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Y4: Infectious Disease > Bacterial RT Infections > Flashcards

Bacterial RT Infections Flashcards

1
Q

What is the mortality rate of bacterial RT infections?

A

8-14%

30% in ICU

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2
Q

Who most commonly gets bacterial RT infections?

A

Extremes of age

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3
Q

What is the pathogenesis of bacterial RT infections?

A
  • Pathogens overcome the immune system due to:
    • Large innoculum
    • Increased virulence
    • Host defense defect
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4
Q

What are the typical pathogens which cause bacterial RT infections?

A
  • Moraxella catharralis
  • Haeophilus influenzae
  • Streptococcus pneumoniae
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5
Q

What are the atypical pathogens which cause bacterial RT infections?

A
  • Legionella. pneumoniae
  • Chlamydia. pnaeumoniae
  • Mycoplasma. pneumoniae
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6
Q

What is the number one cause of community acquired pneumonia?

A

S. Pneumoniae

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7
Q

What are the risk factors for S. Pneumoniae?

A
  • Cancer
  • Asthma
  • Alcohol
  • Smoking
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8
Q

Describe the clinical symptoms of s. pneumniae?

A
  • Abrupt Onset
    • Cough
    • Fever
    • Pleuritic chest pain
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9
Q

What is pictured here?

A

Chest XR of someone with S. pnuemoniae RT infection

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10
Q

What clinical findings would be present with s. pneumoniae infection?

A
  • Dull percussions
  • Coarse crepitations
  • Increased vocal resonance
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11
Q

Describe resistance of s. pneumoniae to penicillin?

A
  • Asia
  • North America
  • Southern Europe
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12
Q

What can S. Pneumoniae be treated with if the patient has a penicilin allergy?

A
  • Macrolides
    • Clarithromycin
  • Tetracyclines
    • Doxycycline
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13
Q

When is a person most likely to become infection with Haemophilus influenzae?

A
  • Older people
  • Underlying lung disease
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14
Q

Describe the clinical presentation of H. influence respiratory tract infection?

A
  • Abrupt onset
    • Cough
    • Fever
    • Pleuritic chest pain
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15
Q

Describe the clinical findings of H. influenzae respiratory tract infection?

A
  • Dull percussions
  • Coarse crepitations
  • Increased vocal resonance
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16
Q

What is the first line treatment for H. influenzae respiratory tract infections?

A

Amoxicillin

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17
Q

What should someone with H. influenzae be treated with if there was a risk of beta lactamase?

A
  • Co-amoxiclav
  • Macrolides (clarithromycin)
  • Tetracyclines (doxycicline)
18
Q

Describe mycoplasma pneumoniae?

A
  • Smallest free living bacterium
  • Lack of cell wall
  • Difficult to grow
19
Q

Describe the spread of mycoplasma pneumoniae?

A
  • Droplet spread (sneezing)
  • Seasonal incidence
    • Autumn
    • Winter
20
Q

How is M. pneumoniae diagnosed?

A
  • Serology
  • PCR
    • sputum
    • throat swab
21
Q

How is L. pneumophila diagnosed?

A
  • Culture
  • Serology
  • Urinary antigen test
22
Q

How should L. pneumophila be treated?

A
  • Macrolides (clarithromycin)
  • Quinolones (ciprofloxacin)
  • Tetracyclines (doxycicline)
23
Q

What is it important to cover with a history in someone with pneumoniae?

A
  • Symptoms
  • Past medical history
  • Epidemiology
    • travel
    • ill contacts
    • water exposure
24
Q

Name the categories of investigations into patients with pneumoniae?

A
  • Blood tests
  • Imaging
  • Microbiology
25
Q

What blood tests should be performed on someone with pneumonia?

A
  • FBC
  • U&Es
  • ABGs
26
Q

What microbiology tests should be performed on someone with pneumonia?

A
  • Blood cultures
  • Sputum culture
  • Throat swab
  • Urine legionella antigen
27
Q

What imaging should be performed on someone with pneumonia?

A
  • CXR
  • ECG
28
Q

How would someone with pneumonia be managed?

A
  • Airway, breathing, circulation
  • Antibiotics?
  • Admission to hospital?
  • CURB65
  • Sepsis?
  • Hypoxia?
29
Q

What is important about H. influenza?

A

The general population are vaccinated against it (Hib)

30
Q

What does Hib cause?

A

Epiglottitis

31
Q

Which H. Influenza strains cause pneumonia?

A
  • All of them apart from Hib
  • (vaccine does not protect against pneumonia)
32
Q

Where does H. Influenza colonise?

What does this mean for what it infects?

A

Colonises the upper RT

Causes infections around about this area

33
Q

Name some infections which H. Influenza can cause due to colonised the upper RT?

A
  • Sinusitis
  • Pneumonia
  • Otitis media
  • Conjuctivitis
34
Q

How will people present with M. pneumonia?

A
  • Tired
  • Fever
  • Headache
35
Q

What is an atypical pneumonia?

A
  • Very non-specific presentation
  • Chest x-ray will show lung consildation
36
Q

Name some complications of M. pneumonia?

A
  • Guillain-Barre
  • Reactive arthritis
  • Haemolysis (cold)
37
Q

How can you be infected by legionella pneumophilia?

What is a major factor which helps diagnose legionella?

A
  • Contaminated water systems
  • Soil and compost

Complete patient history

38
Q

Describe the presentation of legionella pneumophilia?

A
  • Atypical presentation
    • Headache
    • Tiredness
    • Fever
39
Q

Describe the CURB65 scoring system?

A
  • C - Confusion
  • U - Urea > 7
  • R - RR >= 30
  • B - BP, diastolic <60 or systolic <90
  • 65 - Age over 65 years old

Severe pneumonia if they have score >2

40
Q

What defines severe pneumonia regardless of CURB65 score?

A
  • Multilobar consolidation on CXR
    • and/or
  • Hypoxia on room air
41
Q

Describe the qSOFA criteria for sepsis?

A
  • Altered mental status
  • Systolic BP < 100 mmHg
  • RR > 22 breaths/min
42
Q

What clinical assessments can be used with a patient who has pneumonia?

A
  • CURB65 score
  • Sepsis qSOFA
  • Multilobar consolidation on CXR/Hypoxia on room air

Y4: Infectious Disease (18 decks)

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