LRTI in Adults Flashcards

1
Q

What is acute bronchitis

A

Inflammation of bronchi
<3weeks
Cough & sputum
Viral

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2
Q

What are the symptoms which would make a patient go to a GP for acute bronchitis

A
  • Cough severe or > 3 weeks
  • Fever for > 3 days
  • Haemoptysis
  • Increasing SOB
  • Underlying heart/lung condition
  • Recurrent bronchitis -> chronic bronchitis
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3
Q

What are the symptoms for COPD exacerbation

A

Change in colour of sputum
Fevers
Increased breathlessness
Wheeze
Cough

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4
Q

What infections can trigger a COPD exacerbation

A

Strep pneu
H’ Inf
Moraxella catarrhalis
Viral

HMV’S

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5
Q

What is the treatment for COPD exacerbation

A
  • Corticosteroid (oral/IV) +/- Antibiotic
  • Amoxycillin
  • Doxycycline
  • Co-trimoxazole
  • Clarithromycin
    +/- nebulizers
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6
Q

WHat is pneuomonia

A

Inflammation of lung parenchyma
Solidification due to cellular exudate in alveoli

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7
Q

What are the risk factors for pneumonia

A
  • Smoking
  • XS alcohol
  • Extremes of age
  • Preceding viral illness- disruption of mucociliary escalator
  • Pre-existing lung disease (COPD, CF)
  • Chronic illness
  • Immunocompromised (HIV, cancer therapy)
  • Hospitalisation *
  • IV drug users
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8
Q

What are the symptoms of pneumonia

A

Fever, rigors, myalgia
Cough and sputum
Chest pain (pleuritic)
Dyspnoea
Haemoptysis

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9
Q

What are signs of pneumonia

A

Tachypnoea
Tachycardia
Reduced expansion
Dull percussion
Bronchial breathing
Crepitations
Vocal resonance incr.

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10
Q

What does rusty brown sputum mean

A

Strep pneumonia

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11
Q

Hospital

What are the investigations for pneuomonia

A

Bloods – serum biochemistry, FBC, CRP
Blood cultures
CXR
Sputum culture, viral throat swab
Legionella urinary antigen

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12
Q

What are the differential diagnosis for pneumonia

A

Tuberculosis
Lung cancer
Pulmonary embolism
Pulmonary oedema
Pulmonary vasculitis (Wegners granulomatosis

LOVE TB

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13
Q

What does an x-ray of pneumonia look like

A

Shows area of inflammation
Increased white spots on lungs

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14
Q

What are the different types of acquired pneumonia

A

Community acquired (typical/atypical)
Nosocomial >48hrs (hospital acquired)

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15
Q

What are the different causes of Community acquired pneumonia

A

Typical:

S. Pneumoniae
H. influenzae
Mycoplasma pneumoniae
In 4-5 year cycles

Atypical:

Legionella pneumophila
Chlamydia pneumoniae
Chlamydia psittaci
Coxiella burnetti
Moraxella catarrhalis
Influenza virus

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16
Q

What are the different causes of Nosocomial pneumonia

A
17
Q

What is the severity scoring associated with pneumonia

A

CURB 65
* C confusion
* U blood urea> 7mmol/L
* R respiratory rate > 30/min
* B Systolic BP < 90mmHg, diastolic BP <60mmHg
* 65 age>65

Score
0-1 low risk- treated in community
2 moderate risk-hospital treatment
3-5 high risk of death/ITU

18
Q

What is the treatment for pneumonia

A
19
Q

What are some complications of pneumonia

A

Sepsis
Acute Kidney Injury
Adult Respiratory Distress Syndrome
Parapneumonic effusion
Empyema
Lung Abscess
Disseminated infection

PLEAD AS

20
Q

How would you diagnose an Empyema/Parapneumonic Effusion

A

Chest X-ray
D shaped opacity
Consolidation on right lung

CDC

21
Q

How would you diagnose a lung abscess

A

Foul smelling sputum
Haemoptysis
Send sputum for AFB

22
Q

What are the causes of bronchiectasis

A

Idiopathic
Childhood infection
CF
Ciliary dyskinesia
Hypogammaglobulinaemia
ABPA (Allergic Broncho-Pulmonary Aspergillosis)

23
Q

What is bronchiectasis

A

Abnormal dilatation of distal bronchi

Can be exacerbated by infection
- Staph aureus
- H. influenzae
- Pseudomonas aeruginosa

24
Q

What are the symptoms & signs of bronchiectasis

A

Chronic productive cough
Breathlessness
Recurrent LRTI
Haemoptysis

Finger clubbing
Bilateral Crepitations (coarse)
Wheeze
Obstructive spirometry

25
Q

What investigation would you use for bronchiactasis

A

Cxr- signet ring
Sputum culture

26
Q

What is the management for Bronchiectasis

A

Mucolytics
Prolonged antibiotic course 10-14 days
Prophylactic abx