Common Respiratory Diseases

August 4, 2024 All Leave a comment 22 Views

Table of Contents

Common Respiratory Disease Details

Common Respiratory Disease. Mobile Phone Number 01797522136, 01987073965. Common Respiratory Diseases are Common cold, Influenza, Acute Laryngeal Obstruction, Acute bronchitis, COPD, Bronchial Asthma, Respiratory failure, Pneumonia,

Bronchiectasis, Pulmonary tuberculosis, Pleural effusion, Pneumothorax, Hemothorax, etc. For details about common respiratory diseases, some courses are available at HRTD Medical Institute. These courses are Paramedical, Diploma Medical Assistant, Diploma in Medicine and Surgery, Diploma in Medicine and Diploma in Surgery.

1. What are the common respiratory diseases?

Common Respiratory Diseases are:

Common cold
Influenza
Acute Laryngeal Obstruction
Acute Bronchitis
Chronic Obstructive Pulmonary Disease (COPD)
Bronchial Asthma
Respiratory Failure
Pneumonia –
- Acute Lobar Pneumonia (Pneumococcal Pneumonia)
- Suppurative Pneumonia
Bronchiectasis
Pulmonary Tuberculosis
- Primary Tuberculosis
- Post Primary Tuberculosis
Pleural Effusion
Spontaneous Pneumothorax
Pulmonary Aspiration Syndrome

2. Common Cold কি? Common Cold এর কারন, লক্ষন, চিকিৎসা উল্লেখ কর।

Common cold is the most common respiratory disease. Common cold হচ্ছে upper respiratory tract এর একটি viral বা bacterial disease যার লক্ষনগুলি হচ্ছে মাথা ব্যাথা, নাক বন্ধ হওয়া, নাক দিয়ে পানি বা plurent বের হওয়া ইত্যাদি।

Causes of common cold

Viral infection – (Rhinovirus, adenovirus, echovirus, syncytial virus. Rhinoviruses are the most common.)
Bacterial infection – (Purulent nasal discharge থাকবে)

Common cold এর লক্ষনসমূহ

নাক দিয়ে পানি বা পুঁজের মত বের হওয়া।
নাকের ভিতর জ্বালা যন্ত্রনা করা।
মাথা ব্যাথা ও শরীর ম্যাজ ম্যাজ করা।

Treatment of common cold

Tab. Paracetamol
Tab. Azithromycin
Tab. Azithromycin (Bacterial infection থাকলে)
Nasal drop Antazole
Tab. Vitamin – C

3. Influenza কি? Influenza এর কারন, লক্ষন ও চিকিৎসা উল্লেখ কর।

Influenza is a common respiratory disease. Influenza হচ্ছে একটি viral disease যা Myxovirus দ্বারা infection এর ফলে হয়ে থাকে এবং যার লক্ষনগুলি হচ্ছে হঠাৎ গা ম্যাজ ম্যাজ এবং ব্যাথা, জ্বর, শীত শীত অনুভূতি ও দেহের অনৈচ্ছিক কম্পন।

Cause of influenza: Viral infection (Myxoviruses)

Clinical features of influenza

হঠাৎ গা ম্যাজ ম্যাজ করা ও মাথা ব্যাথা
Fever up to 104° F
শীত শীত অনুভূতি ও আক্ষেপমূলক শরীর কম্পন (chill)
সমস্ত শরীর ব্যাথা
Anorexia, Nausea, Vomiting
Dry cough with harshness

Treatment of influenza

Complete bed rest
Tab. Paracetamol
Tab. Antihistamine (to reduce irritation, sneezing and secretion)
Nasal drop Xylometazoline (nasal congestion থাকলে)
Sore throat থাকলে warm saline gurgling

4. Acute Laryngeal Obstruction (ALO) কি? ALO এর কারন, লক্ষন ও চিকিৎসা উল্লেখ কর।

Acute Laryngeal Obstruction হচ্ছে একটি life threatening emergency condition। যদি total obstruction ঘটে তবে ৩ মিনিটের মধ্যে রোগী মারা যেতে পারে।

