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  • 1. • Chronic obstructive pulmonary disease (COPD) Chronic obstructive pulmonary disease is a common condition occurring in 17% of men and 8% of women between the ages of 45 and 64 years. It could perhaps more correctly be called “chronic bronchitis and emphysema” because both conditions coexist in all patients with COPD, to varying degrees. Virtually confined to smokers, mortality from COPD is related to the number of cigarettes smoked per day.
  • 2. • Defining COPD • COPD involves two diseases that are related; bronchitis and emphysema. Both bronchitis and emphysema involve a chronic obstruction of airflow out of a person's lungs which is commonly both permanent and progressive over time. Asthma; another pulmonary disease involving obstruction of airflow out of the lungs, is unlike chronic bronchitis or emphysema in that asthma is commonly reversible. Airflow between asthma attacks is usually good. • Causes of COPD • The main cause of COPD in America is smoking; approximately ninety-percent of persons with COPD have it because of smoking. While not all people who smoke go on to develop COPD, it is estimated that approximately fifteen-percent of smokers will. People who smoke and have COPD experience higher death rates that nonsmokers who have COPD, as well as experiencing more frequent symptoms such as shortness of breath, coughing, and lung deterioration. The effects of second-hand exposure to tobacco smoke are not well-known, although there is evidence suggesting that asthma, and respiratory infections are more common among children and others who do not smoke in households where there is a smoker present.
  • 3. What is Asthma? Simply put, asthma narrows the tubes present in the lungs during an acute attack, which makes it more difficult for the sufferer to breathe. Three factors affect this spasmodic reaction in the lungs' tubes. In addition, because sufferers are struggling to breathe, muscles in the throat also contract during an attack, and edema may also occur (basically, swelling), which makes it even more difficult to breathe. Mucus may also build up because mucus occurs as a reaction to irritants and tries to act as a buffer or coating to both remove any irritant and to soothe the underlying tissue. This constitutes an asthma attack. Asthma attacks be relatively benign or very severe. Simply relaxing and breathing through an attack calmly may be enough to thwart it, perhaps with use of an inhaler. Experienced asthma sufferers know that it helps to be calm during an attack, in order to make symptoms less severe and go away more quickly. Inexperienced sufferers, or those prone to nervousness anyway, may experience panic attacks, which would make the asthma attacks even more severe. The harder you try to breathe, the harder it becomes. You may truly feel as though you are drowning.
  • 4. • Reason 1 - Allergic Rhinitis • The cause of asthma is also known as a trigger and one trigger is rhinitis. Allergic rhinitis is excessive discharge of mucus glands in the nose, congestion of the veins in the nasal cavity that can cause blockage of nasal airflow and cause irritation of the sensory nerves in the nose and throat. • Reason 2 - Heredity Cause • Heredity is a big cause of asthma in children. The tendency to become allergic is inherited and is controlled by genes that only influence the production of an antibody called IgE. However, you will only develop an allergic inherited allergy if exposed to those certain inherited genes, if you are never exposed you will never develop a cause of asthma.
  • 5. Common Ailments of the Respiratory System • The respiratory system if not well taken cared of will develop some respiratory ailments. These ailments are: • 1. Nosebleeding is also called epixtaxis. This may happen due to • a. Picking the mucous • b. Breathing very dry air • c. Common colds • d. High blood pressure • When nosebleeding occurs, the best thing to do is sit up and lean forward rather than lie down. This will help lower your blood pressure and allow the blood to flow out of your nose rather than your throat.
  • 6. • What to learn • Diagnostic definitions – clinical history for bronchitis and pathological for emphysema. • Symptoms and signs, and the two subtypes of patient: pink puffers and blue bloaters. • Management of acute exacerbations and long-term prophylaxis. • Interpretation of arterial blood gas results.
  • 7. • Asthma Asthma is a common chronic inflammatory condition of the airways that causes reversible obstruction. The airways are characteristically hyperresponsive to a wide range of stimuli. Edema, smooth muscle hypertrophy, and mucous plugging cause obstruction. • What to learn • Classification into extrinsic and intrinsic asthma, and the triggering, exacerbating and relieving factors • Structural changes that occur in the airway, and their clinical features • Emergency management of acute asthma • Medical management of chronic asthma and inhaler technique •
  • 8. • Lung cancer Bronchogenic carcinoma is the most common cause of death from cancer in the UK, affecting 30,000 people per year. Males are • What to learn affected more often than • The four main histological types: females, but an increasing squamous cell (50%), small cell incidence is occurring in women. (20%), adenocarcinoma (20%) and Peak incidence is between 40 and large cell anaplastic (10%). 70 years of age. The UK has the highest incidence of this disease • Risk factors, clinical features and prognosis for each type. in the world. • Symptoms and signs of pulmonary involvement, local spread, metastatic spread, and endocrine and neurological syndromes. • Management and palliation.
