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Respiratory > Infection (new facts) > Flashcards

Infection (new facts) Flashcards

1
Q

Gram + alpha haemolytic strep colonising URT?

A

Strep pneumoniae

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2
Q

Gram + beta haemolytic strep colonising URT?

A

Strep pyogenes

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3
Q

What is a non-strep gram + bacteria which also colonises the URT?

A

Staph aureus

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4
Q

What are gram - organisms which colonise the URT?

A

Haemophilius influenzae, Moraxella catarrhalis

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5
Q

What are complications of the common cold?

A

Acute sinusitis or bronchitis

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6
Q

What are organisms causing the common cold?

A

Adenovirus, rhinovirus, RSV

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7
Q

What URTI shows a pseudo-membrane?

A

Diphtheria

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8
Q

What causes epiglottitis and what kind of organism is this?

A

Haemophilius influenzae type B- gram + cocco bacillus

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9
Q

How do you test for epiglottitis?

A

Blood culture

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10
Q

What is the treatment for epiglottitis?

A

Intubation and ceftriaxone

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11
Q

What is a generally big risk factor for most LRTIs?

A

Intubation

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12
Q

What will acute bronchitis show on chest exam and CXR?

A

Normal

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13
Q

As well as cold like symptoms and coughing, what is another common symptom of whooping cough?

A

Vomiting

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14
Q

What causes whooping cough and what type of organism is this?

A

Bortedella pertussis- gram - coccobacillus

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15
Q

When should you give antibiotics for whooping cough?

A

Cough < 21 days

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16
Q

What antibiotics can be given for whooping cough and under what conditions?

A

< 1 month- clarithromycin
> 1 month- clarithromycin or azithromycin
Pregnancy- erythromycin

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17
Q

How is a diagnosis of bronchiolitis made?

A

PCR

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18
Q

How is bronchiolitis treated?

A

Supportive

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19
Q

What does chlamydophila pneumoniae cause?

A

Mostly mild respiratory tract infections

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20
Q

Primary influenza pneumonia after flu is most common in who?

A

During pandemics- young adults

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21
Q

Secondary bacterial pneumonia after flu is most common in who?

A

Infants, elderly, pre-existing disease or pregnancy

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22
Q

What is Influenza A 5HN1?

A

Highly pathogenic avian flu

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23
Q

Who are the only people to receive a live attenuated flu vaccine?

A

Children

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24
Q

What further antibiotic cover does hospital acquired require?

A

Gram -

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25
Q

What further antibiotic cover does aspiration require?

A

Anaerobic

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26
Q

What is the treatment for mild-moderate CAP (0-2 CURB65)?

A

amoxicillin 1g tds IV/PO (doxycycline if penicillin allergic)

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27
Q

What is the treatment for severe CAP (3-5 CURB65)?

A

co-amoxiclav 1.2g tds IV + clarithromycin 500mg bd IV (levofloxacin if penicillin allergic)

28
Q

What are organisms which can cause lobar pneumonia?

A

Strep pneumonia, Klebsiella or Legionella

29
Q

Who normally gets lobar pneumonia?

A

CAP- previously healthy young adults

30
Q

Where does broncho pneumonia start and spread to?

A

Starts in airways and spreads to adjacent alveolar lung

31
Q

Who is broncho-pneumonia more common in?

A

Those with a pre-existing disease or aspiration

32
Q

What antibiotic treatment does mycoplasma, coxiella burnetti and chlamydia psittaci respond to?

A

Tetracycline and macrolides e.g. clarithromycin

33
Q

Apart from pneumonia, what else can coxiella burnetti cause?

A

Q fever

34
Q

Where does coxiella burnetti come from?

A

Sheep and goats

35
Q

What is a complication of coxiella burnetti?

A

Culture negative endocarditis

36
Q

What does chlamydia thrachomatis cause?

A

Infantile pneumonia

37
Q

Is legionella gram - or +?

A

-

38
Q

Where does legionella invade?

A

Alveolar macrophages and then replicates

39
Q

How is legionella diagnosed mainly?

A

Urinary antigen

40
Q

How do you treat legionella?

A

Clarithromycin, erythromycin or quinolones e.g. levofloxacin

41
Q

How do you treat PCP?

A

Co-trimoxazole and maybe prophylaxis

42
Q

how do you diagnose aspergillus or PCP?

A

Bronchioalveolar lavage

43
Q

What type of organism is mycobacterium TB?

A

Acid alcohol fast bacilli

44
Q

What can latent TB cause?

A

Immune alterations or reactivation later on

45
Q

Where is the pathogen taken in primary TB?

A

To hilar lymph nodes

46
Q

Where is secondary TB found?

A

Usually localised to the upper zones but may spread via bloodstream or airways

47
Q

What type of TB will show a Ghon Focus in the midzone and enlarged pulmonary hilar lymph nodes?

A

Primary

48
Q

What will secondary TB show on CXR?

A

Fibrosing and cavitating apical lesion

49
Q

What type of TB is a miliary disease?

A

Secondary

50
Q

What test uses the carbol-fuschin dye and what colour does this stain?

A

Zeihl-Neelson, stains mycobacteria red

51
Q

What should you always check for in patients with chronic pulmonary infection?

A

Underlying immunodeficiency

52
Q

What is usually the cause of a lung abscess?

A

Aspiration

53
Q

What organisms can cause an abscess?

A

Bacteria or fungi

54
Q

What can cause a right sided endocarditis from a DVT?

A

Septic emboli

55
Q

Who are septic emboli common in?

A

IV drug users

56
Q

What shows an uncomplicated effusion?

A

Clear fluid, ph > 7.2, LDH < 1000, glucose > 2.2

57
Q

What type of organisms mainly cause empyema?

A

aerobes

58
Q

When do anaerobic organisms cause empyema?

A

After severe pneumonia or if there is poor dental hygiene

59
Q

What would give clinical suspicion of empyema?

A

Slow to resolve pneumonia

60
Q

What will show a D sign on CXR?

A

Empyema

61
Q

What is the preferred test for empyema?

A

US

62
Q

What initial broad spectrum antibiotics are used for empyema?

A

Amoxicillin and metronidazole

63
Q

What is used to diagnose bronchiectasis?

A

HRCT

64
Q

What shows hallmarks of bronchiectasis but there is no evidence of this on CXR?

A

Chronic bronchial sepsis

65
Q

Who are the two groups of people most likely to get chronic bronchial sepsis?

A

Young women involved in healthcare

Older people with COPD

66
Q

What have been shown to reduce exacerbations of chronic bronchial sepsis?

A

Low dose macrolides

Respiratory (16 decks)

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