Causes of ALO

A) Traumatic causes –

Strangulation (শ্বাসরুদ্ধ)
Laceration (ছেদ, খন্ড বিখন্ড)
Foreign body inhalation
Burn (পুড়ে যাওয়া)
Irritant gases

B) Inflammatory causes –

Acute epiglottitis
Laringo trachio bronchitis
Diphthesis
Angioneurotic edema
Tumors

Treatment of ALO

Better air way সুনিশ্চত করা
Oxygen দিতে হবে
Tracheostomy-যদি cyanosis এবং pulse rate বৃদ্ধি পায়
Hydrocortisone and Adrenaline (in angioneurotic edema or post-radiotherapy edema)

5. Acute bronchitis কি? Acute bronchitis এর কারন, লক্ষন ও চিকিৎসা উল্লেখ কর।

Acute Bronchitis is a Respiratory Disease. Bronchus এ inflammation হলে তাকে bronchitis বা acute bronchitis বলে।

Causes of acute bronchitis

Viral infection (Influenza virus A and B, Para influenza virus, Respiratory syncytial virus, Adenovirus, Rhinovirus)
Bacterial infection (streptococcus pneumoniae, H influenza)

Clinical features of acute bronchitis

Irritating unproductive cough
Mucoid or mucopurulent sputum, occasionally with streaks of blood.
Chest tightness
Wheezing respiration with dyspnoea
Fever up to 103°F, কিন্তু সবসময় fever থাকে না
Occasionally cyanosis

Investigation

Neutrophil Leukocytosis in blood
Sputum for gm. Staining and culture may be Positive
X-ray chest (to exclude other disease)

Treatment of acute bronchitis

Azithromycin
Paracetamol (জ্বর থাকলে)
Desloratadine
Bronchodilator (airway obstruction)
Expectorant
O2 inhalation (in emergency)

6. COPD কি? COPD এর কারন, লক্ষন, ও চিকিৎসা উল্লেখ কর।

COPD is a Respiratory Disease. Chronic Obstructive Pulmonary Disease কে সংক্ষেপে COPD বলে।COPD is a chronic, slowly progressive pulmonary obstructive disorder, characterized by airflow obstruction which doesn’t change markedly over several months and may be partially reversible by bronchodilator therapy

COPD includes –

Chronic bronchitis
Emphysema
Some cases of chronic asthma

Causes of COPD

Cigarette smoking (most important cause)
Dusty or air-polluted environment
Alpha antitrypsin deficiency (cause of emphysema)

Clinical features of COPD

A long history of suffering
History of cigarette smoking
History of living in a dusty or air-polluted environment
Presenting features are s –
- Chronic cough with sputum (chronic bronchitis)
- Dyspnoea (in emphysema)

Treatment of COPD

Bronchodilator therapy
Corticosteroid therapy
Azithromycin (infection থাকলে)
Cough suppressant or sputum liquefier

7. Mention the investigation of COPD and describe it shortly.

investigation of COPD:

Chest X-Ray
Blood hematocrit
Sputum for gm stain and C/S
ECG
Echocardiogram
Alpha- Antitrypsin
Pulmonary function test

Description:

Chest X-Ray -Usually normal But in typical case-Over inflation of lungs with low, flattened diaphragm.
Blood hematocrit- Hemoglobin level and PCV usually elevated to secondary polycythemia
Sputum for gm stain and C/S – Bacterial infection
Echocardiogram-May be done to assess cardiac function
ECG-Finding may correlate with cardiac changes
Alpha-Antitrypsin ( in case of emphysema) normal range 2-4 gL-1
Pulmonary function test finding of airflow limitation

8.Chronic bronchitis কি? Chronic bronchitis এর কারন, লক্ষন, ও চিকিৎসা উল্লেখ কর।

Chronic bronchitis is a Respiratory Disease. Chronic bronchitis হচ্ছে এক ধরনের COPD বা chronic obstructive disease. (এতে দুই বৎসরের বেশী কাল থেকে পরপর তিন মাসের অধিকাংশ দিনগুলিতে কাশির সাথে অতিরিক্ত sputum বের হতে থাকে)

Causes of Chronic Bronchitis

Cigarette smoking
Dusty or air-polluted environment

Clinical features of chronic bronchitis

A long history of suffering
History of cigarette smoking
History of living in a dusty or air-polluted environment
Presenting features are-chronic cough with sputum

