological Treatments

RA 9211: Tobacco Regulation Act of 2003

Government Initiatives to Prevent CRDs:

• Philippines adopted the WHO Framework Convention on Tobacco Control (FCTC) which is a proven global strategy to reduce smoking

RA 10351: Sin Tax Law

Government Initiatives to Prevent CRDs:

• increases taxes on tobacco to reduce consumption and funds health programs

RA 8749: Philippine Clean Air Act of 1999

Government Initiatives to Prevent CRDs:

• regulates emissions and improves air quality

TB-DOTS

Government Initiatives to Prevent CRDs:

• officially managed and coordinated by the DOH through the National TB Control Program

Free or Subsidized Vaccinations in Brgy Health Centers

Government Initiatives to Prevent CRDs:

• for influenza and pneumonia

Health Education

Non-Government Initiatives to Prevent CRDs:

1. ______________ by NGOs and community groups

2. __________________ programs and support groups

3. Advocacy for ______________________________

4. Promotion of ____________________

1 = ?

Smoking Cessation

Non-Government Initiatives to Prevent CRDs:

1. ______________ by NGOs and community groups

2. __________________ programs and support groups

3. Advocacy for ______________________________

4. Promotion of ____________________

2 = ?

clean and safe environments

Non-Government Initiatives to Prevent CRDs:

1. ______________ by NGOs and community groups

2. __________________ programs and support groups

3. Advocacy for ______________________________

4. Promotion of ____________________

3 = ?

healthy lifestyles

Non-Government Initiatives to Prevent CRDs:

1. ______________ by NGOs and community groups

2. __________________ programs and support groups

3. Advocacy for ______________________________

4. Promotion of ____________________

4 = ?

Weak enforcement

CHALLENGES in ADDRESSING the DISEASE

• ___________________ of anti-smoking and clean air laws

Limited funding

CHALLENGES in ADDRESSING the DISEASE

• ____________________ for preventive programs

secondhand smoking

CHALLENGES in ADDRESSING the DISEASE

• Continued exposure to __________________________

High out-of-pocket costs

CHALLENGES in ADDRESSING the DISEASE

• ______________________________ for inhalers and mai

Self-Medication

CHALLENGES in ADDRESSING the DISEASE

• ____________________ instead of professional consultation

Tiis Culture

CHALLENGES in ADDRESSING the DISEASE

• people delay check-ups until severe symptoms develop