What Does Your Doctor Mean? - Squarespace does your doctor mean? A Respiratory Glossary Page 5 of 24...

Version 2: active from March 2014, for review before March 2016.

What Does Your Doctor

Mean?

A key to terms used in respiratory medicine

This patient information booklet contains a short list of

symptoms, disease names, investigations and treatments

useful to people attending a chest clinic.

Dr J Blakey PhD

Senior Lecturer & Honorary Consultant

Respiratory Medicine

What does your doctor mean? A Respiratory Glossary

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Introduction

This booklet contains a list of terms used by doctors and

specialist nurses when discussing lung disease. We hope

this booklet will help you understand the words used in

letters about you to your GP.

We have also included a list of web addresses that

provide more information about certain lung conditions.

If there are words that you feel we have missed out, or if

you have other suggestions as to how this booklet could

be improved, please do get in touch with us.


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A ACE inhibitor: A medicine used to treat raised blood

pressure or heart failure. These medicines can cause

chronic cough.

Acid-fast bacilli: A bacteria in a sputum sample that stains

in a special way that is very suggestive of tuberculosis

(TB).

Adenocarcinoma: A type of cancer that can arise in the

lung.

Airways disease: A problem focussed on the air tubes

(such as asthma or bronchiectasis) that restricts airflow out

of the lungs.

Allergic broncho -pulmonary aspergillosis (ABPA):

Hypersensitivity to the presence of a fungus (aspergillus).

The condition occurs in severe asthma, leading to loss of

control and bronchiectasis.

Alpha-1-antitrypsin deficiency: an inherited condition that

puts people at high risk of developing lung problems such

as emphysema. It is diagnosed by a simple blood test.

Alveolar cell carcinoma (broncho-alveolar cell carcinoma):

An uncommon type of lung cancer.

Angiotensin Converting Enzyme (ACE): A blood test that

can be abnormal in cases of sarcoidosis or tuberculosis.


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ANCA: A blood test used to diagnose and monitor rare

inflammatory lung conditions.

Apnoea: Stopping breathing

Asbestos: is a mineral that was widely used because of its

insulating and fire-resistant properties. Asbestos fibres can

result in: Asbestosis, scarring of the lung itself that can

cause coughing and breathlessness

Asthma: a condition of the airways of the lung that is

associated with coughing, feelings of breathlessness and

chest tightness, all of which may be worse during the

night. Special leaflets are available on this condition and

there is a recommended website.

Atelectasis – a collapse of a small portion of the lung.

Atopy/Atopic : A predisposition to become allergic or to

develop allergic diseases such as asthma, hay fever or

eczema.

Azathioprine: A medicine that allows a smaller dose of

steroid tablets to be used in the treatment of

inflammatory lung conditions (separate leaflet on this

medication).

B BD: Latin terminology which means that a medicine

should be taken twice daily.


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Beclomethasone: An inhaled steroid, usually for asthma.

Biopsy: A sample of body tissue. “Lung biopsy” therefore

means obtaining tissue from part of the lung to look at

under a microscope.

BMI (Body Mass Index): A method of quantifying

somebody’s weight that relates weight to height.

Bronchial Thermoplasty: A procedure used for some cases

of difficult asthma. The patient has a bronchoscopy (see

below) and the airways are heated.

Bronchiectasis: A condition where the airways in the lung

become damaged and dilated leading to chronic cough

and repeated infection.

Bronchodilator: A medicine that opens the airways.

Bronchoscopy: An investigation whereby a thin flexible

camera is passed into the lungs so that the airways can be

inspected and samples collected. A leaflet is available on

this investigation.

Broncho-alveolar lavage (BAL): A sample of cells obtained

during bronchoscopy by passing fluid into the lung and

then quickly removing it.

C


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Cardiopulmonary exercise test: A comprehensive test that

measures the performance of the lungs, heart and muscles

whilst the patient is pedalling an exercise bike.

Cavity (cavitating lesion): A hole in the lung – normally

because a more solid mass has broken down in the centre

and part of the mass has been coughed up.

