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1Principles of Biomedicine - MD1 > 76 - LRT Infections > Flashcards

76 - LRT Infections Flashcards

1
Q

Frequent aetiological agents of acute bronchitis

A

Viral URTI

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2
Q

Frequent aetiological agent of acute exacerbation of chronic bronchitis

A

Usually pneumococci and/or H influenzae

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3
Q

Symptoms of acute exacerbation of chronic bronchitis/COPD

A

Sputum becomes more purulent, bloody

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4
Q

Less-virulent H influenzae and S pneumoniae

A

Higher-numbered pneumococci, unserotyped H influenzae

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5
Q

Frequent aetiological agent of bronchiolitis

A

RSV (particularly common under one year)

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6
Q

Effect of RSV on adults

A

Acute bronchitis symptoms, which can last a few weeks

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7
Q

Why does RSV cause bronchiolitis in under-ones?

A

Babies still have antibodies against RSV from mother.
Antibodies form immune complexes with virus.
Cā€™ activation, etc, which causes more-severe inflammation than in older children without maternal antibodies

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8
Q

Effect of bronciholitis on ventilation

A

Gas is trapped in bronchioles.
On inspiration, bronchioles are opened.
On expiration, bronchioles collapse (no cartilage), trapping air. This manifests as a long expiratory wheeze.

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9
Q

Types of pneumonia
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3

A

1) Acute bacterial
2) Typical pneumonia
3) Atypical pneumonia

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10
Q 
Acute bacterial pneumonia common aetiological agents 
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A

Pneumococci (~80% of non-nosocomial cases. ~50% of nosocomial cases)
H influenzae
Staph (nosocomial)
Klebsiella (nosocomial)
Legionella (often immunocompromised, EG older)
TB
Chlamydophila

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11
Q

Chlamydophila pneumoniae, psittacae

A

Intracellular bacteria, same family as Chlamydia trachomatis.

Have replicative and infective forms.

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12
Q

Chlamidophila species that can cause pneumonia

A

Chlamydophila pneumoniae and psittacae

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13
Q

C psittacae vector

A

Birds.

Live harmlessly in birds, unless bird is stressed (EG: when captured).

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14
Q

Typical pneumonia

A

Sudden onset, sputum is purulent and bloody.

Restricted to one lobe

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15
Q

Atypical pneumonia

A

Chronic
Sputum not bloody, purulent.
Not restricted to one lung section, diffuse through lungs.

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16
Q

Bacterial cause of atypical pneumonia

A

Mycoplasma pneumonia

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17
Q 
Causes of atypical pneumonia 
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6
A 
Mycoplasma
Chlamydia
M. catarrhalis (can also cause otitis media) 
Influenza
RSV
Adenovirus
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18
Q

Chlamydia that can cause pneumonia in babies (particularly first month of life)

A

Chlamydia trachomatis

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19
Q

How do infants get C trachomatis pneumonia?

A

From infected mother.

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20
Q

Where does inflammation from typical pneumonia tend to be?

A

Alveoli

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21
Q

Where does inflammation from atypical pneumonia tend to be?

A

Interstitial tissue

22
Q

Examples of fungal causes of pneumonia
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3

A

Histoplasma
Aspergillius
Pneumocystis

23
Q

Bacteria which can cause lung abscesses

A

Mixed anaerobes.

24
Q

Empyema

A

Pus in the pleural space

25
Q

Aetiological agent of empyema

A

S aureus, as a secondary infection from pneumonia

26
Q

Why make a specific diagnosis of pneumonia?
1
2

A

1) Appropriate antibiotic prescribing

2) Notifiable pathogens

27
Q 
Examples of notifiable pathogen-caused pneumonias 
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A 
SARS, MERS
Influenza (H5N1)
Legionella spp
Bioterrorism agents (anthrax, yersinia)
Community-acquired MRSA
28
Q

