LRTI in adults

Question 1

Describe the pathogenesis of bronchopneumonia and lobar pneumonia and the complications and consequences of lower respiratory tract infection.

Answer 1

bronchopneumonia- inflammation of alveolar
lobar pneumonia- alveolar fill with pus and other liquids

complications- sepsis, acute kidney failure, empyema, lung abscess, parapneumonic effusion

Question 2

Describe the common organisms leading to lower respiratory tract infections.

Answer 2

strep pneumonia, h. influenzae, legionella, staph aureus

Question 3

Be aware of causes of recurrent pneumonia.

Answer 3

immunocompromised, underlying structural lung disease, aspiration (food going into lungs)

Question 4

Be aware of the different spectrum of hospital acquired (nosocomial) pneumonia compared with community acquired pneumonia.

Answer 4

community acquired- strep pneumonia, h. influence, mycoplasma pneumonia
nosocomial- enterobacteria, staph aureus, pseudomonas aerigunisa, klebsiella pneumonia

Question 5

Describe the clinical management of lower respiratory infection, particularly with regard to pneumonia.

Answer 5

CURB 65
Confusion
U-blood urea
Respiratory rate>30
B= systolic BP<90 and diastolic<60
over 65
if score certain level depends on whether they go to hospital.

Question 6

Define the role of supportive therapy in addition to specific antimicrobial therapy.

Answer 6

smoking cessation

Question 7

Be aware of the general approach to management of rarer lung infections including bronchiectasis, lung abscess and empyema.

Answer 7

sputum microscopy, chest physio, mucolytics, prolonged antibiotics course, vaccinations,

Question 8

Be aware of the different approaches of primary care and secondary care management of respiratory infections, including the practice of realistic medicine and strategies for dealing with uncertainty.

Answer 8

CURB 65
Confusion
U-blood urea
Respiratory rate>30
B= systolic BP<90 and diastolic<60
over 65

people usually admitted to hospital if they need oxygen but elderly people may not be in the best interest to admit them

Question 9

Acute bronchitis

Answer 9

Inflammation of bronchi, Lasts less than 3 week, cough and sputum and usually viral

Question 10

chronic bronchitis

Answer 10

basically COPD and a cough lasting 3 months or the year for two years

Question 11

COPD exacerbation

Answer 11

Change in colour/ amount of sputum, fever, increased breathlessness, wheeze, cough

Question 12

treatment of COPD exacerbations

Answer 12

steroids to reduce inflammation
antibiotics- amoxicliin, co-trioxazole
possible nebulisers

Question 13

pneumonia

Answer 13

inflammation of lung parenchyma.
symptoms- fever, right, cough and sputum, dyspnoea, haemoptysis
signs- tachypnoea, tachycardia, reduced expansion, dull persuasion, bronchial breathing, increased viral resonance.
increased risk if you drink or smoke, at the extreme of ages, immunocompromised.

Question 14

rusty brown sputum is a sign of what

Answer 14

streptococcus pneumonia

Question 15

empyema

Answer 15

pockets of pus

Question 16

bronchiectasis

Answer 16

Bronchiectasis is a long-term condition where the airways of the lungs become widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection

chronic cough, breathlessness, finger clubbing, wheeze

Question 17

complication of pneumonia

Answer 17

empyema thoracis- infection of pleural space