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01. Respiratory System - HP > Lower Respiratory Tract Infections in Adults > Flashcards

Lower Respiratory Tract Infections in Adults Flashcards

1
Q

<p>What is the UK incidence of pneumonia?</p>

A

<p>5-11/1000 adult population</p>

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2
Q

<p>What percentage of community acquired pneumonia requires hospitalisation?</p>

A

<p>Between 22 and 42%</p>

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3
Q

<p>What is the mortality of hospitalised patients with pneumonia?</p>

A

<p>6-12%</p>

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4
Q

<p>What are some symptoms of pneumonia?</p>

A

<p>Malaise</p>

<p>Myalgia</p>

<p>Fever</p>

<p>Chest pain</p>

<p>Cough</p>

<p>Purulent sputum</p>

<p>Dyspnoea</p>

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5
Q

<p>What are some signs of pneumonia?</p>

A

<p>Pyrexia</p>

<p>Tachypnoea</p>

<p>Central cyanosis</p>

<p>Dullness on percussion of affected lobe</p>

<p>Bronchial breath sounds</p>

<p>Inspiratory crepitations</p>

<p>Increased vocal resonance</p>

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6
Q

<p>What investigations are done for pneumonia?</p>

A

<p>Serum biochemistry, full blood count and C-reactive protein (CRP) test</p>

<p>Chest X-ray</p>

<p>Blood cultures</p>

<p>Throat swab</p>

<p>Urinary legionella antigen</p>

<p>Sputum microscopy and culture</p>

<p>HIV test</p>

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7
Q

<p>What microrganisms are the 3 three for causing pneumonia?</p>

A

<p>1) Strep pneumoniae (39%)</p>

<p>2) Chlamydophilia pneumoniae (13.1%)</p>

<p>3) All viruses (13.1%)</p>

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8
Q

<p>What is the severity of pneumonia measured by?</p>

A

<p>CURB 65</p>

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9
Q

<p>What does CURB 65 stand up for?</p>

A

<p>C confusion</p>

<p>U blood urea > 7</p>

<p>R respiratory rate > 30</p>

<p>B diastolic blood pressure < 60</p>

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10
Q

<p>What is each aspect of CURB 65 given a score of?</p>

A

<p>0 (low risk and could be treated in the community)</p>

<p>1-2 (hospital treatment usually required)</p>

<p>3 (high risk of death and need for ITU)</p>

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11
Q

<p>What is the treatment for a CURB score of 0-1?</p>

A

<p>Amoxycillin or clarithromycin/deoxycycline</p>

<p></p>

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12
Q

<p>What is the treatment for a CURB 65 score of 2?</p>

A

<p>Amoxycillin and clarithromycin or levoflaxacin</p>

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13
Q

<p>What is the treatment for a CURB 65 score of 3-5?</p>

A

<p>Co-amoxiclav and clarithromycin or levoflaxacin (if penicillin alergic)</p>

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14
Q

<p>What are some things that come before pneumonia?</p>

A

<p>Aspiration pneumonia</p>

<p>Haematological malignancy</p>

<p>Legionnaires disease</p>

<p>Influenza</p>

<p>Staph pneumonia including PVL toxin</p>

<p>MRSA</p>

<p>HIV</p>

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15
Q

<p>What treatment should be used for pneumonia caused by MRSA?</p>

A

<p>Vancomycin or linezolid</p>

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16
Q

<p>What are treatment for pneumonia other than antibiotics?</p>

A

<p>Oxygen</p>

<p>IV fluids</p>

<p>CPAP (continuous positive airway pressure, keeps airways open)</p>

<p>Intubation and ventilation</p>

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17
Q

<p>What does CPAP stand up for?</p>

A

<p>Continuous positive airway pressure</p>

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18
Q

<p>What are some possible complications of pneumonia treatment?</p>

A

<p>Septicaemia</p>

<p>Acute kidney injury</p>

<p>Empyema</p>

<p>Lung abscess</p>

<p>Metastatic infection</p>

<p>ARDS (acute respiratory distress syndrome)</p>

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19
Q

<p>What does ARDS stand up for?</p>

A

<p>Acute respiratory distress syndrome</p>

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20
Q

<p>What is acute respiratory distress syndrome?</p>

A

<p>Widespread inflammation of the lungs</p>

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21
Q

<p>What is differential diagnosis?</p>

A

<p>Process of differentiation between two or more conditions which share similar signs or symptoms</p>

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22
Q

<p>What is the process of differentiating between two or more conditions that share similar symptoms called?</p>

A

<p>Differential diagnosis</p>

23
Q

<p>What does differential diagnosis of pneumonia exclude?</p>

A

<p>TB</p>

<p>Lung cancer</p>

<p>Pulmonary embolism</p>

<p>Pulmonary oedema</p>

<p>Pulmonary vasculitis</p>

24
Q

<p>What is empyema?</p>

A

<p>Collection of pus in the pleural cavity caused by microorganisms</p>

25
Q

<p>What is a collection of pus in the pleura cavity caused by microorganisms called?</p>