Treatment of chronic bronchitis

Bronchodilator therapy
Corticosteroid therapy
Azithromycin (Infection থাকলে)
Cough suppressant of sputum liquefier

9. Pulmonary emphysema কি? Pulmonary emphysema এর কারন, লক্ষন ও চিকিৎসা উল্লেখ কর।

According to the American Thoracic Society, emphysema can be defined as “abnormal permanent enlargement of air spaces distal to the terminal bronchioles with destruction of their walls and without obvious fibrosis.”

Clinical features of pulmonary emphysema

Long history suffering
History of cigarette smoking in most cases
Chronic cough with sputum production and dyspnoea
Rhonchi and prolonged expiration

Treatment of pulmonary emphysema

Antibiotic Cefuroxime + Clavulanic acid or Amoxicillin + Clavulanic acid
Bronchodilator
Corticosteroid
Physiotherapy

Adv. Bronchial irritation must be reduced.

eg. By avoiding smoking, dusty and air polluted environment.

10. Bronchial Asthma কি? Bronchial Asthma এর কারন এবং precipitating factor গুলি কি কি?

Bronchial Asthma is a Respiratory Disease. Paroxysms (sudden recurrent attack) of breathlessness, chest tightness, and wheezing resulting from narrowing of the airways by a combination of (i) muscle spasm (ii) mucosal swelling, and (iii) viscid bronchial secretion – is called bronchial asthma.

Causes of bronchial asthma

Family history
Allergic history
Reading form Ig E antibiotics against the allergen
Depletion of prostaglandin
unknown cause

Precipitating factors of bronchial asthma

Bronchial irritation by smoke, dust, or air pollution
cold air and exercise
Dietary allergens
Bacterial infection in the respiratory system
Drugs
Emotion
Occupational hazards
Menstruation

11.Mention the clinical features and investigation of bronchial asthma.

Clinical features and investigation of bronchial asthma

হঠাৎ শ্বাসকষ্ট, অস্থিরতা, Chest tightness wheezing
Dry cough or cough with sputum
May have history of previous asthmatic attack
Prominent supraclavical fossa
Widening and deepening of inter coastal spaces
Hyper resonant on percussion

Investigation of Bronchial asthma

X-Ray chest (Hyper inflated lungs in acute attack with pegion chest deformity in lateral view)
Pulmonary function test (Evidence of airflow limitation)
Therapeutic test (Patient response quickly with bronchodilators)
Skin sensitivity test (may be positive for specific antigen)

12.Describe in short the clinical types of bronchial asthma

There are three types of Bronchial asthma

Episodic asthma – হঠাৎ শ্বাসকষ্ট (chiefly expiratory) সাথে wheezing cough যা প্রথমে unproductive পরবর্তীতে productive no bronchi.
Chronic asthma- হঠাৎ শ্বাসকষ্ট (chiefly expiratory) সাথে cough, mucoid sputum and recurrent attack of RTI is common attack এর সময় (in between attack) সামান্য rhonchi.
Severe acute asthma (Status asthmaticus)-Life threating attacks of asthma যার বৈশিষ্ট হচ্ছে respiratory distress and arterial hypoxaemia যা usual bronchodilator এ response করে না।

13.Mention the treatment of chronic persistent asthma

Step by step treatment of chronic persistent asthma

i) Step-Occasional symptoms less frequently than daily
- Treatment-Short acting bronchodilator salbutamol Inh. 3 times each week
ii)Step-Daily symptoms
- Regular salbutamol Inh.+ Beclomethasone 800 micro gm twice daily.
iii)Step-Severe symptoms
- Regular salbutamol Inh.+High dose corticosteroid (Beclomethasone) 800-2000 Micro gm daily
iv)Step-Severe symptoms uncontrolled with high dose inhaled cortcosteroid
- Regular salbutamol Inh.+high dose corticosteroid Inh.+ Trial of the following:
  - Long acting bronchodilator Inh. Salmeterol 2puffs twice daily.
  - Sustained release theophylline initially 200 mg orally 12 hourly then200-600 mg orally 8-12 hourly
  - Ipratropium Inh. 2-4 puffs 6 hourly
  - Sodium cromoglycate 2-4 puffs 6 hourly
v)Step-Severe symptoms with deterioretion
- Continious of step + prednisolone oral lowest single dose (40 mg/day) necessary to control symptoms
vi)Step-Severe symptoms deteeriorating inspite of prednisolone
- Hospitalization

14.Mention the accessory management (treatment) of chronic persistent asthma.

