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Systems 1 > Lower Respiratory Tract infections > Flashcards

Lower Respiratory Tract infections Flashcards

1
Q

Symptoms of Pneumonia

A 
Fever
Myalgia 
Fatigue 
Dyspnoea (severe)
Pleuritic pain
Cough (may or may not)
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2
Q

Pneumonia may not present with what in the elderly?

A

Fever

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3
Q

Rusty sputum is suggestive of what?

A

Pneumococcal pneumonia

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4
Q

Signs of pneumonia

A 
Pyrexia
Tachypnoea
Central cyanosis
Dullness on percussion
Bronchial breathing
Crepitations
Increased Vocal Resonance
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5
Q

Investigations in pneumonia

A 
Chest radiograph
Sputum for culture
Acute and convalescent serology	
Mycoplasma IgM      
Atypical serology         
Full blood count
ESR/CRP
Blood culture
Legionella urinary antigen             
Pneumococcal urinary antigen
HIV
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6
Q

Common pathogens in pneumonia

A 
Strep pneumoniae
(gram -ve coccus
chlamydia psittaci
mycoplasma pneumoniae
Staph. Aureus  
Haemophilus influenza
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7
Q

Common cause of bacterial pneumonia in children

A

Mycoplasma pneumoniae

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8
Q

What is the severity scoring system for pneumonia?

A 
CURB 65
Confusion
Urea (blood, >7)
Respiratory rate>30
Blood pressure (diastolic<60)
65 (age >65)
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9
Q

What treatment/drug does a CURB65 score of 0 recommend?

A

Low risk
Treat in community
Amoxycillin OR clarithromycin

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10
Q

What treatment/drug does a CURB 65 score of 1-2 suggest?

A

Hospital treatment required
Amoxicillin AND Clarithromycin
(Beta lactam and macrolide)

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11
Q

What treatment/drug does a CURB 65 score of >3 suggest?

A

High risk of death
Need for ITU
Co-amoxiclav AND clarithromycin

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12
Q

Treatment for aspiration pneumonia?

A

(anaerobes)

Metronidazole and amoxycillin

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13
Q

Haematological malignancy treatment?

A

Broad spec

?antifungals

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14
Q

Influenza pneumonia increases the risk of what?

A

Staphylococcal pneumonia

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15
Q

Treatment for MRSA involved pneumonia?

A

Vancomycin or Linezolid

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16
Q

Pathogen often involved in pneumonia in the immunocompromised?

A

Pneumocystis jirovecii

fungus

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17
Q

Full treatment plan for pneumonia?

A 
Antibiotics
Oxygen
Analgesia
CPAP
Intubation and ventilation
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18
Q

Complications of pneumonia

A 
Scepticaemia 
Acute kidney injury
Empyema
Lung abscess
Metastatic infection 
ARDS
19
Q

Differential diagnosis for pneumonia?

A 
Tuberculosis
Lung cancer
PE
Pulmonary oedema 
Pulmonary vasculitis
20
Q

Empyema may follow which bacterial pneumonias?

A

Streptococcus (50%)
Staph aureus
Anaerobes

21
Q

Symptoms of empyema

A

Chest pain
High swinging fever
Absence of cough

22
Q

Investigations for empyema?

A

CT thorax

pleural ultrasound

23
Q

Diagnosis for empyema?

A

Acidic pleural aspiration

24
Q

Treatment for empyema?

A

Chest drain
IV antibiotics
May need t-PA/DNase
Surgery if not improving

25
Q

Pathogens most likely to cause cavitating pneumonia?

A

Staph aureus
Pseudomonas
Anaerobes

26
Q

Investigations for lung abscess?

A

CT Thorax
Sputum culture
TB microscopy/culture

27
Q

Treatment for lung abscess

A

Prolonged antibiotics

Drainage

28
Q

Causes of Bronchiectasis

A 
Idiopathic
Immotile Cilia syndrome
Cystic Fibrosis
Childhood infections
Hypogammaglobulinaemia
ABPA (Aspergillosis)
29
Q

Symptoms of bronchiectasis

A

Chronic cough
Copious sputum production
?wheeze, dyspnoea, tiredness, pain, haemoptysis

30
Q

Signs of bronchiectasis

A

Finger clubbing

Course inspiratory crepitations

31
Q

Investigations for bronchiectasis

A 
HRCT Thorax
Sputum culture
Serum immunoglobulins
IgE, Aspergillus precipitins
CF genotyping
32
Q

Treatment for bronchiectasis

A

Chest physiotherapy
Prompt treatment of infections
May need inhaled therapy

33
Q

Common LRTI Viruses

A

RSV
Influenza A/B
Adenovirus

34
Q

Common LRTI bacteria

A

Strep pneumoniae
Haemophyilius influenzae
M. pneumoniae
Chlamydia pneumoniae

35
Q

Tracheitis presents as what?

A

“croup which doesn’t get better”
Fever
Stridor

36
Q

Treatment for Tracheitis

A

Augmentin

37
Q

Criteria for persistent bacterial bronchitis

A

Wet cough
>1 month
Remission with antibiotics

38
Q

Bronchiolitis cardinal signs

A

Stuffiness
Tachypnoea
Poor feeding
Crackles

39
Q

Investigations for bronchiolitis

A

Nasopharyngeal aspiration

O2 saturation

40
Q

What does wheeze suggest in paediatrics LRTIs?

A

Bacterial cause unlikely

41
Q

When to diagnose an LRTI as pneumonia in a child?

A

Signs are focal
Crepitations
High fever

42
Q

Management of mild symptomatic pneumonia in a child

A

No Rx

43
Q

Management of symptomatic pneumonia in a child

A

Amoxicillin
(then)
Macrolide
(IV if vomiting)

Systems 1 (25 decks)

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