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01. Respiratory System > 1.2 Lower Respiratory Tract Infections > Flashcards

1.2 Lower Respiratory Tract Infections Flashcards

1
Q

Who commonly get LTRIs?

A

Very young

Od

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2
Q

When is there an increased incidence of LTRIs?

A

During winter

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3
Q

What is the 2nd commonest cause of death in the UK?

A

Pneumonia

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4
Q

What are the symptoms of asthma?

A

They can be variable
Often breathlessness
Pleuritic chest pain
Cough and infected sputum

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5
Q

Is a CXR abnormal in pneumonia?

A

Always abnormal

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6
Q

What is seen in a CXR of someone with pneumonia?

A

Pulmonary shadowing/consolidation

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7
Q

What does the added sound of crackling usually indicate?

A

Infection

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8
Q

What is bronchiectasis?

A

The dilation of bronchi producing sepsis in the chest

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9
Q

What are the symptoms of bronchiectasis?

A 
Daily cough 
Daily copious purulent
Sputum production 
Occasional haemoptysis 
Frequent chest infections
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10
Q

What are the signs of bronchiectasis?

A

Finger clubbing

Lung crackles on inspiration and expiratoin

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11
Q

Can bronchiectasis be cured?

A

No

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12
Q

How is empyema distinguished from a simple effusion?

A

The fluid can be collected and sampled and is found to be pus

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13
Q

Why does the infected fluid need to be drained and not treated with antibiotics?

A

Because antibiotics do not penetrate well into the pleural cavity

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14
Q

What investigations are done for bronchiectasis?

A

Sputum culture
Spirometry
CXR
High resolution CXR are the main diagnostic tests

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15
Q

What infects the fluid in empyema?

A

Micro-organisms

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16
Q

What is a lung abscess?

A

When the bacteria in the lung form a pocket of infected fluid

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17
Q

How is an abscess in the lung removed?

A

Long-term antibiotics

Sometimes the abscess must be drained by a surgeon or radiologist

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18
Q

What are the hosts defences of the lower respiratory tract?

A

Alveolar macrophages
Mucociliary escalator
Cough reflex

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19
Q

What are the aetiological classifications of pneumonia?

A 
Community
Hospital acquired 
Pneumonia in the Immunocompromised
Atypical 
Aspiration 
Recurrent
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20
Q

What is lobar pneumonia?

A

A form of pneumonia that affects a large and continuous area of the lobe of a lung

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21
Q

What are some of the complications of LTRIs?

A

Pleurisy
Pleural Effusion
Empyema

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22
Q

What are some of the common micro-organism causes of LRTIs?

A

Streptococcus pneumonia

Staphylcoccus aureus

23
Q

What are some of the uncommon micro-organism causes of LRTIs?

A

Legionella pneumophila
Klebsiella pneumoniae
Pseudomonas aeruginosa
Bacteroides and other anaerobes

24
Q

What are some of the rare micro-organism causes of LRTIs?

A

Haemophilus influenzae

Escherichia coli

25
What % of pneumonias does streptococcus pneumonia account for?
50%
26
Who gets streptococcus pneumonia?
All ages
27
What are the features of streptococcus pneumonia?
``` Abrupt onset High pyrexia/rigors Pleuritic chest pain Cough with purulent (green) sputum Hypotension and cyanosis Septicaemia ```
28
What is shown in the CXR of streptococcus pneumonia?
Clasically lobar | Often patchy shadowing
29
What is the treatment for streptococcus pneumonia?
IV benzyl penicillin, amoxicillin, oral ampi
30
If the person is allergic to penicillin what antiobiotics should be used?
Macrolide | Clarithromycin
31
What is the treatment for empyema?
Chest drain | IV antibiotics
32
What organisms are more likely to result in cavitating pneumonia?
Staph. aureus Pseudomonas Anaerobes
33
What are the causes of bronchiectasis?
``` Idiopathic Immotile Cilia Syndrome CF Childhood infections such as measles ABPA ```
34
What is the treatment for bronchiectasis?
Chest physiotherapy Prompt treatment of infections with appropriate antibiotics May require inhaled therapy including beta2 agonist and inhaled corticosteroid
35
What % of community diagnosed pneumonia require hospitlisation?
Between 22 and 42%
36
How would you describe the sputum in pneumonia?
Rusty
37
What does CURB65 stand for?
``` C = confusion U= blood urea>7 Respiratory rate >30 B = diastolic blood pressure <60 65 = age>65 ```
38
What are the main features of bronchiectasis?
Dilated and damaged bronchi
39
What are examples of LRTIs?
``` Acute bronchitis Exacerbation of COPD Pneumonia Empyema Lung Abscess Bronchiectasis ```
40
What is the UK incidence of pneumonia?
Between 5 and 11 per 1000 of the adult population
41
What are the symptoms of pneumonia?
``` Malaise Fever Chest pain (pleuritic) Cough Purulent Sputum Dyspnoea ```
42
What are the signs of pneumonia?
``` Pyrexia Tachpnoea Central cyanosis Dullness on percussion of affected lobe(s) Bronchial breath sounds Inspiratory crepitations Increased vocal resonance ```
43
What is tachpnoea?
Abnormally rapid breathing
44
What is the investigation for pneumonia?
``` Serum biochemistry and full blood count CXR Blood cultures Throat swab Sputum microscopy and culture ```
45
What bacteria can cause pneumonia?
``` Strep pneumoniae H. Influenzae Legionella Staph aureus Mycoplasma pneumoniae Chlamydia psittaci ```
46
What treatment is given to pneumonia patients?
Oxygen I.V fluids CPAP Intubation and ventilation
47
What are the potential complications of pneumonia?
``` Septicaemia Acute kidney injury Empyema Lung abscess Haemolytic anaemia ARDS ```
48
What does ARDS stand for?
Acute respiratory distress syndrome
49
How is empyema diagnosed?
By pleural aspiration (draining the fluid and testing)
50
What is the treatment for empyema?
Chest drain | I.V antibiotics
51
What are the causes of bronchiectasis?
``` Idiopathic Immotile Cilia Syndrome Cystic Fibrosis Childhood infections e.g measles ABPA - allergic Bronchopulmonary aspergillosis ```
52
What are the symptoms of bronchiectasis?
Chronic cough | Daily sputum production
53
What are the sometimes symptoms of bronchiectasis?
``` Wheezing Dyspnoea Tiredness Flitting chest pains Haemoptysis ```
54
What is the treatment for bronchiectasis?
Chest physiotherapy Prompt treatment of infections with appropriate antibiotics May require inhaled therapy including beta 2 agonist and inhaled corticosteroid

01. Respiratory System (82 decks)

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