Challenge test: A test to determine if the airways narrow

in response to certain chemicals (e.g. histamine). It is

useful to diagnose and monitor asthma.

Chemoprophylaxis: The use of anti-TB medication to

prevent that disease occurring.

Chronic Obstructive Pulmonary Disease (COPD): a

common condition of narrowing of the airways and

damage to the lung substance, usually from cigarette

smoking. Special leaflets are available on this condition

and there is a recommended website.

Churg-Strauss Syndrome: A rare condition of inflammation

of small blood vessels that occurs more often in people

with asthma.

Combination inhaler: More than one drug in an inhaler.

Control: Amount of daily symptoms (usually in asthma)

Cor pulmonale: Fluid accumulation due to chronic

respiratory illness, usually visible as ankle swelling.


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CPAP (Continuous Positive Airway Pressure): A therapy

that helps to treat sleep apnoea (OSAS) by blowing air

into the airway. A separate leaflet is available on this

treatment and there is a recommended website.

CRP (C-reactive protein): A blood test that is raised in the

presence of inflammation.

CTPA (Computerised tomographic pulmonary angiogram):

A special form of CT scan that shows the blood vessels.

Used when a blood clot in the lungs is suspected.

CT Scan (Computerised tomographic scan): An x-ray

investigation where the patient lies down on a couch and

passes through a “polo mint” shaped device. A computer

constructs images of slices through the body in great

detail.

D DEXA Scan: A scan that looks at bone density and is

therefore used for diagnosing osteoporosis (bone

thinning).

Diaphragm: the main breathing muscle, separates the

chest from the abdomen.

Diffuse Parenchymal Lung Disease (DPLD): is a term used

to describe conditions affecting the “scaffolding” in the

lung rather than the airways. The term covers a wide


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range of diseases and processes that can cause scarring

(fibrosis). Leaflets are available on lung fibrosis.

DVT: Deep venous thrombosis. Blood clots forming in the

legs.

Dysfunctional breathing: An inefficient breathing pattern

that can worsen or cause breathlessness.

Dyspnoea: Breathlessness, shortness of breath or a feeling

of inability to breathe in fully.

E Echocardiogram: An investigation using sound waves to

look at the shape and function of the heart.

Emphysema: describes the appearance on CT or biopsy of

destruction or distortion of the air sacs. It is caused by

smoking so is usually seen in people with COPD.

Epistaxis: Nose bleeds.

ESR (Erythrocyte Sedimentation Rate): A blood test which

is high if there is inflammation but does not suggest what

type of inflammation or where it is.

Erythema Nodosum: A red/bruised type of inflammation

of the shins that can occur in response to infection or in

association with some lung diseases such as sarcoidosis.

Extrinsic Allergic Alveolitis (hypersensitivity pneumonitis):

Inflammation of the air sacs of the lungs following


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exposure to something in the environmental (such as

mouldy hay, pigeons or cockatiels) that a person is

abnormally sensitive to.

F FDG PET: A specialist imaging test that gives information

on both structure and function. Useful if cancer

FeNO (fraction of exhaled nitric oxide): A measure of the

amount of asthma-type steroid responsive inflammation

occurring in the lungs.

FEV1: the amount of air a person can blow out in one

second. This is often low in airways disease.

FVC: the total amount of air a person can blow out when

blowing hard. It is used to help interpret FEV1. See also

spirometry.

Finger Clubbing: A change in the shape of the finger ends

which can be a sign of lung disease.

Fixed airflow obstruction: Narrowing of the airways that

does not get completely better with treatment. May be

seen in chronic asthma, bronchiectasis, or smoking related

lung diseases.

FNA (fine needle aspiration): a procedure that uses a fine

needle to suck out a small number of cells that can be

examination under the microscope.


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H Haemoglobin (Hb): A measurement to assess how much

oxygen the blood can carry.

Haemoptysis: Coughing up of blood.

Hiatus Hernia: part of the stomach slips through a

weakness in the diaphragm. It can sometimes be seen on

a chest x-ray but is often of no importance, al- though

occasionally is associated with Gastro-Oesophageal Reflux

Disease and heart- burn.

