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FIM > 31. Lower RTIs > Flashcards

31. Lower RTIs Flashcards

1
Q

What are the risk factors for pneumonia?

A 
Age
Chronic lung disease
Smoking and alcohol
Winter
Co-morbidities
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2
Q

What pathogens cause community acquired pneumonia?

A 
Strep pneumoniae
Mycoplasma pneumoniae
Haemophilus influenzae
Legionella pneumophilia
Staph aureus
Chlamydia, coxiella and gram negatives
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3
Q

What micro investigations can be done in suspected pneumonia?

A

Blood, sputum and BAL for culture
Urinary antigen for legionella or pneumococcus
Nose/throat swab for influenza PCR

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4
Q

What blood test results are indicative of pneumonia?

A

High WCC
Inflammatory markers
Renal function tests used to calculate severity

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5
Q

How is community acquired pneumonia empirically treated?

A

Benzylpenicillin

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6
Q

What pathogens cause atypical pneumonia?

A

Mycoplasma, legionella, chlamydia, coxiella

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7
Q

How is atypical pneumonia treated?

A

Macrolides
Tetracyclines
Fluoroquinones

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8
Q

What population group is most commonly infected with mycoplasma?

A

Children and young adults

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9
Q

How does mycoplasma spread?

A

Droplet

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10
Q

What complications are associated with mycoplasma?

A

Carditis and encephalitis

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11
Q

How is mycoplasma detected?

A

Serology and NAAT

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12
Q

What is the treatment for mycoplasma?

A

Macrolides or tetracycline

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13
Q

How is legionella detected?

A

Urinary antigen

Sputum culture

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14
Q

How is legionella treated?

A

Macrolide or fluoroquinone

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15
Q

Which chlamydia subspecies cause pneumonia?

A

Psittaci

pneumoniae

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16
Q

Compare the method of spread of chlamydia psittaci and pneumoniae

A

Psittaci: airborne
Pneumoniae: Droplet

17
Q

Compare the incubation periods of chlamydia psittaci and pneumoniae

A

Psittaci: 1-3 weeks
Pneumoniae: 3-4 weeks

18
Q

How is chlamydia pneumonia diagnosed?

A

NAAT

Serology for specific IgG

19
Q

What is the treatment for chlamydia?

A

Tetracycline or macrolides

20
Q

What is the treatment of coxiella?

A

Doxycycline

21
Q

What kind of pneumonia is caused by staph aureus?

A

Severe necrotising pneumonia due to the production of PVL toxin
Causes abscess formation

22
Q

What patient group is associated with klebsiella pneumonia?

A

Alcoholics

23
Q

What kind of pneumonia is associated with klebsiella?

A

Cavitating pneumonia
Redcurrant jelly sputum
Abscess formation

24
Q

What are the viral causes of pneumonia?

A

Influenza
RSV in children
Complication of chicken pox, measles and CMV

25
Q

What pathogens are associated with hospital acquired pneumonia?

A

Gram - bacilli
MRSA
Legionella
Viruses

26
Q

What score is used to predict the mortality of community acquired pneumonia?

A

CURB-65

Used to decide treatment

27
Q

What does CURB-65 stand for?

A 
Confusion
Urea
Respiratory rate
BP
>65
28
Q

What is the treatment for a CURB-65 score of 0-1?

A

PO: Amoxicillin
Clarithromycin
Doxycycline

29
Q

What is the treatment for a CURB-65 score of 2?

A

IV amoxicillin and PO clarithromycin

30
Q

What is the treatment for a CURB-65 score of 3-5?

A

IV co-amoxiclav and PO clarithromycin

31
Q

What are the risk factors for lung abscesses?

A 
Aspiration
Periodontal disease
Bronchiectasis
Bronchial carcinoma
Bacteraemia
32
Q

What fungi are opportunistic causes of pneumonia?

A

PCP
Aspergillus
Cryptococcus neoformans

33
Q

Which bacteria cause lung abscesses?

A

Staph aureus
Klebsiella
Strep pyogenes

34
Q

Why do patients with CF have an increased risk of lung infections?

A 
Reduced microbial clearance
Inactivated defensins and impaired killing by neutrophils in airways
Receptor for pseudomonas
Reduced NO
Airways are hyperinflammatory

FIM (44 decks)

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