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Respiratory and Cardio > Acute respiratory infections and pneumonia > Flashcards

Acute respiratory infections and pneumonia Flashcards

1
Q

Mechanical defences of the respiratory tract =

A 
Nasal hair 
Mucus
Mucociliary escalator
Sneezing
Cough
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2
Q

Innate immunity in the resp.tract =

A 
Alveolar macrophages
Tissue macrophages
Dendritic cells
Mast cells, eosinophils, innate lymphoid cells
Cytokines
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3
Q

Role of alveolar macrophages =

A

Cytokines

Phagocytosis

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4
Q

Macrophages recognise what with what?

A

PAMPs with TLRs (toll-like receptors)

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5
Q

Humoral immunity =

A

sIgA in upper airways
IgG and IgM from blood
IgG in alveoli

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6
Q

What kind of immunoglobulin are in alveoli?

A

IgG

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7
Q

BALT =

A

Bronchus associated lymphoid tissue

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8
Q

What happens in BALT?

A

Antigen presentation

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9
Q

Relationship between 2 organisms where one benefits and the other is unaffected

A

Commensalism

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10
Q

Opportunistic infection =

A

Infection caused by microorganism that normally doesn’t cause disease but becomes pathogenic when bodies defence is compromised

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11
Q

Ex of commensal in the nasal cavity =

A

Staph.aureus

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12
Q

Ex of commensal in pharynx and larynx

A

Staph.aureus
Strep.pneumoniae
Haemophilus influenza
Neisseria meningitidis

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13
Q

Upper resp tract =

A

Nose
Pharynx
Larynx

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14
Q

Collonisers of LRT =

A

Sterile

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15
Q

LRT =

A

Trachea
Bronchi
Lungs

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16
Q

Bacteria pathogenic in LRT:

A 
Streptococcus pneumonia
Haemophius influenzae
Staphloccus aureus
Klebsiella
Group A streptococcus 
Legionella pneumophilia
Mycoplasma pneumonia
Chlamydophila pneumoniae
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17
Q

Strep.pneumonia is

A

Gr +

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18
Q

What antibiotic is effective against Strep.pneumonia?

A

Penicillins

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19
Q

Common bacteria in bronchitis =

A

Haemophilus influenzae

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20
Q

Klebsiella is

A

Gr -

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21
Q

How can klebsiella cause pneumonia?

A

Aspiration

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22
Q

Atypical organisms involved in LRT infection:

A

Mycoplasma pneumonia
Legionella pneumonia
Chlamydophila pneumoniae

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23
Q

What doesn’t work on atypical organisms?

A

Penicillin

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24
Q

Ex of viruses involved in resp infections =

A

Influenza A and V

RSV

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25
Q

Influenza is a

A

Enveloped, +ve RNA

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26
Q

Fungi involved in LRT infection

A

Aspergillus

Pneumocystis jirvecii

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27
Q

Aspergillius is a

A

mould

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28
Q

Pneumocystis jorvecii infection may be seen in

A

HIV patients

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29
Q

Mycobacteria ex

A

Mycobacterium tuberculosis

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30
Q

Ex of URT infections:

A 
tonsilitis
sinusitis
pharyngitis
laryngitis 
otitis media
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31
Q

Symptoms of URT infections:

A 
Nasal congestion
sneezing
Increased secretions
Sore through
Cough
Headache
pain
fever
32
Q

Leading cause of death among all infectious agents =

A

lower respiratory infections

33
Q

Ex of LRT infections:

A

Bronchitis

Pneumonia

34
Q

Acute bronchitis is due to

A

Inflammation of the trachea-bronchial tree

35
Q

Peak incidence of acute bronchitis =

A

winter

36
Q

Symptoms of acute bronchitis =

A

Cough
SOB
Wheeze
Chest pain

37
Q

CXR of acute bronchitis =

A

Normal (no consolidation)

38
Q

Main aetiological agents of acute bronchitis =

A

Virus (rhinovirus, adenovirus, parainfluenza, influenza A or B)

39
Q

Bacterial involved in acute bronchitis =

A

Haemophilus influenzae
Strep.pneumonia
Staph.aureus
Mycoplasma pneumoniae

40
Q

• Pre-existing diagnosis of COPD with sustained increase in symptoms including shortness of breath, cough and wheeze.

