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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
Influenza is a
Enveloped, +ve RNA
26
Fungi involved in LRT infection
Aspergillus | Pneumocystis jirvecii
27
Aspergillius is a
mould
28
Pneumocystis jorvecii infection may be seen in
HIV patients
29
Mycobacteria ex
Mycobacterium tuberculosis
30
Ex of URT infections:
``` tonsilitis sinusitis pharyngitis laryngitis otitis media ```
31
Symptoms of URT infections:
``` Nasal congestion sneezing Increased secretions Sore through Cough Headache pain fever ```
32
Leading cause of death among all infectious agents =
lower respiratory infections
33
Ex of LRT infections:
Bronchitis | Pneumonia
34
Acute bronchitis is due to
Inflammation of the trachea-bronchial tree
35
Peak incidence of acute bronchitis =
winter
36
Symptoms of acute bronchitis =
Cough SOB Wheeze Chest pain
37
CXR of acute bronchitis =
Normal (no consolidation)
38
Main aetiological agents of acute bronchitis =
Virus (rhinovirus, adenovirus, parainfluenza, influenza A or B)
39
Bacterial involved in acute bronchitis =
Haemophilus influenzae Strep.pneumonia Staph.aureus Mycoplasma pneumoniae
40
• Pre-existing diagnosis of COPD with sustained increase in symptoms including shortness of breath, cough and wheeze.
Acute bronchitis on a background of COPD
41
Symptoms of pneumonia =
Symtoms of LRT infction (cough, sputum, SOB, pain, fatigue, fever, headache etc.) with new changes on CXR
42
Signs of consolidation =
Dull to percuss Increased vocal resonance Bronchial breathing
43
Consolidation =
Fluid in lung
44
Progression of lobar pneumonia =
1. Consolidation 2. Red hepatisation 3. Grey haptisation 4. Resolution
45
Red hepatisation -
Exudate full of RBCs, WBCs, proteins etc.
46
Grey hepatisation -
RBCs in exudate broken down
47
What may be seen of CXR of pneumonia?
Air bronchograms
48
Air bronchograms =
Bronchioles look dark due to consolidation of surrounding alveoli
49
Patterns of pneumonia (3)
Lobar Bronchopneumonia Intersitial
50
Lobar pneumonia is common in
Infants | Elderly
51
Bronchopneumonia can be seen as
Multiple focal lesions
52
Bacterial cause of bronchopneumonia:
Strep.pneumoniae
53
Intersitial pneumonia is
Widespread throughout both lung fields
54
What tends to cause intersitial pneumonia?
Atypical organisms like pneumocystis jorvecii
55
Pneumonia can be acquired via
Community | Nosocomial
56
Majority of CAP is caused by which type of organism
Bacteria
57
Bacterial cause of CAP:
Strep.oneumoniae Legionella Staph.aureus
58
Viral causes of CAP:
Influenza Parainfluenza RSV Adenovirus
59
Latrogenic things that can cause pneumonia
Ventilators | Intubation
60
In hospital pneumonia what may be absent
Classical features of pneumonia
61
Causes of HAP in first 4-5 days =
Same as CAP
62
Causes of HAP later than 4 days =
Kelbsiella E.coli Staph.aureus (anaerobes)
63
Which is atypical: legionella or klebsiella
Legionella
64
What is cavitating penumonia?
Complication. Lung necrotises
65
What can cause necrosis and therefore cavitating penumonia?
S.aureus TB Klebsiella
66
Legionella resides in
Warm water
67
Severe legionella disease is associated with
Extra-pulmonary symptoms (confusion, fever, mental state changes, hyponaturemia)
68
What antigens can be found in urine?
Legionella | S.penumomiae
69
Symptoms in mycoplasma pneumonia are often
Mild
70
CXR in mycoplasma pneumonia
Extensive, usually discrepancy with clinical features
71
Treatment of legionella:
Macrolide, quinolone
72
Treatment of mycopalsma pneumonia:
Macrolide | Tetracycline
73
RF for pneumonia:
``` Immunosuppression Impaired defence Smoking Alcohol Alterations in consciousness Latrogenic Drugs ```
74
Why are alterations in conciousness a RF?
reduced epiglottis closure | aspiration
75
Drugs which can be a RF
PPIs
76
Score used to predict mortality after 30 days
CURB-65

Respiratory and Cardio (14 decks)

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