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Respiratory > Infections > Flashcards

Infections Flashcards

1
Q

Name four upper respiratory tract infections

A

Coryza
Pharyngitis
Sinusitis
Epiglottitis

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2
Q

Give four characteristics of strep throat

A
  1. pus
  2. sore throat
  3. dysphagia
  4. dysphonia
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3
Q

Describe quincy

A

complications of tonsillitis, tonsils abscess which can be drained

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4
Q

Describe epiglottitis

A

life threatening infection in children which obstructs the airway and oesophagus

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5
Q

What two viruses cause the common cold and how are they spread?

A

Adenovirus and rhinovirus.

Spread by droplets and formites

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6
Q

What are the symptoms of sinusitis?

A
  • frontal headache
  • retro-orbital pain
  • maxillary sinus pain
  • tooth ache
  • discharge
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7
Q

What is the treatment for sinusitis?

A

Usually resolves within 10 days by itself but may require;

  • nasal decongestant
  • nasal steroids
  • pseudo-ephedrine
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8
Q

name five 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

Describe acute bronchitis

A

‘cold moves to the chest’
Productive cough, fever but normal chest exam & CXR. Self limiting, no need for antibiotics but can lead to morbidity in patients with chronic lung disease

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10
Q

What are the six main symptoms of influenza?

A
  • fever
  • malaise
  • myalgia
  • headache
  • cough
  • prostration
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11
Q

name four causes of influenza

A
  • influenza A
  • influenza B
  • parainfluenza
  • rhinovirus
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12
Q

For treatment of influenza what must be required in addition to standard control?

A

Aerosol control

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13
Q

Name two antivirals that can be administered

A
  • oseltamivir

- zanamivir

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14
Q

state three factors that make pandemics unpredictable

A
  • antigenic shift
  • segmented genome
  • animal reservoir/mixing vessels
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15
Q

What is bronchiolitis?

A

narrowing of the bronchioles resulting in similar symptoms to asthma

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16
Q

How can the diagnosis of bronchiolitis be confirmed?

A

PCR

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17
Q

What is pneumonia?

A

‘disease of the lungs’
infection involving the distal airspaces usually with inflammatory exudation - fluid filled spaces leads to consolidation

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18
Q

How can pneumonia be classified?

A
  • clinical setting
  • organism
  • morphology
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19
Q

Name four organisms that can cause pneumonia

A
  • viruses
  • bacteria
  • chlamydia/mycoplasm
  • fungi
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20
Q

State nine symptoms of pneumonia

A
  • anorexia
  • cough
  • sweats
  • malaise
  • riggers
  • myalgia
  • confusion
  • abdominal pain
  • diarrhoea
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21
Q

State eight signs of pneumonia

A
  • fever
  • riggers
  • herpes labialis
  • tachypnoea
  • crackles
  • rub
  • cyanosis
  • hypertension
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22
Q

What investigations can be done on a patient who has suspected pneumonia?

A
  • blood culture
  • serology
  • arterial gases
  • blood count
  • CXR
  • liver function
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23
Q

Describe what is meant by lobar pneumonia

A

confluent consolidation involving a complete lung lobe.

Often due to streptococcus pneumonia and usually community acquired in healthy young adults

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24
Q

How can the pathology of lobar pneumonia be described?

A

a classical acute inflammatory response;

  • exudation of fibrin rich fluid
  • neutrophil & macrophage infiltration
  • resolution
  • antibodies lead to opsonisation & phagocytosis
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25
Q

What are the four complications of pneumonia?

A
  • organisation (fibrous scarring)
  • abscess
  • bronchiectasis
  • empyema
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26
Q

What is bronchopneumonia?

A

infection that starts in the airways and spreads to adjacent alveolar lung most often seen in patients with pre-existing disease

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27
Q

Name four diseases that bronchopneumonia is usually associated with

A
  • COPD
  • Cardiac failure
  • Complication of viral infection
  • aspiration of gastric contents
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28
Q

State four organisms that cause bronchopneumonia

A
  • strep pneumonia
  • haemophilus influenza
  • staphylococcus
  • anaerobes
  • coliforms
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29
Q

Explain CURB 65

A 
Confusion AMT <8 
Urea > 7mM
Respiratory rate >30/min 
BP <90/60
Over 65
30
Q

In addition to CURB 65 what other markers exist?

A
  • temperature
  • cyanosis
  • white blood count
  • multi-lobar involvement
31
Q

What medication is commonly used to treat pneumonia and why?

A

penicillins and tetracycline because there is an increasing resistance to macrolides

32
Q

Describe mycoplasma pneumonia

A

No cell wall so it is resistance to beta lactic antibiotics. It causes protracted paroxysmal cough - cilia dysfunction and H2O2 which damages the resp membranes

33
Q

Name three special cases of pneumonia and how are they treated

A
  • hospital acquired (amoxicillin & gentamicin)
  • aspiration (amoxicillin & metrinodazole)
  • legionella (levofloxacin)
34
Q

Name seven high risk groups of pneumonia

A
  1. HIV
  2. PWID
  3. Alcohol/Homeless
  4. Frequently hospitalised
  5. Returning traveller
  6. Indian sub-continent
  7. Eastern European
35
Q

What two organisms cause TB in humans?

