Cystic Fibrosis, TB, Bronchitis Flashcards
S+S of bronchitis
Cough with or without sputum
Resolves in 1-3 weeks
Causes of bronchitis
Resp virus
Rarely bacteria - bordetella pertussis, mycoplasma pneumonia, chlamydia pneumonia
Management of bronchitis
Supportive
What are transudate pleural effusions caused by?
Imbalances in hydrostatic + oncotic pressures in the chest
What causes exudative pleural effusions?
Infection Malignancy Immunological responses Lymphatic abnormalities Noninfectious inflammation Trauma
What are Lights criteria?
If 1 of 3 is present, fluid is exudate:
Pleural fluid protein
Pleural fluid LDH/ serum LDH ratio >0.6
Pleural fluid LDH >2/3 the upper limit of normal serum LDH
What measurements can be done with pleural fluid?
Cholesterol Triglycerides Amylase Creatinine pH
What does pleural fluid cytology assess?
Malignancy
Pathology of cystic fibrosis
Mutations in CFTR gene
Deranged chloride transport leads to thick, viscous secretions in lungs, liver, pancreas, intestine + reproductive tract
Diagnosis of CF
Clinical + evidence of CFTR dysfunction (elevated sweat chloride, presence of 2 disease causing mutations, abnormal nasal potential difference)
Sweat chloride test is diagnostic
What should be done following a positive sweat chloride test?
DNA analysis
What pathogens are common in CF?
Staph aureus + pseudomonas aeruginosa
Management of p. aeruginosa
Piperacillin-tazobactam Ceftazidime Imipenem-cilastatin Meropenem PLUS: A fluoroquinolone
What bacteria causes TB?
Mycobacterium tuberculosis
What is active vs latent TB?
Active = symptomatic or progressive Latent = no clinically active TB
RF for TB
Born in high prevalance areas
children
Immunosuppression
S+S of TB
Weight loss, fever, night sweats, anorexia or malaise
Persistent productive cough, SOB, haemoptysis
Investigations for ?TB + results of CXR
CXR + sputum sample + early morning urine, + biopsy
Shows upper lobe cavitation, pleural effusion + miliary appearance
Management of TB
Rifampicin, isoniazid, pyrazinamide, ethambutol for 2 months
Rifampicin + isoniazid for 4 months
SE of TB drugs
Hepato, neuro + opth toxicity
S+S of CF
Nasal polyps Steatorrhea Infertility Osteoporosis Repeated pneumonia chronic sinusitis Bronchiectasis Pancreatic insufficiency
What is non classic CF?
Milder mutation that only causes impairment in 1 organ
Have some CFTR expression
What happens to sperm in CF?
Obstructive azoospermia due to blocked vas deferens
What is DIOS?
Distal infective obstruction syndrome
Unique to CF
Changes in gut lead to accumulation of mucus which form mucofaeculant impactions
