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Respiratory System > General Stack on Respiratory Infection > Flashcards

General Stack on Respiratory Infection Flashcards

1
Q

List the range of upper respiratory tract infections

A

1) Common cold (coryza)
2) Sore throat (pharyngitis)
3) Sinusitis
4) Epiglottitis

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2
Q

What test should be done on someone with an exacerbation of COPD and flu-like symptoms?

A

Viral Throat Swab

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3
Q

Symptoms and treatment of strop throat?

A 
SYMPTOMS 
-exudate
-pus
-sore throat
-dysphagia
-dysphonia 
TREATMENT
-antibiotics
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4
Q

Characteristics of tonsillitis?

A
  • swollen tonsils
  • erythematous
  • dysphagia
  • dysphonia
  • recurrent
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5
Q

What is quincy and how do you treat it?

A

It’s a complication of tonsillitis
Is a tonsilar abscess
Drained by surgeon under general anasthetic

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6
Q

Why can quincy be life threatening?

A

The infection is very close to the carotid artery and so can spread to the brain

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7
Q

A kid comes in with a sore throat, temperature, difficulty in swallowing & breathing, stridor and a hoarse voice. What do you do?

A

NOTHING DO NOT TOUCH THE KID.
Call an anaesthetist & explain you think it may be epiglottitis- a medical emergency.
Keep the child and parents calm, dont let the kid lie down and do NOT go anywhere near his/her throat!!!!!!!!

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8
Q

List the range of lower respiratory tract infections

A
  1. Acute bronchitis
  2. Acute exacerbation of COPD
  3. Pneumonia
  4. Influenza
  5. Fungal Infection
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9
Q

A patient presents with a frontal headache, maxillary sinus pain, tooth ache and discharge. Possible diagnosis?

A

Sinusitis

They may also have retro-orbital pain

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10
Q

Describe acute sinusitis and treatment

A

-preceded by a common cold
-purulent nasal discharge
-TREATMENT
-mostly viral aetiology
-usually self-limited &
resolves in 10 days
-nasal decongestant
(oxymetazoline)
-nasal steroids
-pseudo-ephedrine
-SOME need antibiotics

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11
Q

How can you spot diptheria? (keeping in mind its rarity due to vaccination)

A

a characteristic pseudo-membrane

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12
Q

A patient presents with a productive cough, a transient wheeze but normal CXR and chest examination. You also find out from the history that they had a cold very recently (well done Sherlock!) What is the likely diagnosis?

A

Acute Bronchitis

  • patients may also have a fever although this is only in the minority of cases
  • it is usually viral and self limiting in normal people
  • BUT can lead to significant morbidity in patients with chronic lung disease
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13
Q

What are the signs and symptoms of COPD?

A

Firstly, its a variable disease.

  • chronic sputum production
  • bronchoconstriction
  • inflammation of airways
  • breathlessness
  • chest pains
  • exacerbations
    - infective
    - non-infective
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14
Q

A patient with COPD comes in complaining of increased sputum production&purulence and increased breathlessness . You examine them and find coarse crackles and a wheeze. Whats the likely diagnosis?

A 
Acute Exacerbation of COPD.
Symptoms:
-increased sputum production
-increased sputum purulence
-more wheezy
-breathlessness
Examination Signs:
-respiratory distres
-wheeze 
-coarse crackles 
-may be cyanosed 
-in advanced disease (worsening) ankle oedema
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15
Q

How do you manage acute exacerbations of COPD in primary care?

A

-antibiotic e.g. dooxycycline or amoxicillin
-bronchodilator inhalers
-short course of steroids in some cases
-can refer to hospital if:
-evidence of resp.
failure
-not coping at home

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16
Q

Which infection is the biggest killer in under50s in the UK?

A

Pneumonia

17
Q

What are the symptoms of pneumonia? (15)

A 
Abdominal pain
Anorexia
Arthralgia
Confusion
Cough
Diarrhoea 
Dyspnoea
Headache 
Heamoptysis 
Malaise
Myalgia 
Pleurisy 
Preceding URTI
Rigors
Sweats
18
Q

What are the signs of pneumonia?

A
  • Fever
  • Rigors
  • Herpes Labialis (common due to alteration in immune system)
  • Tachypnoea
  • Crackles
  • Rub
  • Cyanosis
  • Hypotension
19
Q

What’s a useful thing to do when checking for cyanosis in the mouth?

A

Place your fingers next to the patients tongue so you can get a colour comparison

20
Q

What investigations can you carry out/order to confirm/deny a possible pneumonia case?

A
  • blood culture
  • serology
  • arterial gases
  • full blood count
  • urea
  • liver function
  • chest X-Ray
21
Q

When using CXR in a possible case of pneumonia what should you always remember?

A

The symptoms might arrive before it shows up on a CXR. A CXR may not show pneumonia but 2 days later a repeat CXR does.

22
Q

How do you calculate a CURB65 score?

A 
C: New onset confusion
U: Urea >7
R: Resp rate >30/min
B: Blood pressure systolic <90 OR diastolic <61
65: aged 65 or older

Score 1 point for each of above

Add 10% mortality to patient with COPD

Mortality increases as CURB65 score increases

23
Q

What disease is a CURB65 score calculated?

A

Community Acquired Pneumonia

24
Q

What are the approximate mortalities for CURB65 score?

A

0-1= <5% mortality
2-3=<10% mortality
4-5= 15-30% mortality

25
Q

What are some of the other severity markers for pneumonia?

A

Temperature <35 or >40
Cyanosis PaO2 <8kPa
WBC <4 or >30
Mutli lobar involvment

26
Q

How would you manage a case of community acquired pneumonia?

A

-antibiotics
-amoxicillin
-doxycycline
-see ‘antibiotic man’
-oxygen
-maintain SaO2 94-98%
or 88-92%
-fluids
-bed rest
-no smoking

27
Q

IV access is associated with a risk of further infection so they are to be used when…

A

Oral route is not available
Drug resistant organisms
Deep seated infections
e.g. abscesses, bone, endocarditis, meningitis
First dose
rapid increase in plasma concentrations

28
Q

When do sputum samples matter?

A
  • when resistant organism suspected
  • TB or NTM suspected
  • failure to improve on standard therapies
  • high risk individuals
29
Q

What should you ask yourself when predicting the organism?

A
  • young or old?
  • severity?
  • immuno-competent vs immuno-compromised
  • chronic illness?
  • lifestyle?
30
Q

What lifestyle Q&As are associated with which types of pneumonia?

A
  • HIV
    • PCP (pneumocystis pneumonia)
  • PWID (IVDU)
    - staph aureus
  • Alcohol/Homeless
    • TB
    • Klebsiella
  • Frequently hospitalised
    • Pseudomonas
  • Returning Traveller
    • Legionella
    • TB
  • Indian Sub-continent
    • TB
  • Eastern Europe
    • MDR TB
    • XDR TB
31
Q

Complications of pneumonia

A
  • Respiratory failure
  • Pleural effusion
  • Empyema
  • Death
32
Q

Methods to prevent pneumonia

A
  • Influenza & pneumococcal vaccines
    - >65
    - chronic chest or cardiac disease
    - diabetes
    - immunocompromised
    e. g. splenectomy
  • Influenza vaccine
    - health care workers

Respiratory System (12 decks)

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