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Lung
Disease
Introduction:
Lung
disease is common among both men and women. It is more
frequent in smokers than non-smokers.
The
death rate from these diseases is on 4th place (after
heart disease, cancer and stroke) and is increasing in
women as a group versus men.
This
is because women as a group are smoking more now than
men and the associated lung diseases such as lung cancer,
pneumonia, emphysema and chronic obstructive pulmonary
disease (=COPD) lead to premature death. In the following
review I will concentrate on the more common lung problems,
their symptoms, how they are diagnosed and how they can
be treated. It goes without saying that prevention measures
such as stop smoking, wearing protective masks in industrial
high risk areas, moving away from smog infested environments
etc. will always be the most powerful tool (Ref.1).
Symptoms
of lung disease:
The
most common symptoms asssociated with lung disease are
coughing, shortness of breath (=dyspnea), wheezing, stridor,
coughing up blood (=hemoptysis), chest pain, blue skin
discoloration (=cyanosis) and clubbing
(=enlargement of the fingertips). Some of these symptoms
are due to narrowing of the airways, such as wheezing
in asthma, others are due to chronic oxygen deficiency,
such as cyanosis and clubbing.
Diagnostic
tests:
The
simplest way for the practicing physician to come to a
diagnosis regarding lung diseases is to take a thorough
history, to do a careful examination with auscultation
(=listening to the lungs with a stethoscope) and to order
a chest X-ray. Often diagnoses such as asthma, pneumonia,
ephysema, COPD and others can be accurately diagnosed
this way. However, the physician today, particularly the
lung specialist, (=respirologist or pneumologist) has
a number of other tools that can be useful. This is depicted
in this table. The links lead to images where the items
are depicted.
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The
following gives an overview of the most common lung diseases.
The
links transport you right to the beginning of each chapter
where the disease is dealt with in more detail.
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| Common
lung diseases |
| Name
of lung disease: |
Brief
description of disease: |
| adult
respiratory distress syndrome (ARDS) |
Usually
viral in origin, the acute shortness of breath is
very similar to the RSD of premature babies |
| atelectasis |
A
collapse of a segment of the lower lung, usually in
the lower lung area |
| asthma |
Asthma
Introduction |
An important lung disease that affects a lot of people.
It is an inflammatory condition of the small bronchial
tubes (bronchioles), with wheezing and spasm, often
associated with allergies. |
| Classification
of Severity |
| Asthma
Signs and Symptoms |
| Diagnostic
Tests for Asthma |
| Asthma
Treatment |
| bronchiectasis |
Chronic
bronchitis leads to this lung condition where small
air sacs melt together forming larger pockets filled
with pus |
| bronchitis
|
Acute
bronchitis due to viruses or bacteria; chronic bronchitis
often due to smoker's lung with chronic infection
and scarring
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| COPD |
Chronic
obstructive pulmonary disease leads to chronic cough,
many infections and evtl. respiratory failure |
| cystic
fibrosis |
Congenital
lung abnormality with very viscous mucous in airways;
leads to COPD, bronchiectasis |
| emphysema |
Chronic
asthma, COPD and chronic bronchitis can all lead to
this end stage lung disease |
| hypersensitivity
pneumonitis |
Farmer's
lung is one example, red cedar asthma another |
| lung
abscess |
Acute
localized infection/pus in one lung segment |
| lung
cancer |
Bronchogenic
carcinoma is the most common cancer in smokers |
| occupational
lung disease |
Examples
are silicosis, asbestosis or coal worker pneumoconiosis
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| pleural
disorders |
Lung
diseases of the lining of the lungs in the chest cavity
leading to pleural effusions |
| pneumonia |
Infection
of the lung tissue, often bacterial |
| pulmonary
emboli |
Clots
in the lung vessels lead to this life threatening
disease, often originating from clots in the deep
veins of the legs (after surgery etc.) |
| pneumothorax |
Collapse
of part or of all of a lung leads to this life threatening
condition |
| respiratory
failure (life support) |
A
terminal condition of many lung diseases when not
enough oxygen can enter the blood stream because of
advanced chronic lung disease such as severe asthma,
COPD or chronic bronchitis |
| sleep
apnea |
A
sleep disorder where the patient stops breathing intermittently
for more than 10 seconds and blood oxygen drops |
| Return
to top of table |
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Disclaimer:
This
outline is only a teaching aid to patients and should
stimulate you to ask the right questions when seeing your
doctor. However, the responsibility of treatment stays
in the hands of your doctor and you.
References:
1.
Noble: Textbook of Primary Care Medicine, 3rd ed., Copyright
© 2001 Mosby, Inc.
2.
National Asthma Education and Prevention Program. Expert
Panel Report II. National Heart, Lung and Blood Institute,
1997.
3.
Rakel: Conn's Current Therapy 2002, 54th ed., Copyright
© 2002 W. B. Saunders Company
4.
Murray & Nadel: Textbook of Respiratory Medicine,
3rd ed., Copyright © 2000 W. B. Saunders Company
5.
Behrman: Nelson Textbook of Pediatrics, 16th ed., Copyright
© 2000 W. B. Saunders Company
6.
Merck
Manual 1999. Section 6: Pulmonary disorders
7.
Goldman: Cecil Textbook of Medicine, 21st ed., Copyright
© 2000 W. B. Saunders Company
8.
Ferri: Ferri's Clinical Advisor: Instant Diagnosis and
Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
9.
Rakel: Conn's Current Therapy 2004, 56th ed., Copyright
© 2004 Elsevier
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