Pathophysiology for Dietetics 2: Respiratory Diseases

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Questions and Answers

Which cell types are primarily involved in the inflammatory response in asthma?

Basophils, platelets, red blood cells, dendritic cells

Mast cells, eosinophils, T lymphocytes, neutrophils (correct)

Epithelial cells, fibroblasts, macrophages, endothelial cells

Smooth muscle cells, macrophages, T lymphocytes, fibroblasts

What is a common characteristic of airflow obstruction in asthma?

It occurs exclusively during physical exertion without any other triggers.

It is often reversible either spontaneously or with treatment. (correct)

It can be triggered solely by viral infections without any allergens.

It is permanent and always leads to respiratory failure.

Which of the following accurately describes the pathophysiology of asthma?

The process involves vasodilation without involvement of smooth muscle contraction.

Inflammation leads to smooth muscle relaxation in the bronchi.

Airway obstruction is mainly caused by bronchoconstriction and increased mucus production. (correct)

Increased mucus production is due to reduced epithelial cells.

Which of the following is NOT considered a trigger for non-allergic asthma?

Pollen exposure Signup and view all the answers

What is a common initial symptom of asthma?

Cough and dyspnea Signup and view all the answers

What is the primary function of cilia in the respiratory system?

To propel mucus and trap particles Signup and view all the answers

Which anatomical structures are responsible for gas exchange in the lungs?

Alveoli and capillaries Signup and view all the answers

What does an arterial blood gases (ABG) test primarily measure?

Acidity and oxygen levels in the blood Signup and view all the answers

What role do macrophages play in the alveoli?

They engulf and destroy inhaled bacteria Signup and view all the answers

How does malnutrition affect respiratory muscles?

It reduces strength and endurance Signup and view all the answers

What is the approximate area covered by the alveolar-capillary unit?

The area of a tennis court Signup and view all the answers

What is the primary purpose of the respiratory system?

To obtain oxygen and remove carbon dioxide Signup and view all the answers

Which structure is responsible for the initial division of airflow into the right and left lungs?

Trachea Signup and view all the answers

Which nutrients have been correlated with healthy lung function?

Dietary antioxidants like vitamin C and E Signup and view all the answers

What is the purpose of using a spirometer in pulmonary function testing?

To calculate lung air capacity and airflow rate Signup and view all the answers

What are the small air sacs in the lungs where gas exchange occurs called?

Alveoli Signup and view all the answers

Which part of the respiratory system includes structures such as the nasal cavity and pharynx?

Upper respiratory tracts Signup and view all the answers

What is the role of capillaries in the alveoli?

To exchange carbon dioxide for oxygen Signup and view all the answers

What characterizes the lower respiratory tract?

It mainly includes the trachea and bronchi Signup and view all the answers

In what part of the respiratory system does airflow become increasingly divided?

Bronchi Signup and view all the answers

Which disease can affect the normal function of the respiratory system?

Asthma Signup and view all the answers

What characterizes chronic bronchitis in terms of symptom duration?

Productive cough lasting about 3 months or more each year for at least 2 consecutive years. Signup and view all the answers

Which of the following is NOT a sign of hypoxia?

Wheezing Signup and view all the answers

What physiological change occurs in the airways due to chronic bronchitis?

Thickening of airway walls Signup and view all the answers

Which of the following processes is most directly associated with emphysema?

Destruction of alveoli resulting in larger air spaces Signup and view all the answers

What is a consequence of the chronic inflammation seen in chronic bronchitis?

Hyperplasia of mucus-secreting cells Signup and view all the answers

Which condition is specifically associated with shortness of breath due to damage to air sacs?

Emphysema Signup and view all the answers

What is a likely effect of repeated exposure to cigarette smoke on the respiratory system?

Suppressed immunoglobulin A levels Signup and view all the answers

Which symptom is typically associated with hypercapnia in chronic bronchitis patients?

Cyanosis Signup and view all the answers

What is a primary consequence of damaged alveoli in emphysema?

Trapped old air reducing fresh air intake Signup and view all the answers

Which symptom is NOT typically associated with emphysema?

Frequent bloody stool Signup and view all the answers

What genetic mutation causes cystic fibrosis?

Mutation of the cystic fibrosis transmembrane conductance regulator gene Signup and view all the answers

What is a key characteristic of the mucus produced in cystic fibrosis?

Abnormally thick and viscous Signup and view all the answers

Which condition do cystic fibrosis patients face due to blocked pancreatic ducts?

Pancreatic insufficiency Signup and view all the answers

What increased risk is associated with cystic fibrosis due to defective cilia action?

Risk of lung infections Signup and view all the answers

Which treatment method is NOT typically employed for managing cystic fibrosis?

Surgical lung replacement Signup and view all the answers

What effect does increased sodium and chloride in sweat have on cystic fibrosis patients?

Higher risk of dehydration and electrolyte imbalances Signup and view all the answers

Study Notes

Course Information

Course Title: Pathophysiology for Dietetics 2
Course Code: NDT2359
Course Description: Diseases of the respiratory system
Instructor: Ms Jamilah Abd Jamil
Email: [email protected]

Key References

Nelms M, Sucher K.P, Lacey K. Nutrition Therapy and Pathophysiology. 2nd edition. Cencage Learning, 2016
Escott-Stumps S (2012). Nutrition and Diagnosis-Related Care. 7th edition.
Mahan KL and Escott – Stumps (2009). Food Nutrition and Diet Therapy. 12th edition. W.B. Saunders Company, Philadelphia

Learning Outcomes

Describe the normal anatomy and physiology of the respiratory system: pulmonary function
Explain the etiology, pathophysiology, and clinical manifestations of: asthma, chronic obstructive pulmonary disease, cystic fibrosis, pneumonia, patients with tracheostomies, respiratory failure, and transplantation

Normal Anatomy and Physiology of the Respiratory System

The respiratory system has two divisions: upper respiratory tract and lower respiratory tract
Lungs obtain oxygen and support cellular metabolic functions, and remove carbon dioxide.
The air enters the lungs through the trachea, which divides into the right and left bronchi.
Bronchi further divide into smaller and smaller bronchioles.
Bronchioles end in small air sacs called alveoli.
Alveoli are paper thin, containing millions of capillaries involved in oxygen and carbon dioxide exchange.
The alveolar-capillary unit covers an area about the size of a tennis court and contains more than 100 million capillaries.