HIV/AIDS: Human Immuno-Deficiency Virus/Acquired

Immuno-Deficiency Syndrome. Patients with these

conditions may be predisposed to unusual lung infections.

HRCT Scan: A special form of CT scan that produces

pictures of very thin sections of lung.

Hypertension: Raised blood pressure. “Pulmonary

hypertension” implies raised blood pressure in the blood

vessels in the lung.

Hypertonic Saline: A mixture of salt and water that can be

given by nebuliser for conditions where mucus production

is a major problem.

Hyperventilation: Excessively rapid or deep breathing.

Hypoventilation: Excessively shallow or slow breathing.

Hypoxia: Low oxygen levels


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I Induced Sputum: A test where cells in sputum are

examined to see what type of inflammation is happening,

and so what treatment might be best. Usually requires the

patient to be given a nebulised medicine to help them

cough up sputum.

Ischaemic Heart Disease: Heart disease resulting from an

inadequate blood supply to the heart muscle, usually

because of narrowing of the coronary arteries.

K KCO: A measurement done in the lung function

laboratory that shows the rate at which oxygen can move

from the air into the blood stream within a person’s lungs.

L Lobectomy: The surgical removal of one lobe of the lung.

Lung Cancer: The commonest form of cancer in men in

the U.K. and the second commonest in females. It occurs

in several different forms and treatment often depends on

its type, where in the lungs it is situated and how soon it

caused symptoms. Specific leaflets are available on this

condition and there are recommended websites.


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Lung Resection: The surgical removal of a portion of lung

tissue.

Lung Function Tests (also known as Pulmonary Function

Tests): These tests are usually carried out at rest and

involve blowing into machines which analyse the amount

and type of gas to provide information on how well the

lungs are working.

Lymphadenopathy: Swelling of lymph glands.

M MDT (Multidisciplinary team) meeting: This is a method of

delivering care to people with lung diseases whereby

doctors you see in the clinic discuss your case with other

doctors and nurses. MDTs usually involve doctors from

other disciplines such as x-ray specialists, an

administrative coordinator, and specialist nurses.

Mediastinal shift: a term used to comment on X-rays that

describes a change in position of the structures in the

centre of your chest.

Mesothelioma: an uncommon cancer of the coating of the

lung.

Metastasis: The spread of cancer from where it arose to

somewhere else in the body.


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Methotrexate: An anti-inflammatory medication used in

the treatment of some lung diseases to reduce steroid

doses. A separate leaflet exists for this medication.

Monoclonal antibody: A medication that attaches to a

very specific target just like components of the immune

system do. These expensive drugs are usually

administered by injection.

Montelukast: A tablet therapy for the treatment of asthma.

It helps to reduce inflammation but is not a steroid.

MIP/MEP (maximal inspiratory pressure/maximal

expiratory pressure): Tests to investigate whether the

breathing muscles are weak.

MRI (Magnetic resonance imaging): A type of imaging that

use magnetic fields rather than X-rays. These scans involve

being in a tunnel and take longer than CT scans. Advice

will be given to you if you are having one of these tests.

MSLT (multiple sleep latency test): A test designed to see

how sleepy you are during the day. It is performed in

hospital where you are given the opportunity to have five,

20 minute naps over a day.

Mucolytic: A type of medication that makes phlegm less

sticky so it is easier to cough up.

N


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Narcolepsy: A sleep disorder characterised by suddenly

falling asleep in the middle of other activities. Other

symptoms may include paralysis and or hallucination at

times of waking or going to sleep and sudden loss of

muscular control triggered by amusement, anger or

excitement. Further leaflets are available.

Nebuliser: A machine that produces a mist of medication

which can then be breathed in. There is no evidence that

this method of administering medicines is any better than

a standard inhaler used with a spacer.

NIV (non-invasive ventilation): Using a machine that blows

air through a tight fitting mask to assist someone’s

breathing.

Nocturia: Waking at night to pass water.

