LRTI

Question 1

what is a cough on most days during at least 3 months of 2 successive years?

Answer 1

acute bronchitis

Question 2

what is oftn seen with it?

Answer 2

productive sputum

Question 3

who and what is associated?

Answer 3

men
>40 years
smoking
pollution allergens

Question 4

what is pneumonia?

Answer 4

a common infection of the LRT

it is an infection of the most distal airways and aleovli and there is the formation of inflammatory exudate

Question 5

sub-types

Answer 5

bronchopneumonia - patchy distrubition on inflamed bronchioles

lobular - affecting part or whole lobe

CAP - community acquired
HAP - hospital acquired (within 48 hr)
VAP -ventilator acquired (withi 48 hr)

aspiration - often associated with abnormal entry of fluids and pt has impaired swallowing mechanism

Question 6

syptoms and signs

Answer 6

dull to percuss 
tachyponea
dyspnoea 
hypotension
cough 
fever/rigors/chills
headache
lethargy 
pleuritic chest pain 
sputum
confusion 
bronchial breathing 
pleural rub

Question 7

what can be seen in primary vial puenomnia?

Answer 7

cough
breathleness
cyanosis

Question 8

most common cause of lobular puemonia?

Answer 8

strep. pnuemoniae

Question 9

secondary bacterial puenmonia causes

Answer 9

s. puemoniae, h. influenza, s. aureus

Question 10

CAP- most common age group and how many need hosp admissionn

Answer 10

50-70 years old

20-40% need hospitalisation

Question 11

what is atypical puenmonia?

Answer 11

fails to be treated by amoxcillin

Question 12

name an example

Answer 12

mycoplasma puemoniae

Question 13

diagnosis?

Answer 13

X-RAY showing CONSOLIDATION 
sputum microbiology
standard bloods- fbc, u and e 
puenomocall antigen in urine
oxygen sats

Question 14

what is a scoring system used for what?

Answer 14

CURB

is used to assess mortality in CAP

Question 15

what does it stand for and what are the normal ranges?

Answer 15

Confusion 
Urea - 7mmol >   for nitrogen 
Resp rate 30 or more per min 
B - blood pressure - systolic less than 90, diastolic less than 60
 (age over 65)

Question 16

management if septic

Answer 16

ABCDE

then start empirical therapy

Question 17

prevention

Answer 17

puemococcal vaccination in high risk groups - heart, kdney liver disease, splenomegaly
annual influence vaccination

Question 18

management

Answer 18

antibiotics- amoxicillin first line, the clarithromycin, doxycycline 
- oxygen
fluids 
pain relief 
saline nebulised

Question 19

differentials

Answer 19

chronic obstructive pulmonary disease (COPD), asthma, pulmonary edema, bronchiectasis, lung cancer, and pulmonary emboli.

Question 20

what can be given if it is MRSA?

Answer 20

vancomycin

Question 21

what if staph?

Answer 21

flucoaxcillin