Bronchial asthma

Bronchial asthma usually starts in childhood but may not appear until middle age (“late-onset asthma”). It is characterized by attacks of wheezing dyspnoea due to narrowing of bronchial tube by spasm, mucosal edema or mucous secretions. These attacks are brought on by a variety of factors, including allergy to certain inhaled dusts (e.g. house dust, pollens), respiratory infections, emotional upsets or physical exertion (“exercise – induced asthma”). A history of other “allergic” manifestations such as hay fever or a family history of this condition, is common in those with an early onset of the disease. The patient may be quite free of symptoms and abnormal signs between the attacks but the illness can become continuous. Cough usually occurs only during the attacks when it may be associated with the expectoration of vicid mucoid sputum; noctural cough is a characteristic presenting symptom of asthma in childhood.

Physical examination reveals labored breathing associated with a prolonged expiratory wheeze, activity of accessory muscles of respiration, signs of overinflation of the lung due to trapping of air during expiration and, in a severe attack, cyanosis may also be seen. In children, there may be permanent deformity of the chest wall.

Bronchial asthma must be differentiated from the paroxysmal dyspnoea of left heart failure and from localized wheezing due to partial bronchial obstruction by neoplasm.

Ex.9. Read the text, write down the key sentences of it using the following models:

1. This text is concerned with …

2. Particular attention is paid to …

3. It is a well-known fact that …

4. The next point deals with …

5. It has been suggested that …

Pleurisy

Inflammation of the lining surrounding and covering the lungs.

Symptoms: Sudden, intense stabbing pain in the side or shoulder, aggravated by deep breathing, coughing, sneezing or moving. Breathing is usually rapid and not very deep.

Cause: May result from injury or irritation of the underlying lung; entry the irritating substance into the pleural space; entry of infection either from the lung or through the bloodstream; or leakage of tumor cells into the pleural space.

Treatment: depends on treating underlying cause. Heat applied to chest and pain relieves help with symptoms. Antibiotics are used if infection suspected or proved.

Discussion: Inflammation of the pleura, the membranes lining the chest and covering the lungs, causes pain when the lung moves back and forth over the inflamed area. Sometimes infection is irritating enough that fluid gathers in the chest between the ribs and lung (called pleural effusion). This kind of fluid collection, if present can be drained by needle or tube and the fluid studied for infection and abnormal (cancer) cells. Depending on cause, pleurisy can occur one time only or be a recurrent problem.

Ex.10.

a) Look through the text and fill in the table.

forms of pneumonia	pathogenesis	clinical manifestations	course of the disease

b) What diagnostic tests are the most valuable for detecting pneumonia?

c) What is revealed by each of them?