Summary: Respiratory System

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• 1 Respiratory System

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• Asthma, diagnostic methods

  Measurement of serum IgE levels.
  sputum eosinophilia (# high in asthma patients) is a possible method.
  Lung function tests:
  

  • spirometry
    

  • Peak expiratory flow rate on waking (without bronchodilator) and before bed after bronchodilator (demonstrating airflow limitation)
    

  • Carbon monoxide transfer test
    

  • Exercise test
    
  • trial of corticosteroids (should improve FEV1)
    

  skin-prick test (identify allergic cause)

• Asthma, therapy/treatment

  Diet: fruits have a protective effect due to their antioxidant properties. Genetic variants in antioxidant enzymes are associated with severe asthma.
  
  Inhibition of mast cells by special antiinflammatory drugs.
  occupational asthma patients should avoid exposure.
  Active Smoking and passive smoking should be avoided as well as beta blockers.
  Avoid causatives allergens such as pets.
  Use of therapeutic agents delivered as aerosols or powders directly into lungs.
  Use of bronchodilator containing ß2-adrenoceptor agonist for relieving symptoms

• Bronchitis, diagnostic methods

  Measuring number of neutrophils (increased)
  Lung function test: see Asthma

• Bronchitis, therapy/treatment

  usually antibiotics and rest in normally healthy patients.
  
  chronic bronchitis often treated with oxygen supplementation and inhaled steroids

• Emphysema, diagnostic methods

  Staining of the bronchial mucosa → Increased numbers of mucus-secreting goblet cells in the bronchial mucosa
  
  Lung test functions showing evidence of airflow limitation
  
  Chest x-ray and high resolution CT scans
  
  Test for infections which can exacerbate COPD
  Alpha1-Antitrypsin deficiency
  
  History of breathlessness and sputum production  

• Emphysema, therapy/treatment

  Stop smoking
  Vaccination against pneumococcal and influenza
  Bronchodilator
  Pulmonary rehabilitation
  Lung reduction surgery or single lung transplantation

• Pleural effusion, explanation

  Excessive accumulation of fluid in the pleural space  

• Pleural effusion, underlying cause

  • Occurs with pneumonia, pulmonary infarct and carcinoma
    
  • Heart failure
    
  • Hypothyroidism
    
  • Hypoproteinaemia
    
  • Ovarian tumours

• Pleural effusion, main symptoms

  • Localised inflammation producing sharp localized pain
    
  • Pain is worse on deep inspiration, coughing, and twisting/bending movements
    

• Pleural effusion, diagnostic methods

  Detected on x-ray when 300mL or more fluid is present