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Respiratory Sytem > LRT Infections + Pneumonia > Flashcards

LRT Infections + Pneumonia Flashcards

1
Q

List 6 LRT Infections

A
  • Acute Bronchitis
  • Bronchiectasis
  • Bronchiolitis
  • Empyema
  • Lung Abscess
  • Pneumonia
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2
Q

What is Acute Bronchitis?

Cough, fever, increased sputum production, increased dyspnea, normal CXR

A

Inflammation of large airways of lungs (Bronchi)

Different to Chronic Bronchitis, which is not considered infective

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3
Q

What is Bronchiectasis?

What are 4 things its associated with?

A

Permanent dilation and thickening of airways associated with;

  • Chronic cough
  • Sputum production (may be purulent)
  • Bacterial colonisation
  • Recurrent infection
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4
Q

What is Bronchiolitis?

What is the most common cause?
In what patients is it most common?

A

Viral infection of the bronchioles

Most common cause- Respiratory Synctial Virus
Most common in- Children <1

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5
Q

What is Empyema?

What are 3 things it is possibly caused by/ associated with?

A

Collection of Pus in Pleural Cavity

  • Pneumonia
  • Thoracic surgery
  • Trauma
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6
Q

What is a Lung Abscess?

What does radiology typically show?

A

Collection of pus within lung, that leads to cavity formation (usually with a thick wall)

Air-fluid levels in cavity

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7
Q

When do Lung Abscess most commonly occur?

What may they lead to if they communicate with an airway?

A

When microbial infection causes necrosis of lung parenchyma

Can lead to purulent cough (sputum contains pus, may be yellow or green)

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8
Q

What is Pneumonia?

What is Pneumonitis?

A

Pneumonia: Inflammation of lung parenchyma due to infection

Pneumonitis: Inflammation of lung parenchyma due to non-infective causes (physical, chemical damage)

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9
Q

What is a common feature of Pneumonias?

A

Cellular exudate in alveolar spaces

Neutrophils, Macrophages, Fibrin-rich fluid

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10
Q

Compare Lobar Pneumonia and Bronchopneumonia

A

Lobar:
- Localised to particular lobe/ lobes

Bronchopneumonia;
- More diffuse and patchier

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11
Q

Pneumonias are classified according to source of infection and other aetiological factors.

Suggest 4 classifications (not exclusive list)

A
  • Community Acquired (CAP)
  • Hospital Acquired (HAP, Ventilated Acquired is a subset, VAP)
  • Aspiration Pneumonia
  • Pneumonia in the Immunocompromised patient
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12
Q

CAP can be caused by Typical and Atypical organisms.

List 5 Typical organisms

A
  • Strep pneumoniae
  • H. influenzae
  • Moraxella catarrhalis
  • Klebsiella pneumoniae
  • S. aureus (including MRSA)
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13
Q

What organism is the most common organism that causes Pneumonia in smokers?

A

Srep pneumoniae

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14
Q

Smoking associated with COPD increases risk of infection with what 2 organisms, leading to Pneumonia?

A
  • H. influenzae

- M. catarrhalis

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15
Q

What is significant about the structure of the Atypical organism that cause pneumonia?

List 4 Aytpical organisms

A

Lack a cell wall

  • Mycoplasma pneumoniae (Commonest)
  • Chlamydia pneumoniae
  • Legionella pneumoniae (Water contamination)
  • Coxiella burnetii (Farm animals, causes Q fever, Hepatitis)
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16
Q

Define Nosocomical/ Hospital Acquired Pneumonia (HAP)

The infection is more associated with impaired defences.

Suggest 2 causative organisms

A

Infection of LRT in hospitalised patients >48hrs after admission and was not incubating at time of admission

  • S. aureus (MRSA included)
  • Gram negative Bacteria
17
Q

What is Aspiration Pneumonia?

Suggest 3 groups of people who this is more common in

A

Pneumonia due to aspiration of food/ drink/ saliva/ vomit etc. (E.g drowning)

Altered levels of consciousness;

  • Anaesthesia
  • Alcohol/ drug abuse
  • Swallowing related problems (neuromuscular problems/ oesophageal disease
18
Q

Describe the Aetiology of Aspiration Pneumonia

A

Causative organisms include Oral Flora and Anaerobes

In-hospital aspiration increases risk for Pseudomonas aeruginosa infection

19
Q

List some clinical features of Pneumonia

A
  • Malaise + Fever
  • Cough, possibly with sputum (Purulent/ Rust coloured/ bloody)
  • Pleuritic chest pain (pleurisy)
  • Dyspnea
  • ‘Crackles‘ on examination

(May spread to other organs)

20
Q

Persistent dry cough that doesn’t resolve should prompt you to consider Atypical Pneumonia caused by what 2 organisms?

How may Atypical Pneumonia differ in symptoms to Typical?

A
  • Mycoplasma pneumoniae
  • Chlamydia pneumoniae

Symptoms may last for longer, extended Prodromal Period

21
Q

Describe what can be used to asses Pneumonia severity?

A

CURB65 score

C- New confusion
U- Urea >7mM
R- RR >30bpm
B- Sytolic <90 OR Diastolic <60

Age> 65 years

22
Q

Beyond what CURB65 score is Pneumonia classed as Severe

A

Beyond 2, considered mild below this

23
Q

Suggest 2 investigations for Pneumonia

A

CXR: Shadowing in at least one section of lung field

Microbiology: Gram stain and Sputum culture

(Bloods, Urine, Swabs, Serum)

24
Q

List 6 things that suggest a poorer Prognosis of pneumonia

A
  • Older patients
  • High CURB65 score
  • Very high/ low WBC count
  • Absence of fever
  • Extensive CXR shadowing
  • Significant hypoxaemia/ rise in blood [Urea]
25
Q

How can Pneumonia be managed?

A
  • Ensure good fluid intake (possibly IV)
  • Antipyretic drugs
  • Analgesia (for pleural pain)
  • Oxygen may be needed
26
Q

How can Pneumonia be treated?

A
  • Amoxycillin/ penicillin antibiotics(if Strep pneumoniae)
  • Protein synthesis attacking antibiotics if Aytpical (Macrolides or Tetracyclines)
  • HAP: Co-Amoxiclav
27
Q

Suggest 3 complications of pneumonia

A
  • Pleural effusion
  • Empyema
  • Lung abscess formation
28
Q

What are 3 ways of preventing pneumonias

A
  • Vaccination (Flu, Pneumococcal)
  • Chemoprophylaxis
  • Smoking advice

Respiratory Sytem (21 decks)

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