Accessory management (treatment) of chronic persistent asthma

Complete bed rest
O2 Inhalation if required
Antibiotics (to prevent secondary infection)
Precipitating factors should be avoided
Breathing exercise may be helpful
Exercise include asthma (common in atopic children with episodic asthma)- Regular inhalation of sodium chromoglycate (4 weeks).

15.Mention the assessment of severe acute asthma

Assessment of severe acute asthma

Pulse rate >120/min
Pulsus paradoxus >10 mm/Hg
Unable to speak in sentences
Peak flow <50% of expected

16.Mention the life threatening feature of severe acute asthma

life threatening feature of severe acute asthma

Can’t speak
Central cyanosis
Exhaustion, confusion ,conscious level
Bradycardia
Silent chest
Unrecordable peak flow

17.Mention the prevention of COPD

COPD can be prevention by-

Remove of primary cause. Such as- Cessation of smoking
Early diagnosis and treatment. Such as-
- Early treatment of airway infections
- Vaccination against influenza and pneumococcal disease

18.Mention the treatment of acute severe asthma in hospital

Full assessment including PEF or FEV1
Arterial blood gas analysis

Initial Management

Oxygen-High concentration and high rate
IV access
Corticosteroids oral hydrocortisone + prednisolone
Nebulization – salbutamol or terbutaline
Montilukast or Zafirlukast once daily

If satisfactory improvement

Doses of nebulization and oral steroid should be reduced.

If result is not satisfactory

Nebulization of Ipratropium + IV Aminophylline should be added.

19.Define respiratory failure. What are the causes of respiratory failure.

Respiratory dysfunction resulting in abnormalities of oxygenation or CO2 elimination severe enough to impair or threaten the function of vital organs. Arterial blood gas criteria for respiratory failure are arbitrarily established as a PO2 under 60 mm Hg and PCO2 over 50mg Hg.

Causes of respiratory failure– Pulmonary causes

Bronchial asthma
Chronic bronchitis or emphysema
Pneumonia
Congestive heart failure / Pulmonary edema
Acute respiratory distress syndrome
Pneumothorax
Upper airway obstruction
Laryngeal edema
Pulmonary thromboembolism
Fibrosing alveolitis

Non Pulmonary causes

Narcotic or sedative overdose
Botulism
Poliomyelitis
Spinal cord injury
Stroke
Myasthenia gravis
Flail chest
Guillain – barre syndrome

20.Mention the clinical feature and investigation of respiratory failure. Mention its treatment.

Clinical feature of respiratory failure

Disturbance of consciousness
Cyanosis
Restlessness
Heart rate, tachypnoea
Early morning headache
Papilloedema
Asterixis

Investigation of respiratory failure

Arterial blood gases and pH
Chest X- ray

Treatment of respiratory failure

Correction of hypoxaemia by the administration of O2 in high concentration by oro- nasal mask
Mechanical ventilation of necessary
Warming the body to improve peripheral circulation
Treatment according to the cause

21.Define pneumonia. mention the types of pneumonia.

Pneumonia is an inflammatory process in the lung parenchyma, causes by various organisms, associated with lower respiratory tract infection and radiological signs.

Types of Pneumonia

According to source of infection
- Primary pneumonia (usually community acquired)
- Secondary pneumonia (occurs when the host or the lungs are diseased or weakened)
  - Acute bronchopneumonia
  - Nosocomial pneumonia
  - Pneumonia in the immunocompromised patient
  - Aspiration pneumonia
According to site of involvement
- Lobar pneumonia (20%)
- Lobular pneumonia (70%)
- Segmental pneumonia (10%)
According to causative organism
- Bacterial
- Rickettsial
- Viral
- Parasitic
- Fungal

22.Define Acute Lobar Pneumonia (Pneumococcal Pneumonia). Mention its clinical feature.

