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Bronchial sepsis - week 118 > Disease - bronchial sepsis > Flashcards

Disease - bronchial sepsis Flashcards

1
Q

Pharyngitis

A

Sore throat
Bacterial - GP A streptococci, Corynebacterium diptheriaee
Viruses (most common) - EBV, adenovirus, enterovirus, HSV

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2
Q

Epiglottis

A

Can lead to obstruction of the airway
More common in childhood
Usually H Influenza B
Signs/symptoms = drooling, dysphonia, dysphagia, drawn face, stridor breathing on inspiration
Medical (ENT) emergency - secure the airway
IV Cefuroxime

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3
Q

Bronchitis

A

Acute - Viral = yellow sputum, Bacterial = green

Chronic - smokers if constant inflammation of airways, burning, scaring

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4
Q

Tracheitis

A

Often no sputum
Loud and dry barking cough
Normally adults and rarely children
Normally viral

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5
Q

Pneumonia

A

Inflammation and consolidation of lung tissue caused by an infectious agent
Clinically = acute LRTI, usually associated to fever, signs and symptoms in the chest and an abnormal CXR
Most common infectious cause of death, 6th leading cause of death
20-50% mortality of admitted patients
Leading cause of hospital infection deaths

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6
Q

Risk factors for Pneumonia

A

Travel - TB, legionella (Mediterranean), Pseudomonas (SE Asia, N Australia)
Age
Alcoholism, institutions, nutrition, co-morbidities

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7
Q

Symptoms of pneumonia

A

Fever, cough, SOB, right pleuritic chest pain, rigors, minimal cough, sudden onset, headache/myalgia, Coryza/pharyngitis, vomiting, general malaise

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8
Q

General signs of pneumonia

A

Temperature (+/-), confusion, tachypnoea, tachycardia and hypotension (last 3 = signs of shock)

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9
Q

What chest signs are present in pneumonia?

A

Decreased PN
Crackles
Bronchial breathing
Increased VR

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10
Q

Other signs that can be present

A

Generally unwell, dehydrated, palmar erythema, high PR and RR, low BP, crackles and pleural rub, sats @ 90% (28% FiO2)

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11
Q

What investigations should be carried out?

A

Sputum - AFB, general culture and gram stain
Urine - legionella antigen and measure output
Blood - cultures, WBC (severe 20), urea (Severe >7mm)
ECG - check for any ischemic changes that might occur
CXR - bilateral changes
ABG - esp if HR > 20, want to know if Tachypnoea is present

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12
Q

CURB65 score

A

Confusion
Urea > 7
RR > 30
BP - systolic 65

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13
Q

How do you treat uncomplicated Pneumonia?

A

PO Amoxicillin
+
PO Clarithromycin

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14
Q

How do you treat complicated pneumonia?

A

IV Cefuroxime or IV Augmentin
+
PO Clarithromycin

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15
Q

How do you treat atypical Pneumonia?

A

Clarithromycin
+
IV Rifampicin

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16
Q

How do you treat Cavitation or Aspiration?

A

IV Cefuroxime
+
Metronidazole

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17
Q

What are some complications of pneumonia?

A

Empyema, ARDS, Abscess, Bronchiectaisis, PE

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18
Q

What fluids do you give to raise SBP?

A

Colloidal IV fluid

19
Q

Typical pneumonia

A

Abrupt onset, high fever, purulent sputum and focal consolidation

20
Q

Atypical pneumonia

A

Gradual onset, dry cough, myalgais, headache

21
Q

Streptococcus pneumonia

A

Gram +ve, lives in resp tract and multiplies rapidly
Abrupt onset
medical emergency
commenest bacterial infection and most likely to kill

22
Q

Haemopilus influenza

A

Bacterial
UTRI common
usually encapsulated
small effusion can occur but empyema/cavitation is rare

23
Q

Bronchopneumonia

A

Patchy white shadows around the lung

24
Q

Staphylococcus aureus

A

Gram +ve, spreads via airways if viral or Bacteraemia (e.g. endocarditis)
Lung tissue lysis = cavitation occurs
Septicaemia, empyema and abscesses are common
Lives in or on the skin - causes abscesses on skin
IV drug users = high risk

25
Q

Klebsiella

A 
Gram -ve, normally from the GI tract
Colonises e=the oropharynx
Nosocominal and co-morbidities (nursing homes), immunosuppressed people, those vomiting regularly
Haemoptysis
Poor prognosis but treatable with ABs
26
Q

Escherichia Coli

A

Gram -ve
Comorbidity, chronically ill patients
Aspiration and often lower right lobes
Poor Prognosis

27
Q

Pseudomonas aeriginosa

A

G-ve, chronically ill, structural lung disease
Gradual onset, copious green sputum
Never cleared and a constant battle
CAN’T be treated with PENICILLIN

28
Q

Ligionella pneumophilia

A

G -ve intracellular, from water/air-con
Immunosuppressed
Dry cough, fever, myalgia, diarrhoea, rash
Oliguria, acute renal failure, rhabdomyolysis, HSM
5-30% mortality
Treat with Clarythromycin

29
Q

Mycoplasma pneumoniae

A

Occurs in closed populations, 50% UTRI
Arthralgais, LNs, myalgia, diarrhoea, myocarditis, meningitis, hepatitis, immune haemolytic anaemia, skin eruptions, vomiting
Treatable

30
Q

Chlamydia psttacci

A

Intracelluar bacterium, from birds

Fever, myalgia, chest pain, wt loss, dry cough, haemoptysis, cavitation, effusion, millary TB

31
Q

Pneumocystis carinii

A

Fungus (can be bacterial)
Immunocompromised (HIV, chemo)
Progressive SOB, dry cough, fever, wt loss, minimal signs - chest normally sounds clear but are hypoxic, CXR anything
Can lead to death and can infect others if missed.

32
Q

Fungal (aspergillus Cryptococcus)

A

V rare in healthy people
Immunocompromised, similar to bacterial pneumonia
Cavitation is common, haemoptysis, wt loss
Poor prognosis

33
Q

If a person is generally healthy what is the likely cause off pneumonia?

A

Strep pneumoniae

From water, birds, occupation

34
Q

If a patient has hospital acquired pneumonia, what is the likely cause?

A

Gram -ve
Strep aureus
MRSA

35
Q

Immunocompromised, likely cause?

A

PCP, Tb, Fungal

36
Q

Nasal cavity cause?

A

URTI, normally viral

37
Q

Pharyngitis cause?

A

Most likely strep (possible abscess behind tonisls)
Diptheria
Viruses

38
Q

Epiglotitis cause?

A

Usually Haemophilus Influenza B

39
Q

Bronchitis cause?

A 
Acute = virus/bacteria
Chronic = smoking
40
Q

If the infection is below the bronchus what is it?

A

Pneumonia, infection of the lung tissue.

41
Q

Lung symptoms of TB

A

Cough (80%), chest pain, fever/night sweats (55%), wt loss (70%) and haemoptysis (8%)

42
Q

Non-pulmonary symptoms of TB

A

Can affect anywhere in the body!
Lymphadenopathy, fatigue, GI, CVS, CNS, Bones, GU tract
25% of elderly patients present with non-specific symptoms.

43
Q

Investigations for TB

A

Sputum culture - AFB
Urine, blood, ECG, CXR (pleural effusion, cavity amongst shadow, millary TB)
Heaf/Mantoux, PCR (except blood) and histology

44
Q

What is the Quadruple therapy for TB?

A 
Rifamicin
Isoniazad
Pyrazinamide
Ethmbutol
For 2 months minimum

Bronchial sepsis - week 118 (1 decks)

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