ACUTE RESPIRATORY INFECTION AND PNEUMONIA Flashcards
what are some of the main defence mechanisms of the respiratory tract?
nasal hairs nasal turbinates cough reflex mucociliary escalator trachea and bronchial tree narrowing sneezing innate and acquire immune responses
what is commensalism?
a relationship between 2 organisms where 1 benefits and the other is unaffected
what is an infection?
the presence of a microorganism causing damage to body tissues
what is an opportunistic infection?
an infection caused by a microorganism that normally does not cause disease but becomes pathogenic when the body’s defence is compromised
what are some upper respiratory tract infections?
tonsilitis pharyngitis laryngitis sinusitis common cold otitis media
what are some common lower respiratory tract infections?
tracheitis bronchitis pneumonia lung abscess bronchiolitis
what is acute bronchitis?
inflammation of the tracheo-bronchial treae
when is peak incidence for acute bronchitis?
winter
what are symptoms of acute bronchitis?
cough
shortness of breath
wheezing
retrosternal burning chest pain
what does acute bronchitis look like on chest xray?
normal
what are the main aetiological agents of acute bronchitis?
mostly viruses - rhinovirs, coronavirus, adenovirus, parainfluenza, influenza A/B
bacteria - haemophilus influenza, streptococcus pneumonia, staph aureus and mycoplasma pneumoniae
what are exacerbations of COPD?
acute bronchitis on a pre-existing diagnosis of COPD so you present with a sustained increase in symptoms including SOB, cough and wheeze
what is pneumonia?
an infection in the lungs caused by microbes resulting in ifnlamamtion that brings water into the lung tissue, making it harder to breathe.
what are the causative organisms of community acquired pneumonia?
s. pneumonia
s. aureus
h. influenza
group A streptococci
influenza virus
respiratory syncytial virus
parainfluenza
what are risk factors for community-acquired pneumonia?
advanced age, lowered immunity, smoker, alcohol abuse, malnutrition, chronic lung disease
outline the stages of pneumonia?
congestion - day 1-2 as blood vessels and alvelo start filling with excess fluid
red hepatization - days 3-4 as exudate starts filling airspaces, solidifies them and lungs develop a liver-like appearance
grey hepatozation - days 5-7 as lungs remain firm but red blood cells in exudate break down we get a colour change
resolution - day 8 -3 weeks as exudate is digested by enzyme ingested by macrophages and coughed up
what are complications of pneumonia?
meningitis, sepsis, pleural effusions
what are symptoms and signs of pneumonia?
fever cough haemoptysis pleuritis chest pain tachypnea tachycardia dyspnea muscle pain fatigue crepitation on palpation dullness to percussion
what would you see on an x-ray of someone with pneumonia?
interstitial infiltrates consolidation and pleural effusion sometimes
what causes typical pneumonia?
streptococcus pneumoniae
what microroganism causes atypical pneumonia?
mycoplasma chlamydia and legionella
what is nosocomial pneumonia?
hospital acquired pneumonia - occurs >48 hours after admission or following discharge
what microorganisms cause nosocomial pneumonia?
MRSA
klebsiella pneumoniae
pseudomonas aeuginosa
acinetobacter
what are risk factors for nosoconial pneumonia?
intubation
poor staff hygeine
contaminated quipment
which type of pneumonia is associated with community acquired and which with nosocomial?
lobar pneumonia is most commonly associated with community acquired and bronchopneumonia with hospital acquired
what is lobar pneumonia?
pneumonia characterized by inflammatory exudate within the intra-alveolar space resulting in consolidation affecting a large and continuous area of the lobe of a lung
what is bronchopneumonia?
acute inflmmation of the bronchi, accompanied with inflamed patches in nearby lobules of the lungs
what is atypical pneumonia?
pneumonia not caused by one of the pathogens most commonly assocuated with the disease
more likely to present with generlizd symptoms such as fever, headache, sweating, myalgia and bronchopneumonia
what are the 2 syndromes that legionella pneumophila can cause?
legionnaires disease and pontiac fever
what is legionnaires disease?
a type of atypical pneumonia
where does legionella reside?
in warm water
how do we assess the severity of pneumonia?
CURB65 score confusion of new onset urea >7 resp rate >30 SBP <90 or DBP <60 Age >65
whats the treatment for pneumonia?
oral amoxicillin
if atypical pathogens suspected then amoxicillin with clarithromycin or erythromycin (pregnancy)
if they have a penicillin allergy then give clarithromycin or doxycycline
if high severity then give Co-amoxiclav with clarythromycin or oral erythromycin - can give IV
what is co-amoxiclav?
amoxicillin with clavulanic acid to kill the bacteria that cause an infection.
clavulanic acid is a beta lactamase inhibitor which prevents the bacteria from rendering the amoxicillin inactive
what is bronchiectasis?
a long-term condition where the airways of the lungs become widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection.
persistant cough and SOB are common symptoms
what is bronchiolitis?
a common lower respiratory tract infection that affects babies and young children under 2 years old- symptoms similar to a common cold
affects the brionchioles
