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Respiratory > lower respiratory > Flashcards

lower respiratory Flashcards

1
Q

acute bronchitis

A

preceded by common cold

cold which goes to the chest

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2
Q

acute bronchitis clinical features

A 
productive cough
fever 
normal CXR
normal chest exam 
transient wheeze
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3
Q

acute bronchitis treatment

A

usually self limiting
antibiotics not indicated
can lead to significant morbidity in patients with chronic lung disease

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4
Q

infections in patients with COPD

A 
variable disease 
chronic sputum production 
bronchoconstriction 
inflammation of the airways 
SOB
chest pains 
exacerbation - infective, non-infective
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5
Q

acute exacerbation of COPD

A

may be preceded by upper respiratory infection - sputum, wheezy, SOB
examination - respiratory distress, wheeze, coarse crackles, cyanosed, ankle oedema

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6
Q

management of acute exacerbation of COPD primary care

A

antibiotic - doxycycline or amoxicillin
bronchodilator inhalers
short course of steroids
refer to hospital if evidence of respiratory failure, not coping at home

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7
Q

management of COPD exacerbation in hospital

A

arterial blood gases
CXR
oxygen if hypoxaemic
rest, then mobilise

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8
Q

red hpatisation

A

consolidation caused by pneumonia

named as looks more like liver tissue

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9
Q

pneumonia symptoms

A 
malaise
anorexia
sweats
rigors
myalgia 
arthralgia 
headache
confusion
cough 
pleurisy
haemoptysis
dyspnoea
preceding URTI
abdominal pain
diarrhoea
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10
Q

pneumonia signs

A 
fever 
rigors
herpes labialis
tachypnoea
crackles
rub
cyanosis
hypotension
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11
Q

pneumonia investigation

A 
blood culture
serology
arterial blood gases
full blood count
urea
liver function
CXR
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12
Q

CURB65

A 
community required pneumonia 
Confusion
Urea>7
Respiratory rate 
Blood pressure systolic <90 or diastolic <60
65 years or older
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13
Q

community acquired pneumonia management

A 
antibiotics - amoxicillin, doxycycline
oxygen 
fluids
bed rest
no smoking
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14
Q

pathogens

A 
S. pneumoniae
H. influenzae
legionella sp
staph aureus
M. pneumoniae
C. pneumonia
Gm -ve enterobacteria
viruses
influenza A &amp; B
chlamydia psitacci
coxiella burnetii
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15
Q

mycoplasma pneumonia

A 
wide range of pathologies 
pneumonia
hepatitis
immune thrombocytopenic purpura
autoimmune haemolytic anaemia
arthritis
no cell wall
causes protracted paroxysmal cough
common cause of community acquired pneumonia 
person to person spread
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16
Q

hospital acquired pneumonia

A

need extended gram negative cover

amoxicillin, gentamicin

17
Q

apiration pneumonia

A

need anaerobic cover

amoxicillin, metronidazole

18
Q

legionella

A

chest symptoms may be minimal
GI disturbance is common
confusion common
levofloxacin

19
Q

IV antibiotics when

A

oral route not available
sensitivities
deep seated infections -abscesses, bone, endocarditis, meningitis
first dose

20
Q

lifestyle

A 
HIV - PCP
PWID - staph aureus
alcohol/homeless - TB, Klebsiella
frequently hospitalised - pseudomonas
returning traveller - legionella, TB
indian sub-continent - TB
eastern Europe - MDR TB
21
Q

complications of pneumonia

A

respiratory failure
pleural effusion
empyema
death

22
Q

influenza clinical presentation

A 
fever - high, abrupt onset
malaise
myalgia
headache
cough
prostration
23
Q

classical flu

A

influenza A

influenza B

24
Q

Flu like illnesses

A

parainfluenza viruses

25
Q

haemophilus influenzae

A

bacterium
not a primary cause of flu
may be a secondary invader

26
Q

flu transmission

A

by droplets, through direct contact with secretions of someone with the infection

27
Q

flu complications

A 
primary influenzal pneumonia 
secondary bacterial pneumonia 
bronchitis
otitis media
perinatal mortality, prematurity, smaller neonatal size, lower birth weight
28
Q

flu therapy

A

symptomatic - bed rest, fluids, paracetamol

antivirals - oseltamivir (tamiflu), zanamivir

29
Q

lab confirmation of influenza

A

direct detection of virus
PCR
nasopharyngeal swabs
throat swabs

30
Q

coxiella burnetii

A 
Q fever - pyrexia of unknown orign 
pneumonia 
uncommon, sporadic zoonosis
sheeps and goats
complication - culture negative endocarditis
31
Q

chlamydophila psittaci

A

casues Psittacosis
uncommon, sporadic zoonosis
caught from pet birds
presents as pneumonia

32
Q

bronchiolitis

A

lung infection and causes inflammation and congestion in bronchioles
1st or 2nd year of life
fever
coryza
cough
wheeze
severe cases - grunting, decrease PaO2, intercostal/sternal indrawing

33
Q

bronchiolitis complications

A

respiratory and cardiac failure

34
Q

chlamydia trachomatis

A

STI which can cause infantile pneumonia

diagnosed by PCR on urine of mother or pernasal/throat swabs of child

35
Q

chlamydophila pneumoniae

A

person to person
mostly mild respiratory infection
may be picked up by test foe psittacosis

Respiratory (19 decks)

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