Question

1. What is upper respiratory tract infection and treatment? 2. What is a lower tract respiratory infection and treatment? 3. What is COPD and treatment?

Answer 1

1Q).

The diseases of the upper respiratory tract include the sinusitis, otitis media, tonsillitis, laryngitis, etc.

Sinusitis: Sinusitis is the swelling of the mucosal layer (maybe due to inflammation or hypertrophy) blocks the site in the sinus and thereby obstructing the drain of mucus into the nose. The concurrent inflammation of the nasal mucosa is known as rhinosinusitis. Tumors in the nasal region, presence of polyps, septal defect, and foreign bodies can also cause sinusitis.

2Q).

The diseases of the lower respiratory tract include pneumonia, pulmonary tuberculosis, obstructive pulmonary diseases, restrictive pulmonary diseases, etc.

Pulmonary tuberculosis: It is an infectious disease. It is caused by Mycobacterium tuberculosis. It can be infected to any organ, but most commonly involved organ is lungs.

Etiology and pathophysiology: M.tuberculosis is an acid-fast bacillus and gram-positive. It transmits from person to person through droplet spread. Airborne droplets which are produced during talking, sneezing, breathing, and singing and during cough are inhaled by another person will cause the transmission of the disease.

After the inhalation, the inhaled particles get lodged in the bronchioles and alveolus. After that, a local inflammatory reaction occurs and the focus of the infection will be established. This focus is known as “Ghon focus” which eventually develops into granuloma which is the hallmark of the disease.

Granuloma formation is a defensive mechanism which prevents the replication of the bacillus and further spread. In some patients, the mycobacterium is not completely killed and remains in a dormant state which doesn’t undergo replication. M.tuberculosis can infect any organ like kidneys, epiphyses of bone, adrenal gland and cerebral cortex.

3Q).

Chronic Obstructive Pulmonary Disease (COPD): It is a treatable and preventable disease which is characterized by slowly progressive persistent airflow limitation. It is associated with the enhanced chronic inflammatory response of lungs and airways to the noxious particles which are primarily caused by cigarettes smoking. Previously definition of the COPD includes two diseases, chronic bronchitis, and emphysema.

Pathophysiology: In COPD chronic inflammation of the lung parenchyma, pulmonary blood vessels, and airways occurs. Due to the noxious particles and gases due to smoking and air pollution will leads to the following changes in the lungs.

1. Inflammation of the central airways due to the release of the inflammatory mediators, oxidative stress, inflammatory cells like neutrophils, macrophages, lymphocytes.
2. Remodeling of the peripheral airway will occur.
3. Parenchymal destruction occurs due to imbalance between proteinase and ant proteinase.
4. Pulmonary vascular changes like thick vessels, inflammatory cells infiltrate, collagen deposition occurs and destruction of the capillary bed.

Treatment of COPD :

Drugs such as the bronchodilators (salbutamol), oxygen therapy and anti-inflammatory medicines (leukotriene antagonists and corticosteroids) are used in the treatment of both asthma and COPD.

But the usefulness of steroidal anti-inflammatory drugs in the form of inhalers is less in COPD than asthma due to the decreased breathing efficiency. So, intravenous or other injected medications are more helpful in the treatment of COPD. Corticosteroids are more prescribed for COPD than asthma.