LRTI

Question 1

What are some examples of acute lower respiratory tract infections?

Answer 1

• pneumonia
  -bronchitis
  -legionnaires disease
  -whooping cough

Question 2

What are some examples of chronic lower respiratory tract infections?

Answer 2

-TB
-aspergillosis
-cystic fibrosis

Question 3

What are the 2 ways pneumonia can be acquired?

Answer 3

1) CAP = acquired in the community
2) HAP = acquired in hospitals

Question 4

What can cause aspiration pneumonia?

Answer 4

if food travels to the lungs instead of to the intestine

Question 5

What are the signs and symptoms of typical pneumonia?

Answer 5

1) cough and fever
2) cyanosis - lack of blood flow to fingertips aka blue fingertips
3) tachypnoea - low respiratory rate
4) tachycardia - increased heart rate
5) rust coloured sputum

Question 6

What is the microorganism associated with CAP?

Answer 6

streptococcus pneumoniae

Question 7

What are the signs and symptoms of atypical pneumonia?

Answer 7

• non respiratory and common in the young AND old
  1) rash
  2) confusion, diarrhoea, incontinence
  3) no sputum
  4) cyanosis
  5) tachypneoa and tachycardia

Question 8

Which organism is associated with atypical CAP?

Answer 8

mycoplasma pneumoniae - fried egg appearance

Question 9

What is the radiological difference in appearance of typical and atypical pneumonia?

Answer 9

typical pneumonia is widespread in appearance whereas atypical pneumonia is patchy in appearance (occupies smaller area in lungs)

Question 10

What are the risk factors for HAP?

Answer 10

• ventilatory support
• immunosuppression: organ transplant
• immobility and vomiting

Question 11

What are the treatments for pneumonia?

Answer 11

1) uncomplicated CAP: amoxicillin/ erythromycin
2) severe CAP: cefuroxime and erythromycin
3) atypical pneumonia: erythromycin
4) HAP: cefotaxime and gentamicin

Question 12

What is the mechanism of pathogenicity of strep pneumonia?

Answer 12

• has viral capsule and multiple types of capsule: makes it resistant to different antibiotics
• adhesion: interacts with carbohydrates on pulmonary epithelial surface
• protective antigen inhibits opsonisation of pneumococci
• autolysis: inflammation
• pneumolysin: inhibits phagocytosis and lymphocyte proliferation

Question 13

What sample should be taken for pneumonia?

Answer 13

sputum

non culture techniques: microscopy and gram stain

culture techniques: sputum and sputloysin

Question 14

Which sensitivity disc would you use for strep pneumoniae?

Answer 14

optochin sensitivity disk: larg żonę of inhibition differentiates pneumococci from normal oral streptococci