A

<p>Empyema</p>

26
Q

<p>What may follow pneumonia?</p>

A

<p>Empyema</p>

<p>Lung abscess</p>

<p>Bronchiestasis</p>

27
Q

<p>What are the top 3 organisms that cause empyema?</p>

A

<p>Steptococcus (52%)</p>

<p>Anarobes (20%)</p>

<p>Staph aureus (11%)</p>

<p></p>

28
Q

<p>What is the prominant feature of empyema?</p>

A

<p>Chest pain</p>

29
Q

<p>What symptoms is absent with empyema?</p>

A

<p>Cough</p>

30
Q

<p>What is used to investigate empyema?</p>

A

<p>CT thorax and ultrasound</p>

31
Q

<p>What is empyema diagnosed by?</p>

A

<p>Pleural aspiration (pH < 7.2)</p>

32
Q

<p>What is the treatment for empyema?</p>

A

<p>Chest drain and IV antibiotics</p>

<p>Surgery for patients who do not improve</p>

33
Q

<p>What is a lung abscess?</p>

A

<p>Necrosis of lung tissue leading to the formation of cavities containing necrotic debris or fluid caused by microbial infection</p>

34
Q

<p>What is necrosis of lung tissue leading to the formation of cavities containing necrotic debris called?</p>

A

<p>Lung abscess</p>

35
Q

<p>What are organisms that are more likely to cause lung abscess than others?</p>

A

<p>Staph aureus</p>

<p>Pseudonomas</p>

<p>Anaerobes</p>

36
Q

<p>What can the symptoms of lung abscess be?</p>

A

<p>Nonspecific such as lethargy, weight loss and high swing fever</p>

37
Q

<p>What is lethargy?</p>

A

<p>Lack of energy</p>

38
Q

<p>What is a lack of energy called?</p>

A

<p>Lathargy</p>

39
Q

<p>What is lung abscess investigated by?</p>

A

<p>CT thorax</p>

<p>Sputum culture</p>

40
Q

<p>What is the treatment of lung abscess?</p>

A

<p>Prolonged antibiotics</p>

41
Q

<p>How is drainage for a lung abscess done?</p>

A

<p>Via the bronchial tree, occasionally percutaneous draining</p>

42
Q

<p>What is bronchiectasis?</p>

A

<p>Airways of the lung become abnormally widened, leading to excessive build up of mucus that can make the lungs more vulnerable to infection</p>

43
Q

<p>What does bronchiectasis cause in the lungs?</p>

A

<p>Build up of mucus making them more vulnerable to infection</p>

44
Q

<p>What is it called when the airways of the lungs become abnormally widened?</p>

A

<p>Bronchiectasis</p>

45
Q

<p>What are some of the causes of bronchiectasis?</p>

A

<p>Idiopathic</p>

<p>Immotile cilia syndrome</p>

<p>Cystic fibrosis</p>

<p>Childhood infections such as measles</p>

<p>Hypogammaglobulinemia</p>

<p>Allergic bronchopulmonary aspergillus</p>

46
Q

<p>What is immotile cilia syndrome?</p>

A

<p>Genetic disorder that causes defects in cilia</p>

47
Q

<p>What is a genetic disorder that causes defects in cilia?</p>

A

<p>Immotile cilia syndrome</p>

48
Q

<p>What is hypogammaglobulinemia?</p>

A

<p>Reduction in all types of gamma globulins</p>

49
Q

<p>What is a reduction in all types of gamma globulins called?</p>

A

<p>Hypogammaglobulinemia</p>

50
Q

<p>What does ABPA stand up for?</p>

A

<p>Allergic bronchopulmonary aspergillosis</p>

51
Q

<p>What are the symptoms of bronchiectasis?</p>

A

<p>Chronic cough</p>

<p>Daily sputum production</p>

<p></p>

<p>Sometimes:</p>

<p>Wheeze</p>

<p>Dyspnoea</p>

<p>Tiredness</p>

<p>Flitting chest pains</p>

<p>Haemoptysis</p>

52
Q

<p>What are signs of bronchiectasis?</p>

A

<p>Finger clubbing</p>

<p>Course onspiratory crepitation (auscultation)</p>

53
Q

<p>What investigations are done for bronchiectasis?</p>

A

<p>High resolution CT thorax</p>

<p>Sputum culture</p>

<p>Serum immunoglobulins</p>

<p>Total IgE and aspergillus precipitins</p>

<p>CF genotyping</p>

54
Q

<p>What is the treatment for bronchiectasis?</p>

A

<p>Chest physiotherapy</p>

<p>Prompt treatment of infections with antibiotics</p>

<p>May require inhaled therapy including B2agonist and corticosteroid</p>

01. Respiratory System - HP (82 decks)

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