Acute lobar pneumonia is characterized by homogenous consolidation of one or more lobe or segments of lungs.it occurs most commonly in early and middle adult life. Highest incidence is in winter.

Clinical features of Acute lobar pneumonia

Sudden onset with chill and rigor (ঠান্ডা ও কাঁপুনি) (there may have vomiting and convulsion in children)
High continuous fever upto 105 ডিগ্রী F
Pain in the chest commonly on the right side
Painful cough, dry first then cough with tenacious sputum, often rustly colored, occasionally blood stained.
Malaise, weakness, sometimes vomiting, headache, loss of appetite, aching pain in the body and limbs.
The patent looks very ill with hurried respiration.

23.Mention the physical examination and investigation of acute lobar pneumonia.

Physical examination of acute lobar pneumonia

Pulse- rapid
Skin -hot and dry
Face- fiushed
Respiratory- shallow and painful
Central cyanosis- may be oresent
Movement of chest- reduced,
Percussion- dull

Investigation of acute lobar pneumonia

Blood count- shows marked leukocytosis
Blood culture- positive in 25% case
Sputum for gram stain- red cells, white cell and pneumonia
X-ray chest

24.Mention the treatment of acute lobar pneumonia

Treatment of acute lobar pneumonia

Inj. Ceftriaxone 2 gm once, daily dose (14 days) or tab. Azithromycin 500 mg once, daily (14 days)
Tab. paracetamol 500 mg 1+1+1+1

Advice

Full bed rest
O2 inhalation for hypoxemic patient
রোগীর অবস্থার উন্নতি না হতে থাকলে অথবা অবস্থা খারাপ থাকলে হাসপাতালে ভর্তি করতে হবে

25.Suppurative pneumonia কি? Suppurative pneumonia এর কারন, লক্ষন ও চিকিৎসা সংক্ষেপে উল্লেখ কর

পুজ উৎপাদনকারী pneumonia কে Suppurative pneumonia বলে।

Causes of Suppurative pneumonia

Infection in the lung parenchyma with multiple species of anaerobic and aerobic bacteria

Clinical features of Suppurative pneumonia

Cough with large amount of sputum. ( Sputum may fetid or blood stained)
Pleural pain is common
High remittent pyrexia
Finger clubbing may develop quickly
Chest X-ray report -signs of consolidation
Rapid deterioration of general health

Treatment of Suppurative pneumonia

Antibiotic for aerobic infection -Tab. cefuroxime + Clavulenic acid
Antibiotic for anaerobic infection – Tab. Metronidazole 400 mg 1+1+1

26.Bronchiectasis কি? Bronchiectasis এর কারন, লক্ষন ও চিকিৎসা সংক্ষেপে উল্লেখ কর

Chronic necrotizing infection for the bronchi and bronchioles leading to or associated with dilation of the above airways (bronchi and bronchioles).

Causes of Bronchiectasis

Acquired
- Infective- Secondary to Measles, Whooping cough, Tuberculosis
- Obstructive-
  - In the lumen- foreign body
  - In the wall- bronchial carcinoma
  - Outside the wall- enlarged lymph node due to TB, lymphoma
Congenital-
- Cystic fibrosis (50%)
- Ciliary dysfunction syndrome

27.Mention the clinical feature and investigation of Bronchiectasis

Clinical feature of Bronchiectasis

Chronic cough- usually worse in the morning
Purulent sputum-copious and fetid
Recurrent attack of fever, malaise, shivering and chest pain
Hemoptysis
General ill health
Chest movement slightly reduced on affected side

Investigation of Bronchiectasis

X-ray chest- honey comb appearance
Bronchography
AFB and gram staining of the sputum to exclude TB and other pathogenic bacteria
Sputum for c/s
Assessment of ciliary dysfunction

28.Mention the treatment of Bronchiectasis

Treatment of Bronchiectasis

Antibiotic – Cefuroxime + Clavulenic acid or Amoxicillin + Clavulenic acid
Bronchodilators- Salbutamol inhalation / Rotahalation / Tab.