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A2. Respiratory System > Lower Respiratory Tract Infections > Flashcards

Lower Respiratory Tract Infections Flashcards

1
Q

Who commonly get LTRIs?

A

Very young

Od

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2
Q

When is there an increased incidence of LTRIs?

A

During winter

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3
Q

What is the 2nd commonest cause of death in the UK?

A

Pneumonia

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4
Q

What are the symptoms of asthma?

A

They can be variable
Often breathlessness
Pleuritic chest pain
Cough and infected sputum

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5
Q

Is a CXR abnormal in pneumonia?

A

Always abnormal

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6
Q

What is seen in a CXR of someone with pneumonia?

A

Pulmonary shadowing/consolidation

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7
Q

What does the added sound of crackling usually indicate?

A

Infection

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8
Q

What is bronchiectasis?

A

The dilation of bronchi producing sepsis in the chest

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9
Q

What are the symptoms of bronchiectasis?

A 
Daily cough 
Daily copious purulent
Sputum production 
Occasional haemoptysis 
Frequent chest infections
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10
Q

What are the signs of bronchiectasis?

A

Finger clubbing

Lung crackles on inspiration and expiratoin

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11
Q

Can bronchiectasis be cured?

A

No

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12
Q

How is empyema distinguished from a simple effusion?

A

The fluid can be collected and sampled and is found to be pus

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13
Q

Why does the infected fluid need to be drained and not treated with antibiotics?

A

Because antibiotics do not penetrate well into the pleural cavity

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14
Q

What investigations are done for bronchiectasis?

A

Sputum culture
Spirometry
CXR
High resolution CXR are the main diagnostic tests

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15
Q

What infects the fluid in empyema?

A

Micro-organisms

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16
Q

What is a lung abscess?

A

When the bacteria in the lung form a pocket of infected fluid

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17
Q

How is an abscess in the lung removed?

A

Long-term antibiotics

Sometimes the abscess must be drained by a surgeon or radiologist

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18
Q

What are the hosts defences of the lower respiratory tract?

A

Alveolar macrophages
Mucociliary escalator
Cough reflex

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19
Q

What are the aetiological classifications of pneumonia?

A 
Community
Hospital acquired 
Pneumonia in the Immunocompromised
Atypical 
Aspiration 
Recurrent
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20
Q

What is lobar pneumonia?

A

A form of pneumonia that affects a large and continuous area of the lobe of a lung

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21
Q

What are some of the complications of LTRIs?

A

Pleurisy
Pleural Effusion
Empyema

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22
Q

What are some of the common micro-organism causes of LRTIs?

A

Streptococcus pneumonia

Staphylcoccus aureus

23
Q

What are some of the uncommon micro-organism causes of LRTIs?

A

Legionella pneumophila
Klebsiella pneumoniae
Pseudomonas aeruginosa
Bacteroides and other anaerobes

24
Q

What are some of the rare micro-organism causes of LRTIs?

A

Haemophilus influenzae

Escherichia coli

25
Q

What % of pneumonias does streptococcus pneumonia account for?

A

50%

26
Q

Who gets streptococcus pneumonia?

A

All ages

27
Q

What are the features of streptococcus pneumonia?

A 
Abrupt onset 
High pyrexia/rigors 
Pleuritic chest pain 
Cough with purulent (green) sputum 
Hypotension and cyanosis 
Septicaemia
28
Q

What is shown in the CXR of streptococcus pneumonia?

A

Clasically lobar

Often patchy shadowing

29
Q

What is the treatment for streptococcus pneumonia?

A

IV benzyl penicillin, amoxicillin, oral ampi

30
Q

If the person is allergic to penicillin what antiobiotics should be used?

A

Macrolide

Clarithromycin

31
Q

What is the treatment for empyema?

A

Chest drain

IV antibiotics

32
Q

What organisms are more likely to result in cavitating pneumonia?

A

Staph. aureus
Pseudomonas
Anaerobes

33
Q

What are the causes of bronchiectasis?

A 
Idiopathic 
Immotile Cilia Syndrome 
CF
Childhood infections such as measles 
ABPA
34
Q

What is the treatment for bronchiectasis?

A

Chest physiotherapy
Prompt treatment of infections with appropriate antibiotics
May require inhaled therapy including beta2 agonist and inhaled corticosteroid

35
Q

What % of community diagnosed pneumonia require hospitlisation?

A

Between 22 and 42%

36
Q

How would you describe the sputum in pneumonia?

A

Rusty

37
Q

What does CURB65 stand for?

A 
C = confusion 
U= blood urea>7
Respiratory rate >30
B = diastolic blood pressure <60
65 = age>65
38
Q

What are the main features of bronchiectasis?

A

Dilated and damaged bronchi

39
Q

What are examples of LRTIs?

A 
Acute bronchitis 
Exacerbation of COPD
Pneumonia 
Empyema
Lung Abscess
Bronchiectasis
40
Q

What is the UK incidence of pneumonia?

A

Between 5 and 11 per 1000 of the adult population

41
Q

What are the symptoms of pneumonia?

A 
Malaise 
Fever
Chest pain (pleuritic)
Cough 
Purulent Sputum 
Dyspnoea
42
Q

What are the signs of pneumonia?

A 
Pyrexia 
Tachpnoea 
Central cyanosis 
Dullness on percussion of affected lobe(s)
Bronchial breath sounds 
Inspiratory crepitations 
Increased vocal resonance
43
Q

What is tachpnoea?

A

Abnormally rapid breathing

44
Q

What is the investigation for pneumonia?

A 
Serum biochemistry and full blood count 
CXR
Blood cultures
Throat swab 
Sputum microscopy and culture
45
Q

What bacteria can cause pneumonia?

A 
Strep pneumoniae
H. Influenzae 
Legionella 
Staph aureus 
Mycoplasma pneumoniae
Chlamydia psittaci
46
Q

What treatment is given to pneumonia patients?

A

Oxygen
I.V fluids
CPAP
Intubation and ventilation

47
Q

What are the potential complications of pneumonia?

A 
Septicaemia 
Acute kidney injury 
Empyema 
Lung abscess
Haemolytic anaemia 
ARDS
48
Q

What does ARDS stand for?

A

Acute respiratory distress syndrome

49
Q

How is empyema diagnosed?

A

By pleural aspiration (draining the fluid and testing)

50
Q

What is the treatment for empyema?

A

Chest drain

I.V antibiotics

51
Q

What are the causes of bronchiectasis?

A 
Idiopathic 
Immotile Cilia Syndrome 
Cystic Fibrosis 
Childhood infections e.g measles 
ABPA - allergic Bronchopulmonary aspergillosis
52
Q

What are the symptoms of bronchiectasis?

A

Chronic cough

Daily sputum production

53
Q

What are the sometimes symptoms of bronchiectasis?

A 
Wheezing 
Dyspnoea
Tiredness 
Flitting chest pains 
Haemoptysis
54
Q

What is the treatment for bronchiectasis?

A

Chest physiotherapy
Prompt treatment of infections with appropriate antibiotics
May require inhaled therapy including beta 2 agonist and inhaled corticosteroid

A2. Respiratory System (15 decks)

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