Lower Respiratory Tract Infection - Respiratory Pathology

Question 1

What are the predisposing factors to a lower resp tract infection?

Answer 1

1) Loss / suppression of cough reflex / swallow
- Stroke
- coma
- ventilation

2) Ciliary Defects

3) Mucous disorders
- cystic fibrosis

4) Pulmonary oedema
5) Immunodeficiency

6) Macrophage function inhibition
- smoking

Question 2

What bacteria cause Lower Resp tract infections?

Answer 2

1) Streptococcus pneumoniae
2) Haemophilus Influenzae
3) Staph aureus
4) Klebsiella pneumonia
5) Chlamydophila pneumoniae
6) Legionella pneumoniae
7) Mycobacterium tuberculosis

Question 3

What viruses causes LRTIs?

Answer 3

1-influenza
2-parainfluenza
3-respiratory syncytial virus
4-adenovirus

Question 4

What fungi cause LRTIs?

Answer 4

1) Aspergillus
2) Candida
3) Pneumocystitis jiroveci

Question 5

What LRTI is associated with retrosternal pain?

• also has inflammation and oedema of trachea and bronchi.
• cough (usually dry), dyspnoea and tachypnoea

Answer 5

Acute Bronchitis

Question 6

What are the causes of acute bronchitis?

Answer 6

Usually viral cause:

• rhinovirus
• coronavirus
• adenovirus
• influenza

Sometimes bacterial cause:

• H.influenzae
• M.pneumoniae
• B.pertussis

Question 7

Who is usually affected by acute bronchitis?

Answer 7

children under 5yrs

Question 8

“Cough productive sputum on most days during at least 3 months of 2 successive years” - is the definition of???

Answer 8

Chronic bronchitis

Question 9

What is chronic bronchitis associated with?

Answer 9

smoking
pollution
allergens

Question 10

Who is affected by chronic bronhitis?

Answer 10

• 10-25% of adult population

- most commonly affects men and those above 40yrs

Question 11

What is bronchiolitis most commonly caused by?

Answer 11

RSV

Question 12

A condition in infants that has acute onset of wheeze, nasal discharge, respiratory distress is usualll?

Answer 12

Bronchiolitis

Question 13

What infection affects the most distal airways and alveoli with the formation of inflammatory exudate?

Answer 13

Pneumonia

Question 14

What pathogen are most lobar pneumonia caused by?

Answer 14

Strep pneumoniae

Question 15

What are the characteristics of Bronchopneumonia?

Answer 15

1) PATCHY around inflamed bronchioles and bronchi. then spread to surrounding alveoli

Question 16

what are the typical bacteria that cause community acquired pneumoniae?

Answer 16

1) Strept pneumoniae
2) Haemophilus influenzae
3) Moraxella catarrhalis
4) Staph aureus
5) Klebsiella pneumoniae

Question 17

Rapid onset of
fever/chills
productive cough
mucopurulent sputum
pleuritic chest pain
and general malaise
are all symptoms of?

Answer 17

Bacterial community acquired pneumoniae.

Question 18

What are the “atypical” bacterial causes of community acquired pneumoniae?

Answer 18

1) Mycoplasma pneumoniae
2) Legionella pneumophilia
3) Chlamydophila pneumoniae
4) Coxiella burnetii

Question 19

What atypical bacterial cause of CAP (community acquired pneumoniae)
is associated with birds?

Answer 19

Chlamydophila psittaci

Question 20

what atypical bacterial cause of CAP is colonises water piping systems to cause high fever, diarrhoea, vomiting and confusion?

Answer 20

legionella pneumophilia

Question 21

CURB-65 score is how we assess disease severity. What does CURB-65 score include for pneumonia?

Answer 21

Confusion

Urea >7mmol/l

Respiratory rate >30

Blood pressure:
-systolic 65yrs