Ways to specifically diagnose pneumonia
1
2
3

A

Clinical
Radiological
Lab

29
Q 
Clinical considerations of pneumonia 
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A

1) Community- or hospital-acquired
2) Severity index (becoming less used)
3) Underlying illness: COPD, ADIS, cystic fibrosis
4) Occupation (contact with animals, air quality, air conditioning)
5) Travel
6) Homelessness

30
Q

Bacteirum that can be in potting mix for gardening

A

Legionella longbeachii

31
Q

Bacterium that can be from animal furs

A

Bacillus anthraxis

32
Q

Infection particularly associated with homelessness in Melbourne

A

Tuberculosis

33
Q 
Types of specimens for pneumonia diagnosis 
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A

1) Properly collected sputum
2) Transtracheal aspirate
3) Aspiration via tracheostomy, endotracheal tube
4) Aspiration via bronchoscope
5) Pleural tap (if effusion)
6) Lung biopsy (by needle or open)
7) Blood for culture and serology

34
Q

Properly collected sputum

A

Coughed from lungs, observed by a clinician.

NOT spit - same organisms are in saliva that can cause pneumonia

35
Q 
Culture diagnosis of pneumonia
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A

1) Look for purulent part of sample.
2) Plate purulent sample, gram stain.
3) Look for polymorphonuclear cells (must be present).
4) Look for buccal bacteria, as this indicates contamination.

36
Q

Ways to collect sputum with less contamination than coughing

A

Transtracheal tube, tracheostomy, endotracheal tube, aspiration via bronchoscope

37
Q

How to take a sample with a bronchoscope

A

Inject a small amount of saline, take sample

38
Q

Use of a pleural tap

A

If pleural space is purulent, probably the same agent that caused pneumonia

39
Q

Lung biopsy by needle
1
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3

A

1) Relatively non-invasive, performed by a radiologist.
2) Radiologist locates area of interest, inserts needle between ribs to site of inflammation.
3) Perform in unresolved pneumonia, not in standard pneumonia

40
Q

Is blood cultured from a pneumonia patient often positive for pneumonia-causing organism?

A

No

41
Q

Transtracheal tube

A

Anaesthatise patient with a local.

Insert needle into cricothyroid space, insert into lungs.

42
Q

When is serological diagnosis of pneumonia useful?

A

When bacterium is hard to grow.

43
Q 
Examples of bacteria that are diagnosed with serological techniques for pneumonia
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A

1) Mycoplasma pneumonie
2) Legionella pneumophila
3) Chlamydophila, Chlamydia
4) Coxiella burnetii

44
Q

Cause of typhus fever

A

Ricketsia prowazechii (spread by insects)

45
Q

What do you look for in a serological test?

A

Specific IgM, rising titre

46
Q

Which aetiological agents for pneumonia are tested for with antigen detection?

A

Common viruses (RSV, influenza, parainfluenza, etc), Bordatella, Legionella pneumophila type 1

47
Q

How is the sample for antigen detection taken?

A

Tube inserted into nose, fluid form nose taken

48
Q

When is an URT swab useful for diagnosing LRT infection?

A

When it is a viral infection. Bacteria living in URT can cause LRTI, but viruses do not live here normally

49
Q

Best-guess antibiotics prescribed for community acquired pneumonia

A

Pen G/Amoxycillin + doxycycline/macrolide

Pen G for pneumococcus.
Tetracyclines and macrolides are effective for less-common bacteria (EG: mycoplasma are resistant to Pen G, as have no cell wall)

50
Q

Why is using penicillin and tetracyclines together unusual?

A

When treating meningitis, are antagonistic

51
Q

When do you modify best-guess antibiotic prescription

A

If severe, if there are specific risk factors, if you known the causative organism

52
Q

Examples of vaccines for pneumonia
1
2
3

A

1) Influenza vaccine
2) Pneumococcal vaccines (23-valent polysaccharide, 13-valent conjugate)
3) Coxiella (Q fever)

1Principles of Biomedicine - MD1 (157 decks)

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