Lower Respiratory Tract Infections Flashcards

1
Q

What are examples of loss/suppressed cough reflex/swallowing?

A

Coma, Stroke or artificial ventilation.

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2
Q

Why does pulmonary oedema pre-dispose to LRTI?

A

Collection of fluid in alveoli.

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3
Q

What is Acute Bronchitis?

A

Inflammation and oedema of the bronchi.

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4
Q

What are the usual causes of Acute Bronchitis?

A

Viruses (Rhino, adeno, coronavirus and influenza)

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5
Q

What is the less common cause of Acute Bronchitis?

A

Bacteria.

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6
Q

Whom does Acute Bronchitis usually affect?

A

Children

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7
Q

What disease are cough (dry), tachypnoea and dyspnoea associated with?

A

Acute Bronchitis

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8
Q

What would help with diagnosis in severe Acute Bronchitis?

A

Culture of resp secretions - not routine.

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9
Q

What treatment is used for severe Acute Bronchitis?

A

Oxygen therapy

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10
Q

Who is affected most in Chronic bronchitis?

A

Men over 40.

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11
Q

What one exposure is Chronic Bronchitis exposed with?

A

Smoking

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12
Q

What mediates airway oedema and irritation?

A

Exogenous (not infective) irritants.

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13
Q

What causes 75% of Bronchiolitis cases?

A

Respiratory Syncytial Virus

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14
Q

What other viruses cause Bronchiolitis?

A

> Parainfluenza
Adenovirus
Influenza

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15
Q

Who does Bronchiolitis most commonly affect?

A

Young babies

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16
Q

What symptoms would occur in Bronchiolitis?

A

> Nasal discharge
Acute onset of wheeze
Cough
Resp distress (flaring, grunting, intercostal retractions)

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17
Q

How would Bronchiolitis be diagnosed?

A

> Chest x-ray and FBC

> Nasopharyngeal aspirate - viral PCR

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18
Q

What are the types of pneumonia?

A

> Community acquired Pneumonia

> Hospital Acquired Pneumonia

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19
Q

What infectious agents cause Hospital Acquired Pneumonia?

A

> Enterobacteriacae

> Pseudomonas Spp

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20
Q

What are the sub-types of Hospital Acquired Pneumonia ?

A

> Ventilator Acquired Pneumonia.

> Aspiration Pneumonia - abnormal entry into LRTI.

21
Q

Who is affected by community acquired pneumonia?

A

50-70 year old’s peak age.

22
Q

What pneumonia causing organisms come from a persons existing commensals?

A

> S.Pneumoniae

> H. Influenzae

23
Q

What pneumonia causing organism comes from the environment?

A

L.Pneumophilia

24
Q

What pneumonia causing organism comes from animals?

A

C.pstittaci

25
Q

What are the atypical organisms that cause pneumonia?

(Hint: My legs burn, they smell of tacky clams”

A
> Mycoplasma Pneumoniae
> Legionella Pneumoniae
> Coxiella burnetii
> Chlamydophila psittaci
> Chlamydophilia pneumoniae.
26
Q

What disease does fever, malaise, anorexia, productive sputum, pleuritic chest pain and fever belong to?

A

Bacterial community acquired Pneumonia.

27
Q

What are the clinical signs of bacterial community acquired pneumonia?

A

> Tachypnoea
Tachycardia
Hypotension
Consolidation - dull percussion.

28
Q

A cough is the main symptom of what pneumoniae?

A

Mycoplasma Pneumoniae

29
Q

Who does Mycoplasma Pneumoniae affect?

A

Young adults/children

30
Q

What are the rare complications of Mycoplasma Pneumoniae?

A

> Guillan-Barre syndrome
Peripheral Neuropathy
Pericarditis
Arthritis

31
Q

What disease (type of pneumonia) is found in showers?

A

Legionella Pneumonia

32
Q

What are the main symptoms of Legionella Pneumonia?

A
> High fever
> Vomiting
> Diarrhoea 
> Confusion
> Cough : dry --> productive
33
Q

Low sodium (SIADH) and deranged LFT’s are found with what disease?

A

Legionella Pneumonia

34
Q

What pneumonia can go on to cause mild pneumonia or bronchitis?

A

Chlamydophila Pneuminae

35
Q

What disease is characterised by exposure to birds?

A

Chlamydophila psittaci

36
Q

What should you consider in pt’s exposed to Chlamydophila Psittaci?

A

> Bird expsosure
Splenomegaly
Pneumonia

37
Q

What symptoms may pt’s with Chlamydophila Psittaci have?

A

> Reactive arthritis
Haemolytic Anaemia
Rash
Hepatitis

38
Q

What disease does sore throat, dry cough, fever, headache, myalgia?

A

Influenza (viral)

39
Q

What is primary viral pneumonia common in?

A

Those with pre-existing lung and cardiac conditions.

40
Q

What symptoms are common in Primary Viral Pneumonia?

A

Cough, cyanosis, breathlessness.

41
Q

What may develop after initial primary viral pneumonia ?

A

Secondary bacterial Pneumonia

42
Q

How is influenza diagnosed?

A

Viral antigen in PCR.

43
Q

What are the mycobacterial investigations of Influenza?

A
> Sputum culture
> Blood culture
> Legionella urinary antigen
> Pneumococcal urinary antigen 
> PCR/Serology
44
Q

What method are viral pathogens and mycoplasma pneumoniae discovered using in Influenza?

A

PCR of respiratory sample

45
Q

What method is used to find Chlamydophilia Pneumonia?

A

Complement fixed blood test

46
Q

What tool is used to assess CAP disease severity?

A
CURB 
Confusion
Urea >7mmol/l 
Respiratory Rate >30
Blood pressure (systolic
47
Q

What is the Pneumococcal vaccination against?

A

S. Pneumoniae

48
Q

Who is the pneumococcal vaccination for?

A

Pt’s with chronic heart, lung, kidney disease and splenectomy.