Infectious lung disease Flashcards
What is pneumonia?
Swelling of the alveoli
Stages of pneumonia pathophysiology?
Congestion - exudate into alveolar space
Red hepatisation - cells into alveolar space
Grey hepatisation - fibrin accumulation, destruction of cells
Resolution - resorption of exudate
Pneumonia symptoms?
Fever
Productive cough
Chest pain
Dyspnoea
Elderly pneumonia presentation?
Afebrile
Confused
Decompensation of other disease
Most common cause of pneumonia?
Streptococcus pneumonia - vaccine available
Other common bacterial causes of CAP?
Haemophilus influenza, Staphylococcus aureus,
Group A strep
Moraxella catarrhalis
Hospital acquired pneumonia definition?
New infection more than 48 hours post admission
Most common organisms of HAP?
Gram negative bacteria
Staph aureus
Legionella
Atypical pneumonia agents?
Mycoplasma pneumonia
Chlamydia pneumonia
Legionella pneumophila
Mycoplasma pneumonia course?
Slow onset Constitutional upset Fever Headache Dry cough
Which cohort get klebsiella pneumoniae infection?
Alcoholics
Legionella pneumonia cause?
Most severe, headache, myalgia and fever predominate early phase followed by respiratory symptoms
When do patients get staph aureus pneumonia
Hospital or post influenza
What is idiopathic interstitial pneumonia?
Non-infective pneumonia e.g. cryptogenic organising pneumonia
What is cryptogenic organising pneumonia?
Bronchiolitis which develops secondary to rheumatoid or amiodarone therapy
Signs of pneumonia?
Pleural rub
Increased vocal resonance
Dullness to percussion,Bronchial breathing
Investigations for pneumonia?
CXR FBC U+Es Blood culture Sputum culture Urinary antigen testing - legionella and pneumococcus LFTs
First line treatment for community acquired?
Macrolide or tetracycline
Complications of pneumonia?
Sepsis Heart failure ACS Arrhythmia Necrotising pneumonia Pleural effusion Abscess Empyema
What is TB
Tuberculosis - infection caused by mycobacterium tuberculosis
Symptoms of pulmonary TB?
Cough Haemoptysis Chest pain Cachexia Weight loss Night sweats Fever Fatigue
Symptoms of extra-pulmonary TB?
Haematuria Meningitis Hoarseness Loss of appetite Weight loss Night sweats Fever Fatigue
Tests for TB?
Tuberculin skin test
Quantiferon test - interferon gamma release assay
Risk factors for developing tuberculosis?
Silicosis Chronic renal failure HIV Organ transplantation IV drug use Haematological malignancy anti-TNF treatment Previous gastrectomy Underweight
Treatment for TB?
RIPE Rifampin Isoniazid Pyrazinaminde Ethambutol
Phases of TB treatment
Initial phase - RIPE - 2 month
Continuation fase - RI - 4-7 month
When is continuation phase 7 months long?
Extensive disease, initial phase didn’t include pyrazinamide
What is special about TB treatment?
Long + directly observed therapy