Role of Lungs in Protecting the Body

Lungs protect against infection and harmful environmental toxins.
Inhaled particles (smoke, bacteria, viruses) are trapped by sticky mucus.
Hair-like structures (cilia) in the trachea, bronchi, and bronchioles move mucus and trapped particles upward toward the pharynx for removal (coughing or swallowing).
Macrophages in the alveoli engulf and destroy inhaled bacteria

Measures of Pulmonary Function

Spirometer: measures the amount of air the lungs can hold and the rate the air can be inhaled and exhaled.
Impulse Oximetry: measures the percentage of oxygen in the blood.
Gas diffusion: measures how well oxygen and other gases pass through the lung's air sacs and are absorbed by the blood..
Arterial blood gases (ABG) test: measures the acidity (pH), oxygen, and carbon dioxide levels in the blood. This test is used to determine how well the lungs move oxygen and remove carbon dioxide from the blood

Nutrition and Pulmonary Health

Malnutrition negatively affects clinical outcomes.
Malnutrition can weaken respiratory muscles (especially the diaphragm) and reduce lung parenchyma (including bronchioles, alveoli, and capillaries).
Dietary antioxidants, like vitamin C, vitamin E, beta-carotene, and selenium, are associated with healthy lung function.

Asthma

Definition: Chronic inflammatory disorder of the airway involving many inflammatory cells
Etiology (Causes): Allergic (most common) triggered by inhaled allergens (dust mites, pet dander, pollen); Non-allergic (triggered by anxiety, stress, exercise, cold air, dry air, hyperventilation, smoke, viruses, or other irritants)
Pathophysiology: Bronchospasm (contraction of smooth muscle), which leads to inflammation and edema, and increased mucus production. This results in partially or totally obstructed airways

Clinical Manifestations of Asthma

Initial symptoms: cough, dyspnea, tight chest feeling
Signs include: wheezing, increased respiratory rate, labored breathing, increased heart rate (tachycardia), and hypoxia (low oxygen levels in the tissues)

Chronic Obstructive Pulmonary Disease (COPD)

Definition and Etiology: Progressive disease limiting airflow. Often involves both bronchitis (inflammation of bronchial tubes) and emphysema (destruction of alveoli).

Bronchitis

Definition: Inflammation of the main airways (bronchi) due to infection.
Types: Acute (lasts up to 3 weeks); Chronic (productive cough and shortness of breath for at least 3 months of the year, for 2 or more consecutive years)

Chronic Bronchitis - Pathophysiology

Repeated exposure to irritants (e.g., cigarette smoke) causes increased mucus production in the airways and decreased cilia function
Increased mucus and edema lead to airway obstruction
Increased risk of bacterial infection due to thickened mucus

Chronic Bronchitis - Clinical Manifestations

Decreased airflow, dyspnea (shortness of breath), hypoxemia (low oxygen), and hypercapnia (high carbon dioxide levels) in the blood.
Cyanosis (bluish discoloration), a sign of chronic hypoxia, may occur

Emphysema - Pathophysiology

Damage to air sacs (alveoli): walls weaken and rupture, leading to larger air spaces.
Reduced surface area for gas exchange: limits the amount of oxygen reaching the bloodstream.
Exhalation difficulties; old air gets trapped
This leads to difficulty breathing.

Emphysema - Clinical Manifestations

Symptoms: coughing, wheezing, shortness of breath, chest tightness, and increased mucus production
Often, symptoms aren't noticed until significant lung tissue damage occurs.
Increased risk of pneumonia, bronchitis, and other lung infections

COPD Treatment

Smoking cessation and avoidance of pollutants
Good nutrition
Exercise, as tolerated

Cystic Fibrosis (CF)

Definition: Inherited disorder characterized by abnormally thick mucus secretions from epithelial surfaces (leading to lung disease, pancreatic insufficiency, and gastrointestinal/genitourinary dysfunction).
Etiology: Mutation of the cystic fibrosis transmembrane conductance regulator (CFTR) gene, located on chromosome 7.
Pathophysiology: Defective CFTR protein results in thick, sticky mucus that obstructs glands, ducts, and airways
Increased risk of infection due to impaired mucus clearance

CF - Pathophysiology

Pancreatic insufficiency: problems digesting food due to blocked ducts
Symptoms: Frequent bulky, foul-smelling, oily stools (steatorrhea)
Electrolyte imbalances: Increased sodium and chloride in sweat

CF Treatment

Aerosol therapies: increase airflow, reduce mucus accumulation, and reduce infection risk
Inhaled medications: bronchodilators, anti-inflammatory agents, mucolytics, and antibiotics
Chest physiotherapy: reduce airway obstructions
Lung transplantation: aggressive treatment for end-stage respiratory failure
Pancreatic enzyme replacement therapy: supplementation for digestive enzyme deficiencies.

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Description

Test your knowledge on the anatomy and physiology of the respiratory system. This quiz covers key topics such as asthma, COPD, cystic fibrosis, and more, focusing on their etiology and clinical manifestations. Perfect for students in the Pathophysiology for Dietetics course.