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Clinical Pathology > Lower respiratory tract infection > Flashcards

Lower respiratory tract infection Flashcards

1
Q

What constitutes the lower respiratory tract?

A

Anything below the larynx!

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2
Q

What are the predisposing factors to LRTI?

A
  • Loss/suppression of cough reflex
  • Ciliary dysfunction e.g. primary ciliary dyskinesia
  • Mucus dysfunction e.g. CF
  • pulmonary oedema
    Immunodeficiency
  • Macrophage function inhibition e.g. smoking
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3
Q

What are the main fungi that cause LRTIs and who do they infect most?

A

Immunocomprised

  • aspergillus spp
  • candida spp
  • pneumocytitis jiroveci
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4
Q

What is bronchitis?

A

Inflammation and oedema of bronchi and trachea

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5
Q

What are the main symptoms of bronchitis?

A

dry cough, dyspnoea, tachypnoea

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6
Q

What is the main cause of bronchitis?

A

Viruses e.g. rhinovirus, adenovirus, influenza

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7
Q

Are bacterial causes of acute bronchitis common?

A

NO - mainly viruses but can be by

  • M pneumoniae
  • B pertussis
  • H influenza
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8
Q

What are the diagnoses and treatment of acute bronchitis?

A

usually, mild self limiting disease

  • supportive treatment
  • O2 for co- morbidities
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9
Q

What is the definition for chronic bronchitis?

A

Sputum producing cough on most days for 3 months of 2 consecutive years (which is not attributable to another cause)

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10
Q

What is the main cause of chronic bronchitis?

A

Smoking, pollution, allergen - exogenous irritants (not infection)

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11
Q

What is bronchiolitis?

A

Inflammation and oedema of the bronchioles

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12
Q

Who does bronchiolitis effect the most?

A

Paeds (2-10 months)

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13
Q

What is the main cause of bronchiolitis?

A

RSV

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14
Q

How is bronchiolitis diagnosed?

A
  • Chest x-ray
  • FBC
  • Microbiological analysis (nasopharyngeal aspirate)
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15
Q

What is pneumonia?

A

Inflammation of the most distal airways (formation of inflammatory exudate i.e. pus)

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16
Q

Name the two anatomical patterns of pneumonia; what do they look like

A
  • Bronchopneumonia - patchy

- Lobar pneumonia - large part or entire lobe

17
Q

What is the most common cause for lobar pneumonia?

A

S Pneumoniae

18
Q

Name the 4 types of pneumonia

A
  • Community acquired pneumonia (CAP)*
  • Hospital acquired pneumonia (HAP) (48hrs after admission - diff. organisms to CAP)
  • Ventilator acquired pneumonia (48hrs after ventilation/ET intubation)
  • Aspirate pneumonia abnormal entry of food/fluid/stomach acid into LRT
19
Q

What are the main modes of pneumonia acquisition?

A
  • Person-to-person
  • Own commensal bacteria
  • Environment
  • Animals
20
Q

What are the typical organisms for pneumonia?

A 
S Pneumoniae
H Influenzae
S Areus
Moraxella catarrhalis
Klebsiella pneumoniae
21
Q

What are the major symptoms of pneumonia?

A

Productive cough (bloody)
RAPID ONSET
(fevers, rigor, pleuretic chest pain etc)

22
Q

What are the major SIGNS of pneumonia?

A

Tachycardia, hypotensive, consolidation

23
Q

What are the atypical bacterial that cause pneumonia?

A
  • Mycoplasma pneumoniae - associated with nephropathy (e.g. Guinean-Barre, peripheral neuropathy)
  • legionella pneumonia - water works/AC/showers - fever, D&V, confusion
  • Chlamoydophila pneumoniae
  • Chlamoydophila psittaci - birds
24
Q

What patients are affected by primary viral pneumonia?

A

Patients with pre-existing cardiac/lung disorders - primary = rare

25
Q

What non-microbiological investigations would you perform for investigating pneumonia?

A
  • Chest X-ray
  • Bloods - FBC,U&E,CRP, LFTs
  • Obs - BP, pulse, oximetry
26
Q

What microbiological testing should we conduct?

A
  • Sputum gram stain and culture
  • Blood culture
  • Legionella urinary antigen
  • Pneumococcal urinary antigen
  • PCR (e.g. influenza) and serology e.g. chlymydophila sp. mycoplasma pneu
27
Q

How do we assess pneumonia?

A

CURB65 (1 point for each!)

C= confusion

U = urea above 7mmol

R= respiratory rate above 30

B= Blood pressure (low)

65 = above 65yrs

28
Q

How do we prevent LRTIs

A

Pneumococcal vaccinations (S. pneumoninae)

Flu vaccines

Clinical Pathology (50 decks)

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