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CommonDiseases

oftheRespiratorySystem

TherespiratorysystemdiseasesareverycommonSocialandenvironmentalfactorsareimportantcausesRespiratorySystemDiseasesInflammatorydiseasesBronchialasthma

ChronicobstructivepulmonarydiseaseInfectiousdiseasesPneumonia

BronchiectasisOthers

LungcancerInterstitiallungdiseases

BronchialasthmaOverviewOneofthemostcommonchronicdiseasesworldwidePrevalenceincreasinginmanycountries,especiallyinchildren

Amajorcauseofschool/workabsenceTotalestimatedcostofasthmawas$6.2billion/yearintheworldAsthma:Definitionachronicinflammatorydisorderoftheairways

manycellsandcellularelementsplayarole

mastcells,eosinophils,Tlymphocytes

Thisinflammationcausesanassociatedincreaseinairwayhyperresponsivenessthatleadstorecurrentepisodesofwheezing,breathlessness,chesttightness,andcoughing,particularlyatnightorintheearlymorning

Asthma:EtiologyGeneticfactorsainheritabledisorderAtopyAirwayhyperresponsivenessEnvironmentalfactors(triggers)Asthma:pathogenesisAirwayinflammation(inflammatorycells)Airwayremodelling(airwaysmoothmuscle)AirwayhyperresponsivenessAllergicresponseneurogenicdysregulationandreceptordysregulationAsthma:pathogenesis

Asthma:symptomsandsigns

Symptoms:coughingwheezingshortnessofbreathchesttightnesssputumproductionSigns:Diffusing,expiratorywheezingProlongedexpiration

Asthma:lungfunctionBronchialprovocationtest(BPT):>15%decreaseinFEV1afterinhalationofspecificagentsBronchialdilationtest(BDT):>12%increaseinFEV1,and>200ml,15minutesafterinhalationofashortacting2agonistPEF(peakexpiratoryflow)>20%PEFvariability(AM:PM)

Asthma:Labexamination

BloodtestsArterialbloodgasanalysisSputumstudiesChestX-rayElevationinserumIgElevelsPositiveskinprickteststocommonantigens

Asthma:Diagnosis

symptomssignslungfunctionchestradiography

Asthma:Evaluationnon-exacerbationintermittent,mild,middle,severeexacerbationmild,middle,severe,veryseveren

Asthma:Treatment

RescueTreatmentβ-AdrenergicagonistTheophyllineAnticholinergicsContrllerTreatmentInhaledcorticosteroidsSystemiccorticosteroidsLong-actingβ-agonistsLong-actinganticholinergicsAntileukotrinesMonoclonalantibodytreatmentAsthmacannotbecured,butcanbecontrolled.AsthmaintheEmergencyDepartmentDrugsOxygenVentilation

Asthma:Treatment

ChronicObstructiveLungDisease

(COPD)OverviewTheprevalenceis8-10%inpeopleabove40yearsPersistentandirreversibleairwayobstructionIncludingchronicbronchitisandemphysemathemostcommomcauseforrespiratoryfailure

ChronicBronchitis:AetiologyandDefinition

Definition:Persistentproductivecoughforatleast3consecutivemonthsinatleast2consecutiveyearsCauses:CigarettesmokingAirpollutionsandweatherchangeInfectionsAllergicfactors

:

ChronicBronchitis:Pathogensis

Hypertrophyandhypersecretionofmucousgland,beginninginthelargeairways,bronchiolescanbeinvolvedGobletcellmetaplasticformationInjureofmucosaandthewallofthebronchusInflammatorycellsinfiltrationSymptoms:CoughMucusormucopurulentsputumWheezle

ChronicBronchitis:ClinicManifestation

Emphysema:Definition

Emphysemaischaracterizedbypermanentenlargementoftheairspacesdistaltotheterminalbronchiolesaccompaniedbydestructionoftheirwalls

Emphysema:PathologyAlveolaremphysema:CentriacinarPeriacinarPanacinar

Emphysema:PathogenesisCough(withbronchitis)Purulentsputum(withbronchitis)DyspneaChesttightnessCynosis

Emphysema:ClinicalmanifestationChestradiography:empysemaorpulmonarybullaLungfunctionobstrutctivepattern,FEV1/FVC<70%aftertheinhalationofbronchdilator,BDTnegative

Emphysema:Labexamination

ChronicbronchitisvsEmphysema

COPD:Diagonsis1.Historysmokinghistory,airwayinfectionhistory2.symptoms3.lungfunctiontest4.chestradiography

COPD:Therapy

Preventionisthemostimportant!StableDiseaseBronchodilatorsCorticosteroids(theless)OxygenPulmonaryRehabilitationExacerbationsAntibioticsCorpulmonale

Definition

Italsocalledpulmonaryheartdisease,isusedtodescribediseaseoftheright-sidecardiacchamberscausedbypulmonaryhypertensionresultingfrompulmonaryparenchymalorpulmonaryvasculardiseasesDisordersthatpredisposetocorpulmonale

Diseasesofthelungs

Chronicobstructivelungdisease

DiffusepulmonaryinterstitialfibrosisExtensive,persistentatelectasisCysticfibrosis

Diseasesofpulmonaryvessels

PulmonaryembolismPrimarypulmonaryvascularsclerosisExtensivepulmonaryarteritisDrug-,toxin-,orradiation-inducedvascularsclerosis

DisordersaffectingchestmovementPulmonaryhypertensionPulmonaryhypertensionPulmonaryhypertensionHeartchangesrightventricularhypertrophyrightventriculardilationrightheartfailure

leftheartfailureClinicalcourseSymptomsofprimarypulmonarydiseaseProgressiverightcardiacfailureandrespiratoryfailureCompensatorystageDecompensatorystage

ComplicationsPulmonaryencephalopathyAcid-baseimbalanceandelectrolytedisturbanceArrhythmia

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