Lower respiratory tract infections Flashcards
What is classed as lower respiratory tract
Anything below the trachea (including the trachea)
Name the lower respiratory tract infections
Acute bronchitis
Acute exacerbation of COPD
Pneumonia
Tuberculosis
What causes acute bronchitis
Usually a virus
What are presenting symptoms of acute bronchitis
wet cough
When should you see GP with acute bronchitis
If symptoms are severe or have been going on for more than 3 weeks.
What is the main indication of an acute exacerbation of COPD
Change in the colour of sputum (yellow or brown)
What is the usual cause of acute exacerbation of COPD
viral Infection (most common)
Bacterial infection
- —-Streptococcus pneumoniae
- —-Moraxella cararrhalis
What is Pneumonia
Inflammation of the lung parenchyma and consolidation due to cellular exudate which impairs gas exchange
What are the three types on pneumonia
Bronchopneumonia - inflammation of tubes
Lobar pneumonia - inflammatory exudate in alveoli
Interstitial pneumonia - rare and doesnt arise from infection
What are the presenting symptoms for Pneumonia
Fever, rigors and myalgia
Cough and Sputum
Sharp pleuritic chest pain
S.O.B
What are the clinical signs of pneumonia
Dull percussion Reduced expansion increased vocal resonance Coarse breathing sounds (brochial breath sounds) Visible consolidation on CXR Fine Coarse Crackles
What other illness increases your chance of getting pneumonia
FLU
What investigations should be done if suspect pneumonia
Chest X-ray FBC (FBC and CRP) Sputum culture Viral throat swab Blood cultures
What are the differentials to pneumonia
Tuberculosis Lung cancer Pulmonary Vasculitis (destruction of blood vessels) PE Pulmonary oedema
What is used to score the severity of Pneumonia
CURB65
What is curb 65
C- confusion U - Blood urea >7mmol R- respiratory rate >30 B - Systolic BP <90 and diastolic <60 65 - >65?
Get score out of 5.
0-1 - low risk
2 - moderate risk
3-5 - severe risk
What is the treatment for pneumonia if Curb 0 or 1
Amoxacillin or clarythromycin (If allergic) - 5 days
What is the treatment for pneumonia if Curb 2
Amoxacillin and clarythromycin or Levofloxacin (if allergic)
- 5-7 days
What is the treatment for pneumonia if Curb 3-5
Co-amoxiclav + clarithromycin or Levofloxacin/
co-trimoxazole (if allergic) - 7-10 days
What can happen in pneumonia is left untreated
Sepsis
Kidney injury
ARDS
Parapneumonic effusion
What TYPICAL pathogens cause pneumonia
Pneumococcal pneumonia
Haemophilus influenzae
What ATYPICAL pathogens cause pneumonia
Legionella pneumophilia
Chlamydia pneumonia
Viruses
In the hospital, what pathogens can cause cavatating pneumonia
Staph Aureus and Klebsiella pneumoniae
What does the CURB65 scale not take into consideration
young people
Hypoxia
Multi-lobal consolidation
What is bronchiectasis
Long term consolodation where the airways of the lung become abnormally widened, building up mucous and increasing the chances of infection.
What does the patient present with in bronchiectasis
Chronic wet cough
S.O.B
Frequent Lower respiratory tract infections
HAEMOPTOSIS
What are the clinical signs of bronchiectasis
Finger clubbing
coarse voice
wheeze
Obstructive spirometry (reduced ratio)