O Obstructive Sleep Apnoea Syndrome: A disorder

occurring during sleep where parts of the upper airway

narrow or close. This causes brief periods of not breathing

often terminated by a loud snore or gasping for air. This

happens repetitively so sleep is disrupted and people

wake feeling unrefreshed and can feel sleepy in the

daytime. Special leaflets are available on this condition



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OD: A Latin abbreviation meaning that a medicine should

be taken once daily.

Oedema: Excess fluid in the tissues, often in the ankles

(“ankle oedema”) or lungs (“pulmonary oedema”).

Orthodeoxia: Low oxygen levels when lying flat

Orthopnoea: Breathlessness on lying flat.

Oxygen Saturation: An indirect measurement of how

much oxygen there is in the bloodstream.

P Parenchymal: In the lung substance, as opposed to the

airways.

Peak Flow: A simple blowing test that shows how fast a

person can blow air from the lungs. Can be used to

monitor people with asthma but not helpful in other

conditions.

Pleurocentesis: Draining fluid that has collected around

the lung by a needle inserted into the chest wall under

local anaesthetic.

Pleural Effusion: Fluid collecting between the lung and the

chest wall. This may occur as a result of heart or liver

disease or because of an illness in the lung such as an

infection or inflammation or tumour.


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Pleural plaques, minor scarring of the coating of the lung

visible on a chest x-ray

Pleural Thickening: Thickening of the coating of the lung –

often occurs because of an infection, or injury to the chest

wall or sometimes as a result of previous exposure to

asbestos.

Pneumococcus: A common type of bacterial which can

cause pneumonia.

Pneumothorax: An abnormal collection of air between the

lung and the chest wall.

Pneumonia: An infection of the airways and air sacs of the

lungs – the air sacs become filled with infected material.

Pneumonia can occur in previously healthy people.

Polysomnography: A detailed investigation of sleep

patterns, breathing and movements. The test is done in

hospital as special sensors are connected to monitor

different parts of the body as you sleep.

Post-nasal Drip: Mucous dripping from the sinuses into the

back of the throat where it is often sensed as catarrh.

Postural drainage: A type of physiotherapy technique that

is taught to patients with bronchiectasis to help them

bring up phlegm.

Prednisolone: A steroid tablet.


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Proton Pump Inhibitor: a type of medication that reduces

acid production in the stomach.

PRN: A Latin abbreviation meaning that a medicine is

taken as required.

Pulmonary Embolism: A clot in the main blood vessels in

the lungs. The clots usually occur in the pelvis or legs

before breaking off and going to the lungs.

Q QDS: A Latin abbreviation indicating that a medicine

should be taken four times a day.

Quadruple Therapy: A term usually used to imply the use

of four medicines simultaneously for the first two months

of treatment for tuberculosis.

R RCP score (Royal College of Physicians score): A score that

shows how well someone’s asthma symptoms are

controlled.

Restrictive Lung Disease: This term describes a condition

whereby the lungs are smaller than usual. This may be

because there is a disease of the lung such as scarring

from DPLD, or the lungs may be small because they are


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restricted in size by problems of the chest wall or

breathing muscles.

Rifater: A combination tablet which contains three

medicines used for tuberculosis and which saves patients

having to take multiple, separate tablets.

S Salbutamol: The commonest form of inhaled

bronchodilator (airway opener).

Sarcoidosis: A disease of unknown cause, whereby

collections of cells known as granulomata arise and these

can interfere with the function of the lungs and other parts

of the body. A special leaflet is available on this condition


Shuttle Walk Test: An assessment of exercise capacity.

Sinusitis: Inflammation occurring in the air spaces in the

bones of the front of the skull known as sinuses.

Sleep Hygiene: A term used to describe the routines and

habits associated with sleep and waking up.

Small Cell Lung Cancer: A type of lung cancer nearly

always treated with chemotherapy.

Spirometry: A common breathing test where a person

breathes in as much as possible then blows as hard and

fast as possible.


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Sputum cytology: A test to look at cells in samples of

phlegm.

Squamous Cell Carcinoma: The commonest type of lung

cancer.

T Thoracoscopy: A keyhole procedure where a camera is

used to examine and sample the inside of the chest wall.