A

Acute bronchitis on a background of COPD

41
Q

Symptoms of pneumonia =

A

Symtoms of LRT infction (cough, sputum, SOB, pain, fatigue, fever, headache etc.) with new changes on CXR

42
Q

Signs of consolidation =

A

Dull to percuss
Increased vocal resonance
Bronchial breathing

43
Q

Consolidation =

A

Fluid in lung

44
Q

Progression of lobar pneumonia =

A
  1. Consolidation
  2. Red hepatisation
  3. Grey haptisation
  4. Resolution
45
Q

Red hepatisation -

A

Exudate full of RBCs, WBCs, proteins etc.

46
Q

Grey hepatisation -

A

RBCs in exudate broken down

47
Q

What may be seen of CXR of pneumonia?

A

Air bronchograms

48
Q

Air bronchograms =

A

Bronchioles look dark due to consolidation of surrounding alveoli

49
Q

Patterns of pneumonia (3)

A

Lobar
Bronchopneumonia
Intersitial

50
Q

Lobar pneumonia is common in

A

Infants

Elderly

51
Q

Bronchopneumonia can be seen as

A

Multiple focal lesions

52
Q

Bacterial cause of bronchopneumonia:

A

Strep.pneumoniae

53
Q

Intersitial pneumonia is

A

Widespread throughout both lung fields

54
Q

What tends to cause intersitial pneumonia?

A

Atypical organisms like pneumocystis jorvecii

55
Q

Pneumonia can be acquired via

A

Community

Nosocomial

56
Q

Majority of CAP is caused by which type of organism

A

Bacteria

57
Q

Bacterial cause of CAP:

A

Strep.oneumoniae
Legionella
Staph.aureus

58
Q

Viral causes of CAP:

A

Influenza
Parainfluenza
RSV
Adenovirus

59
Q

Latrogenic things that can cause pneumonia

A

Ventilators

Intubation

60
Q

In hospital pneumonia what may be absent

A

Classical features of pneumonia

61
Q

Causes of HAP in first 4-5 days =

A

Same as CAP

62
Q

Causes of HAP later than 4 days =

A

Kelbsiella
E.coli
Staph.aureus
(anaerobes)

63
Q

Which is atypical: legionella or klebsiella

A

Legionella

64
Q

What is cavitating penumonia?

A

Complication. Lung necrotises

65
Q

What can cause necrosis and therefore cavitating penumonia?

A

S.aureus
TB
Klebsiella

66
Q

Legionella resides in

A

Warm water

67
Q

Severe legionella disease is associated with

A

Extra-pulmonary symptoms (confusion, fever, mental state changes, hyponaturemia)

68
Q

What antigens can be found in urine?

A

Legionella

S.penumomiae

69
Q

Symptoms in mycoplasma pneumonia are often

A

Mild

70
Q

CXR in mycoplasma pneumonia

A

Extensive, usually discrepancy with clinical features

71
Q

Treatment of legionella:

A

Macrolide, quinolone

72
Q

Treatment of mycopalsma pneumonia:

A

Macrolide

Tetracycline

73
Q

RF for pneumonia:

A 
Immunosuppression
Impaired defence
Smoking
Alcohol
Alterations in consciousness
Latrogenic
Drugs
74
Q

Why are alterations in conciousness a RF?

A

reduced epiglottis closure

aspiration

75
Q

Drugs which can be a RF

A

PPIs

76
Q

Score used to predict mortality after 30 days

A

CURB-65

Respiratory and Cardio (14 decks)

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