Lower Respiratory Tract Infection - ADULTS Flashcards
1
Q
Acute bronchitis
A
- Inflammation of bronchi
- Temporary <3 weeks
- Cough and sputum
- Usually viral
- Supportive management
2
Q
COPD exacerbation
A
- Change in colour of sputum
- Fevers
- Increased breathlessness
- Wheeze
- Cough
3
Q
Treatment for COPD exacerbation
A
- Steroids
- Antibiotics:
~ amoxicillin
~ doxycycline
~ co-trimoxazole
~ clarithromycin - +/- nebulisers
4
Q
Pneumonia
A
- Inflammation of lung parenchyma
- 1 in 20 acute bronchitis -> pneumonia
5
Q
Risk factors for pneumonia
A
- Smoking, alcohol XS
- Extremes of age
- Preceding viral illness
- Pre-existing lung disease
- Chronic illness
- Immunocompromised
- Hospitalisation
- IVD
6
Q
Symptoms of pneumonia
A
- Fever, rigors, myalgia
- Cough and sputum
- Chest pain (pleuritic)
- Dyspnoea
- Haemoptysis
7
Q
Signs of pneumonia
A
- Tachypnoea
- Tachycardia
- Reduced expansion
- Dull percussion
- Bronchial breathing
- Crepitations
- Vocal resonance
8
Q
Investigations of pneumonia
A
- Community: Maybe none!
CXR if diagnosis in doubt, not improving, ?ca - Hospital:
Bloods – serum biochemistry, FBC, CRP
Blood cultures
CXR
Sputum culture, viral throat swab
Legionella urinary antigen
9
Q
Microbiology
A
- Strep Pneumoniae 39%
- H. Influenzae 5.2%
- Legionella 3.6%
- Staph aureus 1.9%
- Moxarella catarrhalis 1.9%
- Mycoplasma pneumoniae 10.8%
- Chlamydophila pneumoniae 13.1%
- Chlamydophyla psittaci 2.6%
- Coxiella burnetii 1.2%
- All viruses 13.1%
10
Q
CLASSIFICATION
A
SEE NOTES
11
Q
Pneumonia - severity scoring
A
CURBS
C = confusion
U = blood urea > 7mmol/L
R = respiratory rate >/= 30/min
B = systolic BP < 90 mmHg, diastolic blood pressure < 60mmHg
65 = age >/= 65
A SCORE OF
0-1 low risk - could be treated in community
2 moderate risk - hospital treatment usually required
3-5 high risk of death and need for ITU
12
Q
Pneumonia - treatment
A
SEE NOTES TABLE
13
Q
Lung abscess
A
- More likely with Staph aureus, pseudomonas, anaerobes…
- Purulent sputum, haemoptysis
- Screen for TB
- CT scan +/- bronchoscopy
- Prolonged abx
14
Q
Recovery of lung abscess
A
- Takes weeks!
- Repeat CXR 6 weeks if >50yrs, smokers
- Smoking cessation
15
Q
What questions may arrise from recurrent pneumonia?
A
- Immunocompromised?
- Underlying structural lung disease?
- Aspiration?