Can be done as a daycase or under anaesthetic by

surgeons.

Thoracotomy: An operation to open the chest.

TNM: A classification system that records how large a lung

cancer is and if it has spread.

Transbronchial lung biopsies: Samples from near the edge

of the lung taken during a bronchoscopy. X-rays may be

needed to guide the sampling.

Tuberculosis (TB): An infection of the lungs, lymph nodes,

or other organ. The bacteria grow slowly and are resistant

to common antibiotics so six months of specific treatment

is needed.

Tumour Markers: Blood tests that can suggest the

presence or activity of some types of cancers.


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Tuberculin Test: A skin test that determines someone’s

immunity to tuberculosis or reflects the degree of previous

exposure to that disease.

Type II respiratory failure: A description of any breathing

problem that results in both low oxygen levels and also

difficulty in getting rid of the waste gas carbon dioxide.

V V/Q scan: A scan that looks for blood clots by comparing

the movement of air and blood in the lungs. It involves

radioactive markers so certain precautions will be

discussed with you if one is needed.

VATS (Video assisted thorascopic surgery): Key-hole chest

surgery.

Vocal cord dysfunction: A problem where the vocal cords

do not move as they should, narrowing the space for air to

pass through. It often exists with asthma and causes

breathlessness.


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Useful Web Addresses General Information on Lung Diseases The following websites contain information about lung

conditions and are a good place to start if you are looking

for more information about your condition or about a

procedure that you are going to have.

The British Lung Foundation - www.lunguk.org

This UK Charity has an excellent website that provides

useful information about almost every lung condition, and

offers support to those with lung disease and their carers.

NHS Direct Online - www.nhsdirect.nhs.co.uk

Information on many aspects of health, including a health

encyclopaedia, best treatment guide and self-help guide.

BBC Health Online - www.bbc.co.uk/health

Well-presented information on a wide range of lung

disorders, and on other health-related topics.

Patient UK - www.patient.co.uk

A comprehensive selection of leaflets on lung conditions,

treatments and procedures. Also provides a list of useful

patient groups & organisations.

The Department of Health - www.doh.gov.uk


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Health and social care policy, guidance and publications.

MedicAlert Foundation - www.medicalert.org.uk

Information on how to obtain MedicAlert bracelets.

Specific Lung Diseases The following websites offer information and support to

people with specific diseases, and many have information

on current research.

1. Asthma

· Asthma UK - www.asthma.org.uk

· Allergy UK - www.allergyuk.org

· Health and Safety Executive - www.hse.gov.uk/asthma

2. Chronic Obstructive Pulmonary Disease

· COPD International - www.copdinternational.com

3. Cystic Fibrosis

· TheCysticFibrosisTrustUK-www.cftrust.org.uk

4. Lung Cancer

· Cancer Research UK - www.cancerresearchuk.org

· CancerBACUP - www.cancerbacup.org.uk

· Roy Castle Lung Cancer Foundation -


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www.roycastle.org

5. Sleep Apnoea

· The British Snoring and Sleep Apnoea Association -

www.britishsnoring.co.uk

· The Sleep Apnoea Trust - www.sleep-apnoea-trust.org

· The Sleep Council - www.sleepcouncil.com

6. Smoking

· NHS Giving Up Smoking - www.givingupsmoking.co.uk

· QUIT www.quit.org.uk -

· Action on Smoking and Health (ASH) -

www.ash.org.uk

7. Tuberculosis

· The Health Protection Agency - www.hpa.org.uk

· TB Alert - www.tbalert.org

· Stop TB - www.stoptb.org

8. Other Lung Conditions

· Alpha 1 Antitrypsin Deficiency

www.alpha1.org.uk/Alpha1

· The National Eczema Society www.eczema.org


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· LAM (Lymphangioleiomyomatosis) Action

www.lamaction.org

· Pulmonary Hypertension Association www.pha-uk.com

· Respiratory Muscle Weakness

www.respiratorymuscle.co.uk

· Sarcoidosis and Interstitial Lung Associaton (SILA)

www.sarcoidosis.org.uk

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