A

Mycobacterium tuberculosis

Mycobacterium bovis

36
Q

Name a disease that promotes TB

A

HIV

37
Q

How is TB transmitted?

A

-singing
- coughing
- sneezing
through droplets

38
Q

If a person is infected with TB what are the three possible outcomes

A
  • healthy, negative & no symptoms
  • no symptoms but positive TST some progress and get sick
  • symptoms, TST positive and active TB
39
Q

How long does it take for the immune system to find the TB?

A

8 weeks

40
Q

Name four high risk groups of TB

A
  • 25-34 year olds particularly men
  • immigrants from high incidence countries
  • socially deprived
  • immunosuppressed
41
Q

State three forms of TB

A

Primary lymph node
Reactivation TB
Military TB

42
Q

Name two types of extra-pulmonary TB

A

Potts disease - in the spine

Tuberculoma - in the brain

43
Q

Describe the pathology of primary TB

A

inhaled organism is phagocytose and carried to hilar lymph nodes. This causes a granulomatous response, large hilar nodes and small focus in periphery of mid zone lung

44
Q

Describe the pathology of secondary TB

A

reactivation in person with immunity means the disease is initially localised. It can spread by airways.
Fibrosing and cavitating lesion

45
Q

How can TB disease reactivation occur?

A

Due to

  • decreased T cell function
  • coincident disease
  • immunosuppressive therapy
  • reinfection at high dose or more virulent organism
46
Q

How can TB specimens be obtained?

A

sputum, gastric washings, bronchoalveolar lavage, early morning urine, biopsies

47
Q

What will histology of TB show?

A

Granulomata with central caseous necrosis

48
Q

How may a immunocompromised host be infected with TB?

A
  • virulent infection with common organism

- infection with opportunistic pathogen

49
Q

What are the symptoms of TB?

A
  • fever
  • night sweats
  • weight loss
  • organ specific
50
Q

What is the treatment for active TB?

A

4 drugs for 2 months (rifampicin, isoniazid, pyranzinamide, ethambutol)
2 drugs for a further 4 months (rifampicin & isoniazid)

51
Q

What is the treatment for latent TB?

A

2 drugs for 3 months (rifampicin & isoniazid)

or 1 drug for 6 months (isoniazid)

52
Q

How does latent become active TB?

A

The bug breaks out of the granuloma

53
Q

How can chronic pulmonary infection be diagnosed?

A
  • shadow on CXR
  • weight loss
  • persistent sputum production
  • chest pain
  • increasing SOB
54
Q

What is the differential diagnosis for CPI?

A
  • lung cancer
  • intrapulmonary abscess
  • empyema
  • bronchiectasis
  • cystic fibrosis
55
Q

State three risk factors for CPI

A
  1. abnormal host response
  2. abnormal innate host defence
  3. repeated insult
56
Q

Name two types of abnormal host response

A
  • immunodeficiency

- immunosuppression

57
Q

Name three types of abnormal host defence

A
  • damaged bronchial mucosa
  • abnormal cilia
  • abnormal secretions
58
Q

Name two types of repeated insult

A
  • aspiration

- indwelling material

59
Q

State six drugs/drug types that can cause immunosuppression

A
  • steroids
  • azathioprine
  • methotrexate
  • cyclophosphamide
  • monoclonal antibodies
  • chemotherapy
60
Q

How can mucosa be damaged?

A

smoking, pneumonia, malignancy

61
Q

What causes abnormal cilia?

A

Kartenager’s/Young’s syndrome

62
Q

What causes abnormal secretions?

A

CF, channelopathies

63
Q

What causes recurrent aspiration?

A

NG tube, poor swallow, pharyngeal pouch

64
Q

What can be indwelling material?

A

misplaced NG tube, chest drain, inhaled foreign body

65
Q

Name three forms of chronic infection

A
  1. intrapulmonary abscess
  2. septic emboli
  3. empyema
66
Q

How will intrapulmonary abscess present?

A
  • weight loss
  • lethargy, tiredness, weakness
  • cough (with or without sputum)
  • usually preceding illness (pneumonic infection, post viral, foreign body)
67
Q

Describe preceding illness

A
  • pneumonia
  • aspiration pneumonia (vomiting, lowered level of consciousness, pharyngeal pouch)
  • poor host immune response
68
Q

What types of pathogens may be responsible for preceding illness chronic infection?

A

Bacteria - gram negative, e.coli, strep, staph

Fungi - aspergillus

69
Q

Describe septic emboli

A
  • right sided endocarditis
  • infected DVT
  • septicaemia
  • IV drug users
70
Q

What is the bacteriology of empyema?

A

gram positive - step milleri, staph aureus
gram negative - e.coli, pseudomonas, klebsiella
anaerobes

71
Q

How can a empyema be diagnosed?

A
  • clinical suspicion
  • CXR - look for D sign
  • Ultrasound
  • CT
72
Q

What is the treatment for empyema?

A

IV antibiotics - broad spectrum

Oral antibiotics - directed to specific bacteria

Respiratory (20 decks)

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