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Respiratory System > Lower Respiratory Tract Infection in Adults > Flashcards

Lower Respiratory Tract Infection in Adults Flashcards

1
Q

LRTIs

A 
Acute bronchitis
Pneumonia
Exacerbations of COPD
Empyema
Lung abscess
Bronchiectasis
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2
Q

Acute bronchitis

A

Temporary inflammation of bronchi (< 3 weeks)

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3
Q

Symptoms of acute bronchitis

A

Cough and sputum

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4
Q

Acute bronchitis is caused by a

A

Virus

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5
Q

Management of acute bronchitis

A

Supportive management

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6
Q

Symptoms of COPD exacerbations

A 
Change in colour of sputum
Fevers
Increased breathlessness
Wheeze
Cough
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7
Q

Treatment of COPD exacerbations

A

Steroids
Antibiotics - amoxicillin, clarithromycin etc.
Nebulisers

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8
Q

Pneumonia

A

Inflammation of lung parenchyma (gas exchange part)

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9
Q

Consolidation

A

Solidification due to cellular exudate in alveoli leads to impaired gas exchange

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10
Q

Different types of pneumonia

A

Bronchopneumonia
Lobar pneumonia
Interstitial pneumonia

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11
Q

Bronchopneumonia

A

Patches everywhere

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12
Q

Lobar pneumonia

A

Whole lobe is effected by consolidation

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13
Q

Interstitial pneumonia

A

Inflammation alone, interstitial pattern

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14
Q

Risk factors of pneumonia

A 
Smoking
Alcohol
Extremes of age
Chronic illness
Immunocompromised
Preceding viral illness
IV drug use
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15
Q

Pneumonia symptoms

A 
Fever, rigor, myalgia
Cough and sputum
Pleuritic chest pain
Dyspnoea
Haemoptysis
Lethargy
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16
Q

Pleuritic chest pain

A

Sharp shooting pain, particularly when taking deep breaths

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17
Q

Rusty brown sputum in pneumonia indicates infection by

A

Streptococcus pneumoniae

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18
Q

Pneumonia signs

A 
Pyrexia
Tachypnoea
Tachycardia
Reduced expansion
Dull percussion at left lobe
Bronchial breathing at left lobe
Crepitations 
Increased vocal resonance
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19
Q

Community pneumonia investigations

A

Chest x-ray

20
Q

Hopsital pneumonia investigations

A 
Bloods - FBC, ESR/CRP, serum biochemistry, mycoplasma IgM
Blood cultures
Sputum culture and microscopy 
Viral throat swab
Legionella urinary antigen
Atypical serology
21
Q

Differential diagnosis of pneumonia

A 
Tuberculosis
Lung cancer
PE
Pulmonary oedema
Pulmonary vasculitis
Congestive heart failure
Empyema
Acute bronchitis
AE of COPD
22
Q

Microbiology of typical community acquired pneumonia

A

Streptococcus pneumoniae
Haemophilus influenzae
Mycoplasma pneumoniae

23
Q

Microbiology of atypical community acquired pneumonia

A 
Legionella pneumophilia
Chlamydia pneumoniae
Chlamydia psittaci
Coxiella burnetti
Moraxella catarrhalis
Viruses
24
Q

Microbiology of hospital acquired pneumonia

A 
E.coli
Staph aureus
Pseudomonas aerigunosa
Klebsiella pneumoniae
Anaerobes
Fungi
Legionella pneumphilia
25
Q

Method used to measure severity of pneumonia

A

CURB 65

26
Q

CURB 65

A 
Confusion
Blood urea > 7mmol/L
Respiratory rate > 30/min
Blood pressure < 90mmHg, 60mmHg
Age > 65
27
Q

CURB 65 score 0-1

A

Low risk

28
Q

CURB 65 score 2

A

Moderate risk

29
Q

CURB 65 score 3-5

A

High risk

30
Q

Factors to beware of considering CURB 65

A

Young people
Hypoxia
Multi-lobar consolidation

31
Q

Treatment for CURB 65 score 0-1

A

Amoxicillin for 5 days

32
Q

Treatment for CURB 65 score 2

A

Amoxicillin and clarithromycin for 5-7 days

33
Q

Treatment for CURB 65 score 3-5

A

Co-amoxiclav and clarithromycin for 7-10 days

34
Q

Supportive management of pneumonia

A

Oxygen
Fluids
Antipyretics, NSAIDs (fever, inflammation)
Intubation and ventilation

35
Q

Complications of pneumonia

A 
Sepsis
Acute kidney injury
ARDS
Parapneumonic effusion
Empyema
Lung abscess
Disseminated infection
36
Q

Empyema

A

Pus in the thoracic cavity

37
Q

Lung abscess is more likely with which bacteria

A

Staph aureus
Pseudomonas
Anaerobes

38
Q

Treatment for empyema

A

Drain and prolonged antibiotics

39
Q

Symptoms of lung abscess

A

Purulent sputum

Haemoptysis

40
Q

Treatment for lung abscess

A

Prolonged antibiotics

41
Q

What might cause recurrent pneumonia

A

Immunocompromised
Underlying structural lung disease
Aspiration

42
Q

Symptoms of bronchiectasis

A 
Chronic productive cough
Breathlessness
Recurrent LRTI
Haemoptysis
Finger clubbing
Crepitations
Wheeze
Obstructive spirometry
43
Q

Bronchiectasis

A

Widening of airways leading to a build up of excess mucous

44
Q

Infective agents of bronchiectasis

A

Staph aureus
haemophilus influenzae
Pseudomonas aerigunosa

45
Q

Investigation of bronchiectasis

A

Sputum culture

46
Q

Treatment of bronchiectasis

A

Chest physio
Mucolytics
Prolonged antibiotics
Vaccinations

47
Q

Management of pneumonia

A 
Antibiotics - macrocodes and beta-lactams
Supplemental oxygen
Analgesia
IV fluids
Anti-pyretics

Respiratory System (20 decks)

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