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Respiratory system > lower respiratory tract infections-adults > Flashcards

lower respiratory tract infections-adults Flashcards

1
Q

give some examples of LRTIs?

A 
acute bronchitis
AECOPD
pneumonia
empyema
lung abscess
bronchiestasis
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2
Q

what are the symptoms of pneumonia?

A 
malaise and lethargy
myalgia
fever
pleuritic chest pain
cough
purulent sputum
dyspnoea
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3
Q

infection with which organism causes rusty sputum?

A

streptococcus pneumonia

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4
Q

what are the signs of pneumonia?

A 
pyrexia
tachypnoea
central cyanosis
dullness on percussion of affected lobe (if lobar)
bronchial breath sounds
inspiratory crepitations
increased vocal resonance
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5
Q

what are the investigations for pneumonia?

A 
serum biochemistry- U&Es, LFT
CRP
full blood count
blood cultures
throat swab (for atypical pathogens)
urinary (for legionella)
sputum microscopy and culture
HIV test
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6
Q

what are the most common pathogens that cause pneumonia?

A 
strep. pneumoniae
H. influenzae
legionella
mycoplasma pneumoniae
chlamydophila pneumoniae
viruses
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7
Q

what is the CURB 65 scoring system for pneumonia?

A 
C- confusion
U- urea >7
R- respiratory rate >30
B- blood pressure, diastolic <60
65- age >65

the presence of one is a score of 1, presence of two is 2 etc.

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8
Q

what does a score of 0 on the curb 65 test mean?

A

low risk and could be treated in community

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9
Q

what does a score of 1-2 on curb 65 test mean?

A

hospital treatment usually required

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10
Q

what does a score of 3-5 on the curb 65 test mean?

A

high risk of death and need for ITU

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11
Q

what is the treatment of curb 0-1 pneumonia?

A

amoxycilline or clarithromycin/doxycycline if allergic to penicillin

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12
Q

what is the treatment of curb 2 pnemonia?

A

amoxycillin and clarithromycin or levofloxacin (if allergic to penicillin)

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13
Q

what is the treatment for curb 3-5 pneumonia?

A

co-amoxiclav and clarithromycin or levofloxacin (if penicillin allergy)

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14
Q

what sort if organisms cause apiration pneumonias?

A

anaerobes

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15
Q

what is the treatment for aspiration pneumonia?

A

metronidazole (for anaerobes) and amoxycillin

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16
Q

why is a combination of antibiotics given for pneumonia?

A

to cover atypical bacteria

17
Q

what sort of anitbiotics are given to pneumonia patients with haemotological malignancy?

A

broad spectrum and possibly antifungals

18
Q

who must be notified if legionnaires disease is diagnosed?

A

public health

19
Q

what is used to treat pneumonia caused by MRSA?

A

vancomycin or linezolid

20
Q

what are the general treatments for pneumonia?

A

oxygen
IV fluids
CPAP
intubation and vantilation

21
Q

what are the possible complications of pneumonia?

A 
sepricaemia
acute kidney failure
empyema
lung abscess
metastatic infaction
ARDS
22
Q

what conditions must be ruled out when pneumonia is suspected?

A 
TB
lung cancer
pulmonary embolism
pulmonary oedema
pulmonary vasculitis
23
Q

what may empyema follow on from?

A

pneumonia

24
Q

what are the symptoms of empyema?

A

chest pain, absence of cough

25
Q

what are the signs pf empyema?

A

swinging fever

26
Q

what are the investigations for empyema?

A

CT thorax, pleural ultrasouns, diagnostic aspiration

27
Q

what is the treatment of empyema?

A

chest drain and IV antibiotics

surgery for patients who do not respond to standard treatment.

28
Q

which organisms are most most likely to cause cavitating pneumonia (lung abscess)?

A

staph. aureus, pseudomonas and anaerobes

29
Q

what are the symptoms of a lung abscess?

A

non specific symptoms-lethargy, weight loss, high swinging fever

30
Q

what are the investigations for a lung abscess?

A

CT of thorax and sputum culture (w/ TB microscopy and culture)

31
Q

how is a lung abscess treated?

A

prolonged antibiotics

32
Q

how are lung abscesses drained?

A

usually via the bronchial tree but occasionally via a chest drain

33
Q

what are some causes of bronchiectasis?

A

most are idiopathic

  • immotile cilia syndrome
  • CF
  • infections such as measles and croup
  • hypogammglobulinaemia
  • allergic bronchopulmonary aspergillosis
34
Q

what are the symptoms of bronchiectasis?

A

chronic cough
copious daily sputum production
sometimes:
wheeze, dyspnoea, tiredness, flitting chest pains, haemoptysis

35
Q

what are the signs of bronchiectasis?

A

finger clubbing

course inspiratory crepitations

36
Q

what are the investigations for bronchiectasis?

A 
HRCT thorax
sputum culture
serum immunoglobulins
total IgE and aspergillus precipitins
CF genotyping
37
Q

what is the treatment of bronchiectasis?

A

chest physiotherapy
prompt treatment of infection with antibiotics
inhaled therapy eg. beta2 agonists and inhaled corticosteroids

Respiratory system (38 decks)

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