  • 9. • Pneumonia Pneumonia is defined as the consolidation of lung tissue caused by formation of intraalveolar inflammatory exudates as a result of a lung infection. This must be visible on X-ray to be properly called pneumonia, as opposed to ‘chest infection’. Pneumonia is the fifth most common cause of death, according to US data. • What to learn • Predisposing factors to chest infection and pneumonia. • Common causative organisms and the distinction between community-acquired and hospital-acquired pneumonia. • Diagnostic and pathological features of bronchopneumonia, lobar pneumonia and atypical pneumonia. • The special features of pneumonia in immunocompromised patients. • Appropriate antibiotic use for the various types of pneumonia.
  • 10. • Pulmonary tuberculosis (TB) This is a chronic granulomatous infection of the lung caused by Mycobacterium tuberculosis. It is uncommon in the UK, with an incidence of 7 per 100,000 per year, but is extremely common worldwide. Pulmonary TB is a very common exam topic because of the increasing incidence in elderly, immunocompromised, and homeless people, and the emergence of drug-resistant strains. • What to learn • Risk factors for infection and routes by which the organism can be spread. • Pathogenesis: primary and secondary TB; the histopathological sequence of events that leads to granuloma formation. • Symptom, signs and diagnosis of TB. • Nonpulmonary TB. • Drug treatments for TB, public health measures to prevent spread and the problems of ensuring compliance with treatment. •
  • 11. • Cystic fibrosis Cystic fibrosis is a hereditary disease characterized by the production of abnormally thick mucus due to the presence of an abnormal transmembrane chloride ion transporter. It primarily affects the lung and pancreas. It is the most common autosomal recessive disorder, affecting 1 in 2000 newborns. Cystic fibrosis is a common exam topic. • What to learn • Pathogenesis: learn the genetic and molecular mechanisms and the physiological effects that produce the clinical features of the disease. • Symptoms, signs and methods of diagnosis. • Prognosis and management of the pulmonary and pancreatic effects of the disease •
  • 12. • Diffuse interstitial diseases (alveolitis) These diseases comprise a group of noninfectious, nonmalignant disorders in which there is inflammation of the alveolar walls with a thickening of the interstitium between the alveoli, usually with fibrosis. Learning about the features of the general disease process and one or two of the conditions in more detail is worthwhile. What to learn • Histopathological changes for this general group of diseases, and management, which is similar for all of them. • Symptoms, signs and diagnostic features of interstitial diseases. • The three main causes of chronic pulmonary fibrosis: (1) idiopathic (sarcoidosis and cryptogenic fibrosing alveolitis); (2) dust inhalation, which might be inorganic (coal workers’ pneumoconiosis) or organic (farmers’ lung); and (3) iatrogenic (radiation pneumonitis or drug-induced by amiodarone or anticancer drugs). •
  • 13. • Pneumothorax Pneumothorax is the presence of air in the pleural cavity. It is common and can be spontaneous or caused by trauma. The severity can range from mild to life threatening. • What to learn • Causes of pneumothorax: spontaneous (idiopathic or secondary to underlying disease) and traumatic (accidental or iatrogenic). • Diagnosis and assessment of severity. • Management and risks of recurrence. •
  • 14. • Reason 3 - Bronchial Irritability • Bronchial irritability is the basic cause of asthma problems. The inflammation of the bronchial walls causes loss of protective cells from mucosa therefore exposing sensitive nerve endings to the affected area. This is probably a direct result of genetics. • Other Causes • Besides the top 3 reasons, there still other thing we should know that bring on an asthma attack. Dogs and cats cause asthma attacks in some people. Tobacco smoke, cold air, exercises and even laughing can cause attacks. • Exposure to certain things in your work environment is another cause of asthma in adults who never suffered a day in their life from asthma suddenly develops asthma.
  • 15. • Chronic Obstructive Pulmonary Disease (COPD) - Irritation of the lungs can lead to asthma, emphysema, and chronic bronchitis and people can develop two or three of these together. • Chronic Bronchitis - Any irritant reaching the bronchi and bronchioles will stimulate an increased secretion of mucus. In chronic bronchitis the air passages become clogged with mucus, and this leads to a persistent cough. • Emphysema - The delicate walls of the alveoli break down, reducing the gas exchange area of the lungs. The condition develops slowly and is seldom a direct cause of death.
  • 16. • Asthma - Periodic constriction of the bronchi and bronchioles makes it more difficult to breathe. • Pneumonia - An infection of the alveoli. It can be caused by many kinds of both bacteria and viruses. Tissue fluids accumulate in the alveoli reducing the surface area exposed to air. If enough alveoli are affected, the patient may need supplemental oxygen. • Disorders of the respiratory system are usually treated internally by a pulmonologist or respiratory physician. • Asthma Allergies Bronchial
  • 17. • Pneumonia is an inflammatory illness of the lung(s). Pneumonia can result from a variety of causes, including infection with bacteria, viruses, fungi, or parasites, and chemical or physical injury to the lungs. Prior to the discovery of antibiotics, one-third of all people who developed pneumonia subsequently died from the infection, • Symptoms associated with pneumonia include cough, chest pain, fever, and difficulty in breathing. Diagnostic tools include x-rays and examination of the sputum. Treatment depends on the cause of pneumonia; bacterial pneumonia is treated with antibiotics.