Types of Bronchial Asthma

Bronchial asthma arise from spasm (with narrowing ) of the intrapulmonary bronchi.
It is caracterised by wheezing and shortness of breath.
Spasmodic attack of asthma varies in severity,but is usually temporary for short time,then clears up.
The patient is exposed to reccurent attack at varied intervals.

Types of Bronchial Asthma:
1.Extrinsic :
Attack of asthma fallows inhalation of external antigenic substances.
Allergenic substances that can cause asthma attack are:house dust,pollen grains,animal hair and fur,some drugs (aspirin).
2.Intrinsic:
No apparent allergen can be accused.
Intrinsic type differs from extrinsic type by:
-later age of onset
-have more persistent attacks
-less response to bronchodilator drugs.

The Cough-Types,Causes and Effects

The cough is a defensive mechanisme aiming of secretions or inhaled particules from the respiratory tract.

Types:
1.Reflex Cough: (Due to irritation of vagal receptors)
Causes:
-pharyngits,tonsilitis,ulcer,tumours,post-nasal discharge.
-foreign body,laryngitis,ulcer,tumours
-bronchial asthma,bronchial tumours
-pneumonias,abcess,T.B
-pulmonary infections

In case of pharyngeal diseases the cough is painful,non-productive and may be accompanied by nausea and vomiting.
In case of laryngeal diseases the cough is painful,barking and may be accompanied by hoarseness of voice or stridor.

Extra-respiratory causes:
-pulmonary congestionin left sided heart failure
-pulmonary embolism
-ressure on a bronchus
-aortic aneurysm
In this case the cough is brassy and bovine.

2.Central Cough: (Due to irritation of cough centre)
Causes: brain tumours,cerebrovascular strokes,encephalitis.
In this case the cough is dry and is a result of neurological manifestations.

Cough Effects:
-rupture of pulmonary bullae or blebs leading to pneumothorax
-stress fractures of ribs
-precipitate rupture
-hernia
-prolapse of rectum or uterus
-incontinence of urine and stools
-retinal and subconjunctival hemorrhage
-retinal detachment
-insomnia
-infection dissemination.

Sleep Apnea Syndrome-Symptoms and Treatment

Types of Sleep Apnea:
-Obstructive -due to obesity
-Central-due to genetic defect of respiratory drive
-Combinated.

Symptoms:
-insomnia at night& sleepiness at daytime
-condition is aggravated by sedatives given for treatment of insomnia due to further suppression or respiration
-snoring
-cynosis may occur
-complications: arrhythmias,death.

Treatment:
For the Obstructive Type:
-weight reduction
-airway prosthesis
-tractheostomy
For Central Type:
-progesteron treatment
-aminophylline treatment
-protryptyline treatment.

Pulmonary Tuberculosis-Transmission,Symptoms and Diagnosis

Tuberculosis is an infection disease that may involve any part of the body,though the majority of cases re pulmonary.

Sources and Transmission:
1.MAN: open cases of active pulmonary TB are the sources of infection for the human tubercle bacillus.
The infection is exit by respiratory secretions,on coughing and expectoration..

Infectivity: persists so long the disease is active(open into the air pssages).
-proper chemotherapy of case controls infection whitin few months.
-untreated and drug-resistant case remain infective for long time.

Modes Of Transmission:
1.Direct respiratory infection:the most important favoured by repeated close association whit the case (at home,school,institute,cmp or work),specially in crowded badly ventilated places.

2.CATTLE:
Animals having respiratory TB are the reservoirs of infection,for the bovine tubercle bacillus.the orgnisms find exit in respiratory spray.

Mode of Transmission:inhalation of tubercle bcilli in cough spary of diseased animal.Infection is usually occupational in farmers and agriculture workers.

The infected individul is exposed to reinfection from the environent that he usually overcomes.Sometimes,however,reinfection is followed by active disease.This depends on the number and virulence of inhaled tubercle bacilli and the body resistance.

Symptoms:
Unmanaged cases of active tuberculosis show constitutional and local chest manifestations that vary according to stage and severity of disease.Cases are usually chronic and may show exacerbations and remissions.
Clinical picture: general and chest manifestations are not specific,but only suggestive like afternoon low-grade fever,night sweat.anorexia,mild loss of weight and hemoptysis.

Diagnosis:
-Chest X-ray:screens suspected cases.
-sputum examination: to demonstrate tubercle bacilli.It is the only evidence of conclusive diagnosis by:
direct smear microscopy and culture for particulary cses.

Bronchial Asthma

Bronchial Asthma arises from spasm of the intrapulmonary bronchi.
It is characterized by wheezing and dyspnoea(shortness of breath).
Spasmodic attack of asthma varies in severity,but is usually temporary for short time,then clears up.
The subject is exposed to recurrent attacks at varied intervals.
Exist 2 types of causes:
1.Extrinsic causes:attack of asthma fallows inhalation of external antigenic substances(allergens).Atopic individuals are at-risk of developing asthma,due to hypersensitivity,usually to more than one,and rarely only one,antigen.
Allergenic substances provoking asthma attack:
-Dust:house dust,organic dust in industry.
-Pollen grains,animal hair and fur,bird feathers
-Some drugs as aspirin for exemple.
2.Intrinsic Causes:no history of hypersensitivity,no skin sensitivity reaction is given.So no apparent allergen can ba accused.
Intrinsic causes differs from extrinsic by:
-later age of onset
-more persistent attacks
-less response to bronchodilator drugs

Aggravation factors of asthma:
1.Allergenic substances that provoke extrinsic asthma attacks.
2.Nonspecific factors that may:
-precipitate asthma attack
-increase severity of existing attack(upper respiratory infection,inhalation of respiratory irritants as smoke,tobacco smoke,dust;physical exertion,muscular activity and exercise,emotional disorders as anxiety and anger.
3.Sometimes no obvious precipitating factor is found.

Prevention:
Primary prevention cannot be achieved,due to:
-causative agent is unknown in many cases,specially of intrinsic asthma.
-provoking/precipitating factors of asthmatic attack are not always practically available.
Preventive measures:
-sanitary,clean,plluation-free environment
-healthful lifestyle and open-air recreation
-avoiding exposure to provoking factors.No:smoking or passive smoking,exposure to polluted air,muscular exertion,emotional disturbance,drug abuse.