lower respiratory tract infections Flashcards
What parts of the body are included in the lower respiratory tract?
trachea
bronchus
bronchioles
lungs
What are the LRTI associated with the lungs?
Pneumonia
abscesses
What are the two types of bronchitis?
Acute
chronic
What are the 4 types of pneumonia?
hospital acquired
community acquired
ventilator acquired
aspiration
What types of microorganisms cause LRTI?
bacteria
viruses
fungi - mainly only in immunocompromised
What is acute bronchitis?
inflammation and oedema of the trachea and bronchi
What are the symptoms of acute bronchitis?
dry cough - may be associated with retrosternal pain due to inflammation
dyspnoea - dificulty breathing
tachypnoea - fast breathing
Which microorganisms are the main cause of acute bronchitis?
viruses e.g. rhinovirus coranovirus adenovirus influenza
How do you diagnose acute bronchitis?
diagnostic tests not included in mild presentation
vaccination/previous exposures helps to rule out organisms
cultures of respiratory secretions
What is the treatment for acute bronchitis?
supportive treatment
oxygen/respiratory support for severe disease/co-morbidites
bacterial = antibiotics
What is chronic bronchitis?
sputum producing cough on most days for at least 3 months of two successive years
caused by exogenous irritants not microorganisms
have acute exacerbation via infective agents
How would you treat a acute exacerbation in chronic bronchitis?
oxygen/ventilation
What is bronchiolitis?
inflammation and oedema of the bronchioles
What are the symptoms of bronchiolitis?
acute wheeze
cough
nasal discharge
respiratory distress
What microorganism commonly causes bronchiolitis?
RSV (Respiratory syncytial virus)
How is bronchiolitis diagnosed?
chest x ray
FBC
microbiological diagnosis of nasopharyngeal aspirate via PCR
What is the treatment for bronchiolitis?
oxygen
feeding support
bacterial = antibiotics
What is pneumonia?
infection affecting the most distal airways and alveoli forming inflammatory exudate
What are the two anatomical patterns of pneumonia?
bronchopneumonia - patchy distribution from inflammed bronchioles and bronchi to alveoli
lobar pneumonia - large part or whole of lobe
What microorganism is lobar pneumonia normally caused by?
streptococcus pneumoniae
What 2 categories are the bacterial causes of pneumonia split into?
typical
atypical
What is ‘atypical’ in reference to pneumonia and microorganisms?
fails to respond to penicillin
difficult to grow
What are examples of typical organisms?
streptococcus pneumoniae haemophilus influenza moraxella catarrhalis staph aureus klebsiella pneumoniae
What are examples of atypical organisms?
mycoplasma pneumoniae legionella pneumophillia chlamydophilia pneumoniae chalmydophila psittaci coxiella burnetii
What are the symptoms of pneumonia?
rapid onset fever/chills productive cough (can have blood) sputum pleuritic chest pain malaise
What are the signs of pneumonia?
tachypnoea - fast breathing tachycardia - fast heart rate hypotension dull to percuss reduced air entry, bronchial breathing - hollow blowing sounds, crackles
What are the symptoms of primary viral pneumonia?
cough
breathlessness
cyanosis
what are examples of microorganisms that cause secondary viral pneumonia?
s. pneumoniae
h. influenzae
s. aureus
How is viral pneumonia diagnosed?
viral antigen detection using PCR routin observations bloods chest x ray nasal flush in children
What is tool is used to assess the severity of pneumonia?
CURB65
What acronym is used for the management of patients with community acquired pneumonia?
A = airway B = breathing C = circulation
Why do you have to be careful when providing oxygen to a patient with COPD?
rely of hypoxic drive to breath
