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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
What are the four complications of pneumonia?
- organisation (fibrous scarring) - abscess - bronchiectasis - empyema
26
What is bronchopneumonia?
infection that starts in the airways and spreads to adjacent alveolar lung most often seen in patients with pre-existing disease
27
Name four diseases that bronchopneumonia is usually associated with
- COPD - Cardiac failure - Complication of viral infection - aspiration of gastric contents
28
State four organisms that cause bronchopneumonia
- strep pneumonia - haemophilus influenza - staphylococcus - anaerobes - coliforms
29
Explain CURB 65
``` Confusion AMT <8 Urea > 7mM Respiratory rate >30/min BP <90/60 Over 65 ```
30
In addition to CURB 65 what other markers exist?
- temperature - cyanosis - white blood count - multi-lobar involvement
31
What medication is commonly used to treat pneumonia and why?
penicillins and tetracycline because there is an increasing resistance to macrolides
32
Describe mycoplasma pneumonia
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
Name three special cases of pneumonia and how are they treated
- hospital acquired (amoxicillin & gentamicin) - aspiration (amoxicillin & metrinodazole) - legionella (levofloxacin)
34
Name seven high risk groups of pneumonia
1. HIV 2. PWID 3. Alcohol/Homeless 4. Frequently hospitalised 5. Returning traveller 6. Indian sub-continent 7. Eastern European
35
What two organisms cause TB in humans?
Mycobacterium tuberculosis | Mycobacterium bovis
36
Name a disease that promotes TB
HIV
37
How is TB transmitted?
-singing - coughing - sneezing through droplets
38
If a person is infected with TB what are the three possible outcomes
- healthy, negative & no symptoms - no symptoms but positive TST some progress and get sick - symptoms, TST positive and active TB
39
How long does it take for the immune system to find the TB?
8 weeks
40
Name four high risk groups of TB
- 25-34 year olds particularly men - immigrants from high incidence countries - socially deprived - immunosuppressed
41
State three forms of TB
Primary lymph node Reactivation TB Military TB
42
Name two types of extra-pulmonary TB
Potts disease - in the spine | Tuberculoma - in the brain
43
Describe the pathology of primary TB
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
Describe the pathology of secondary TB
reactivation in person with immunity means the disease is initially localised. It can spread by airways. Fibrosing and cavitating lesion
45
How can TB disease reactivation occur?
Due to - decreased T cell function - coincident disease - immunosuppressive therapy - reinfection at high dose or more virulent organism
46
How can TB specimens be obtained?
sputum, gastric washings, bronchoalveolar lavage, early morning urine, biopsies
47
What will histology of TB show?
Granulomata with central caseous necrosis
48
How may a immunocompromised host be infected with TB?
- virulent infection with common organism | - infection with opportunistic pathogen
49
What are the symptoms of TB?
- fever - night sweats - weight loss - organ specific
50
What is the treatment for active TB?
4 drugs for 2 months (rifampicin, isoniazid, pyranzinamide, ethambutol) 2 drugs for a further 4 months (rifampicin & isoniazid)
51
What is the treatment for latent TB?
2 drugs for 3 months (rifampicin & isoniazid) | or 1 drug for 6 months (isoniazid)
52
How does latent become active TB?
The bug breaks out of the granuloma
53
How can chronic pulmonary infection be diagnosed?
- shadow on CXR - weight loss - persistent sputum production - chest pain - increasing SOB
54
What is the differential diagnosis for CPI?
- lung cancer - intrapulmonary abscess - empyema - bronchiectasis - cystic fibrosis
55
State three risk factors for CPI
1. abnormal host response 2. abnormal innate host defence 3. repeated insult
56
Name two types of abnormal host response
- immunodeficiency | - immunosuppression
57
Name three types of abnormal host defence
- damaged bronchial mucosa - abnormal cilia - abnormal secretions
58
Name two types of repeated insult
- aspiration | - indwelling material
59
State six drugs/drug types that can cause immunosuppression
- steroids - azathioprine - methotrexate - cyclophosphamide - monoclonal antibodies - chemotherapy
60
How can mucosa be damaged?
smoking, pneumonia, malignancy
61
What causes abnormal cilia?
Kartenager's/Young's syndrome
62
What causes abnormal secretions?
CF, channelopathies
63
What causes recurrent aspiration?
NG tube, poor swallow, pharyngeal pouch
64
What can be indwelling material?
misplaced NG tube, chest drain, inhaled foreign body
65
Name three forms of chronic infection
1. intrapulmonary abscess 2. septic emboli 3. empyema
66
How will intrapulmonary abscess present?
- weight loss - lethargy, tiredness, weakness - cough (with or without sputum) - usually preceding illness (pneumonic infection, post viral, foreign body)
67
Describe preceding illness
- pneumonia - aspiration pneumonia (vomiting, lowered level of consciousness, pharyngeal pouch) - poor host immune response
68
What types of pathogens may be responsible for preceding illness chronic infection?
Bacteria - gram negative, e.coli, strep, staph | Fungi - aspergillus
69
Describe septic emboli
- right sided endocarditis - infected DVT - septicaemia - IV drug users
70
What is the bacteriology of empyema?
gram positive - step milleri, staph aureus gram negative - e.coli, pseudomonas, klebsiella anaerobes
71
How can a empyema be diagnosed?
- clinical suspicion - CXR - look for D sign - Ultrasound - CT
72
What is the treatment for empyema?
IV antibiotics - broad spectrum | Oral antibiotics - directed to specific bacteria

Respiratory (20 decks)

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