L19: Respiratory Infections

Question 1

What sort of respiratory infections are there

Answer 1

Bronchitis 
Pneumonia 
TB 
Bronchiectasis 
Cystic fibrosis 
Acute exacerbation of COPD or asthma

Question 2

What are the 2 types of bronchial infections

Answer 2

Acute bronchitis

Recurrent bronchitis

Question 3

Who does acute bronchitis occur in

Answer 3

Previously well people

Question 4

What are features of acute bronchitis

Answer 4

Cough and sputum

Question 5

What is recurrent bronchitis

Answer 5

Cough and sputum over at least 2 months

Question 6

What is chronic bronchitis

Answer 6

Flem for 3 months over 2 years

Question 7

What are the underlying cause for recurrent bronchitis

Answer 7

Sinus infection
Past nasal drip
Bronchiectasis

Question 8

What are the 2 types of pneumonia

Answer 8

Typical pneumonia

Atypical pneumonia

Question 9

Who does typical pneumonia occur in

Answer 9

People with pre-existing lung disease

Question 10

What are the sympmtoms of typical pneumonia

Answer 10

Pleuritic pain
Purple the pain
High temperature
Crackles and dullness and increased vocal resonance in the lungs

Question 11

What is the treatment for typical pneumonia

Answer 11

Beta lactams (penicillins)

Question 12

Who does atypical pneumonia occur in

Answer 12

Previously well people

Question 13

What are the symptoms of atypical pneumonia

Answer 13

Dry cough

Wheeze

Question 14

Does atypical pneumonia react to beta lactams (penicilin)

Answer 14

No

Question 15

Is it hard to distinguish between typical and atypical pneumonia in patients

Answer 15

Yes

Question 16

If distinguishing the 2 types of pneumonia is difficult how do we treat it

Answer 16

Use 2 different antibiotic at the same time two cover both bases of pneumonia

Question 17

What are the pathogens that can cause pneumonia

Answer 17

Mycoplasma

Legionella

Question 18

When does mycoplasma come in

Answer 18

Winter peaks and epidemics

Question 19

What is legionella related to

Answer 19

Travel to Spain and turkey

Clusters

Question 20

How do we diagnose pneumonia

Answer 20

Chest x-ray

Question 21

What does pneumonia look like an a chest x-ray

Answer 21

Opacity (white over the lobe of infection)
Loss of right heart border (if middle lobe)
Loss of right diaphragm (if lower lobe)

Question 22

What are the other features on a chest x-ray for pneumonia

Answer 22

Cavities

Question 23

What are cavities

Answer 23

Areas of dark area

Question 24

How do we manage pneumonia that is non severe

Answer 24

Amoxycilin and macrolide

Question 25

What type of drug is amoxycilin

Answer 25

Beta lactam antibiotic

Question 26

How do we manage severe cases of pnuemonia

Answer 26

Intra venous amoxiclav and IV macrolide

Question 27

What are the complications of pnuemonia

Answer 27

Respiratory failure Lung abscess Parapneumonic effusion

Question 28

What happens to the fluid in parapneumounic effusion as it goes from simple to complex to empyema

Answer 28

Thickens

Question 29

What is the management of empyema

Answer 29

Antibiotics Drainage Surgery

Question 30

What are the antibiotics used to manage empyema

Answer 30

Penicillins | Metronidazole

Question 31

What is tuberculosis caused by

Answer 31

Mycobacteria TB

Question 32

What are the symptoms of tuberculosis

Answer 32

``` Night sweats Fevers Weight loss Productive cough Haemoptysis ```

Question 33

How do we diagnose TB

Answer 33

``` Test sputum Bronchoscopy if there is no sputum Test for HIV Aspirate lymph node Vitamin d levels (deficiency) ```

Question 34

Where does TB spread in the body

Answer 34

``` Meninges (brain) Musculoskeletal Genitourinary Gastrointestinal Pericardial (lining of the heart) ```

Question 35

What does the treatment of TB involve

Answer 35

4 different antibiotics

Question 36

What are the 4 different antibiotics used to treat TB

Answer 36

Isoniazid Pyrizinamide Rifampicin Ethambutol

Question 37

What are the problems with treating TB

Answer 37

Resistance to TB bugs | Drug interactions and side effects

Question 38

What is the most common side effect from antibiotics

Answer 38

Hepatitis

Question 39

What is hepatitis

Answer 39

Inflammation of the liver

Question 40

What do we have to monitor for a TB patient on treatment

Answer 40

The liver

Question 41

how can we control Tb

Answer 41

Housing Overcrowding Nutrition Immunisation

Question 42

What is bronchiestasis

Answer 42

A condition whereby you get chronic bronchial dilation that leads to poor mucus clearance which leads to recurrent or chronic infection and infection causes more chronic bronchial dilation

Question 43

What are the common causes of bronchiectasis

Answer 43

Previous pnuemonia or TB

Question 44

What are the symptoms of bronchiestasis

Answer 44

Coughing up large volume of flem | Crackles in chest in inspiration and expiration

Question 45

What are the other causes apart from infection to bronchiestasis

Answer 45

``` Aspiration e.g peanut Mechanical obstruction Immune deficient Rheumatoid arthritis Cystic fibrosis Primary ciliary dyskinesia ```

Question 46

How do we treat bronchiestasis

Answer 46

Treat the underlying cause

Question 47

How do we investigate bornchiectasis

Answer 47

Chest x-ray Sputum culture CT scan

Question 48

How do we manage bronchiestasis

Answer 48

Postural drainage Antibiotics Bronchodilators

Question 49

What is cystic fibrosis

Answer 49

A mutation to the deltaf506 deletion to CFTR

Question 50

What type of channel is CFTR

Answer 50

Chloride channel

Question 51

What does cystic fibrosis lead to

Answer 51

Steaky secretions

Question 52

What are the other consequences of cystic fibrosis apart from bronchiestasis

Answer 52

Pancreatic insufficiency | Infertility

Question 53

How do we investigate cystic fibrosis

Answer 53

Sweat test | Genetic testing

Question 54

What is the management for cystic fibrosis

Answer 54

``` Aggressive management of bronchiectasis Pancreatic enzyme supplements Insulin Nutrients Lung transplantation ```

Question 55

What are the diseases where infection can cause flare ups

Answer 55

COPD exacerbation | Asthma exacerbation

Question 56

What are the symptoms of exacerbated COPD

Answer 56

Increased breathlessness Green sputum Increased sputum volume

Question 57

How do we treated exacerbated COPD

Answer 57

Antibiotics for 5 day Or Steroids (severe)

Question 58

How is exacerbation of asthma treated

Answer 58

Steroid