chest infections (W7)

Question 1

most common bacterial cause of chest infection

Answer 1

streptococcus pneumoniae

Question 2

how do chest infections present

Answer 2

fever
cough
sputum production
breathlessness
chest pain
confusion

Question 3

respiratory viral infections predictable pattern?

Answer 3

rhinoviruses sept-oct, march
parainfluenza

Question 4

investigations for chest infections?

Answer 4

covid-19 PCR
urea and electrolytes, full blood count, C-reactive protein
blood cultures
arterial blood gas
chest X-ray
sputum investigations
liver tests

Question 5

C-reactive protein?

Answer 5

non-specific marker of inflammation

Question 6

what treatment should be given for chest infections?

Answer 6

oxygen saturation 94-96%
glucocorticoid
other irrelevant things

Question 7

glucocorticoids?

Answer 7

supress

Question 8

bronchial breathing?

Answer 8

sound harsh and loud. fluid

Question 9

CURB65 stands for what?

Answer 9

point for each feature:
C-confusion
U-urea > 7mmol/l
R-respiratory rate > 30 breaths per minute
B-blood pressure (<90/60)
A-age > 65 years

Question 10

CURB65 scores meaning?

Answer 10

0 or 1 - low risk, <3% mortality risk
2 - moderate risk, 3-15% mortality risk
3-5: high risk, 15-40% mortality risk

Question 11

what is CURB65 used for?

Answer 11

community-acquired pneumonia
score guides treatment

Question 12

pneumonia treatment

Answer 12

oxygen (start at 40% via face mask)
antibiotics
thromboprophylaxis

Question 13

pneumocystis jirovecii - what is it and how is it spread? who does it infect?

Answer 13

human specific fungus
airborne spread
lung infection in those who are immunosuppressed

Question 14

diagnosis of pneumocystis jirovecii?

Answer 14

induced sputum (hypertonic nebuliser and physiotherapist)
bronchoscopy (if induced sputum doesn’t work)
PCR for microbial DNA

Question 15

pneumocytis jirovecci treatment?

Answer 15

anti inflammatory agent - high dose corticosteroids
and antimicrobial - oral cotrimoxazole