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Lung cancer and diseases > Lower RTI in adults + children > Flashcards

Lower RTI in adults + children Flashcards

1
Q

What is acute bronchitis?

A
  • inflammation of bronchi
  • temporary ( < 3 weeks)
  • viral infection
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2
Q

When will a patient need to see GP following acute bronchitis?

A
  • longer than 3 weeks
  • high temperature for >3 days
  • coughing blood
  • underlying heart/lung condition ( asthma, HF, emphysema)
  • breathlessness
  • repeated episodes of bronchitis
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3
Q

What is chronic bronchitis (COPD)

A
  • inflammation of bronchi

- cough lasting 3 months of year for at least 2 years in a row

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4
Q

What is COPD exacerbation

A

-sudden worsening of COPD symptoms

  • change in color sputum
  • fevers
  • increased breathlessness
  • wheeze
  • cough
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5
Q

What can cause COPD exacerbation?

A
  • Streptococcus pneumoniae
  • Haemophillus influenzae
  • Moraxella catarrhalis
  • VI
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6
Q

Treatment of COPD eacerbation

A

Steroids
Antibiotics: amaxicillin, doxyclcline, co-trimaoxazole, clarithomycin

+/- nebulisers

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7
Q

What is pneumoniae?

A
  • inflammation of lung parenchyma

- acute bronchitis likely to lead to this

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8
Q

State the risk factors of pneumoniae

A
  • smoking, alcohol XS?
  • age
  • preceding viral illness
  • pre-existing lung disease
  • chronic illness
  • immunocomprised
  • hospitalisation
  • IVDU
  • acute bronchitis ( 5%)
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9
Q

What causes consolidation in pneumoniae

A
  • solidification due to cellular exudate in alveoli leads to impaired gas exchange
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10
Q

Clinical features of pneumoniae - Symptoms + signs

A 
SYMPTOMS
- Fever, rigors, myalgia
-cough + sputum)
-chest pain ( pleuritic)
-dyspnoea
-haemoptysis
( rust brown sputum caused by s.pneumoniae)

SIGNS

  • tachypnoea
  • tachycardia
  • reduced expansion
  • dull percusion
  • bronchial breathing
  • crepitations
  • vocal resonance increased
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11
Q

Investigations of pneumoniae

A
  • CXR in doubt
  • community may have no outbreaks

Hospital

  • Bloods; serum biochemistry, FBC, CRP
  • Blood cultures
  • CXR
  • Sputum culture, viral throat swab
  • legionella urinary antigen
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12
Q

Differential diagnosis of pneumoniae

A
  • Tubersculosis
  • Lung cancer
  • pulmonary embolism
  • pulmonary oedema
  • pulmonary oedema
  • pulmonary vasculitis ( wegners granumatosis)
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13
Q

Community acquired typical Pneumoniae causes(microbiology)

A

Pneumococcal pneumoniae
Haemophilus influenzae
Mycoplasma pneumoniae

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14
Q

Community acquired atypical pneumoniae (microbiology)

A 
Legionella pneumophilia
Chlamydia pneumoniae
Chlamydia psittaci
Coxiella burnetti
Moraxella catarrhalis
Viruses ( influenza, RSV, SARS, VZ)
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15
Q

Noscomial pneumoniae

A

Enterobacteria
Staphylococcus aureus
Pseudomonas aerigunosa
Klebsiella pneumoniae

Clostridia
Anaerobes
TB

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16
Q

Severity scoring of pneumoniae

A 
CURB 65
C	-	confusion
U	-	blood urea > 7mmol/L
R	-	respiratory rate ≥ 30/min
B	-	systolic BP < 90 mmHg, diastolic blood pressure < 60mmHg
65	age ≥ 65

A score of Risk of death
0-1 low risk - could be treated in community < 3%
2 moderate risk - hospital treatment usually required 9%
3-5 high risk of death and need for ITU 15-40%

17
Q

Treatment

A

(slide 14 )

18
Q

Complications of Pneumoniae

A
  • Sepsis
  • acute kidney injury
  • adult respiratory distress syndrome
  • parapneumonic effusion
  • empyema
  • lung abscess
  • disseminated infection
19
Q

Parapneumonic effusion / Empyema + lung abscess

A

slide 17

20
Q

Recovery time of pneumoniae

A
  • weeks
  • repeat CXR 6 weeks if >50yrs, sokers
  • cmoking cessation
21
Q

Recurrent pneumoniae causes

A
  • immuncomprised
  • underlying structural lung disease?
  • Aspiration?
22
Q

Cuases of bronchiextasis

A
  • idopathic
  • childhood infection
  • CF
  • Ciliary dyskinesia
  • hypogammaglobineaemia
  • Allerigic broncho-pulmonary aspergillosis (ABPA)
23
Q

Bronchiectasis symptoms

A
  • chronic productive cough
  • breathlessness
  • recurrent LRTI
  • haemotptysis
  • finger clubbing
  • course creptitations
  • wheeze
  • bstructive spirometry
24
Q

Infective exacerbations of bronchiectasis

A

Staph aureus
Haemophilus influenzae
Pseudomonas aerigunosa

Sputum Cx essential (including AAFB)
Chest physio
Mucolytics
Prolonged antibiotic course 10-14 days
Vaccinations

Consider prophylactic abx

Lung cancer and diseases (13 decks)

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