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Chronic Pulmonary Infections Flashcards

1
Q

What are the risk factors for developing chronic pulmonary infections?

A

Abnormal host response
Abnormal innate host defence
Repeated Insult

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2
Q

What type of immunodeficiency are IgA deficiency and Hypogammaglobulinaemia?

A

Immunoglobulin deficiencies

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3
Q

What type of infection does an IgA deficiency increase risk of?

A

Acute infections

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4
Q

What type of infection does Hypogammaglobulinaemia increase the risk of?

A

Acute and chronic infections

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5
Q

What is the commonest cause of immunodeficiency and what type of infection does it predispose to?

A

Common Variable Immunodeficiency (CVID)

Recurrent infections

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6
Q

What are the (defective) mechanisms of a defective innate host defence?

A

Damaged bronchial mucosa - smoking, pneumonia, ‘flu, malignancy.
Abnormal cilia - Kartagener’s and Young’s syndromes
Abnormal secretions - CF or channelopathies

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7
Q

Examples of repeated insult which predispose to chronic pulmonary infections?

A

Recurrent aspiration - NG feeding / poor swallow / pharyngeal pouch
Indwelling material - NG tube in wrong place / chest drain / inhaled foreign body

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8
Q

What is Kartagener’s syndrome?

A

Primary ciliary dyskinesia; internal organs on wrong side of body, neonatal respiratory distress

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9
Q

What is Young’s syndrome?

A

Similar symptoms to CF (exclusion diagnosis and genetic testing)

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10
Q

Weight loss, tiredness, a cough with sputum and recent history of pneumonia. CXR shows consolidated mass…?

A

intrapulmonary abscess

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11
Q

‘Flu -> Staph Pneumonia -> Cavitating Pneumonia -> …?

A

Abscess

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12
Q

How can aspiration pneumonia lead to an intrapulmonary abscess?

A

Vomiting, lowered level of consciousness; pharyngeal pouch

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13
Q

How can hypogammaglobulinaemia lead to an intrapulmonary abscess?

A

Not enough gamma-globulins in blood; not enough antibodies exist; impaired immune system
Staph pneumonia -> Cavitating pneumonia -> abscess

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14
Q

Which pathogens are likely to cause an intrapulmonary abscess?

A

Staphylococcus (post-flu)
Streptococcus
E. coli
Gram -ve bacteria

Aspergillus (fungi)

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15
Q

Septicaemia, right sided endocarditis and infected DVT can all cause…?

A

Septic emboli

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16
Q

How do PWIDs get intrapulmonary abscesses?

A

inject into groin
DVT
infection
PE + abscess

17
Q

Which bacteria is most common in PWIDs?

A

Staph aureus

18
Q

What is empyema?

A

Pus in the pleural space

19
Q

An exudate with what pH is indicative of empyema?

A

<7.2

20
Q

Empyema is caused by mostly aerobic or anaerobic bacteria?

A

Aerobic

21
Q

Which gram positives cause empyema?

A

Strep Milleri

Staph Aureus

22
Q

Which gram negatives are likely to cause empyema?

A

E coli
Pseudomonas
Haemophilus influenzae
Klebsiellae

23
Q

When would anaerobes cause empyema?

A

severe pneumonia or porr dental hygiene

24
Q

A patient who has just had a hip replacement and is recovering in hospital, has a pleural exudate of pH <7.2…what is diagnosis and what is the causative organism?

A

Empyema caused by staph aureus

25
Q

D sign on CXR is indicative of?

A

empyema

26
Q

What is used to differentiate between empyema and abscess?

A

CT

27
Q

Which chronic pulmonary infection is the localised, irreversible dilation of the bronchi?

A

bronchiectasis

28
Q

Is bronchiectasis a restrictive or obstructive condition?

A

obstructive

29
Q

A daily productive cough with lots of green sputum in a non-smoker with PMH of recurrent chest infections. ?

A

bronchiectasis

30
Q

Which radiological test is used to diagnose bronchiectasis?

A

HRCT (high res)

31
Q

What is the typical cause of abnormal fixed dilatation of the bronchial tree?

A

fibrous scarring following infection

32
Q

Which chronic infection has all the hallmarks or bronchiectasis but is differentiated using HRCT?

A

chronic bronchial sepsis

33
Q

Why is it important to remember the sinuses in a patient which chronic bronchial sepsis?

A

they are a reservoir of infection

34
Q

Young woman, working in a nursery who smokes,

A

chronic bronchial sepsis

35
Q

A low dose of macrolide antibiotics are shown to reduce exacerbation rates in which chronic infection?

A

bronchiectasis

36
Q

An individual colonised with a psuedomona should be given what as anti-inflammatory treatment?

A

Azithromycin 250mg 3 times a week (macrolide)

37
Q

How are patients with CF at a greater risk of infection?

A

have abnormally viscous mucous which can block the conducting airways and lungs
also have abnormal cilia lining airways so reduced clearance and build-up of mucus

38
Q

What is a gram negative aerobic organism which is sensitive to Gentamicin?

A

Pseudomonas aerginosa

Resp (8 decks)

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