LRTI'S in adults

Question 1

what are clinical features of acute bronchitis?

Answer 1

inflammation of bronchi, cough & sputum, usually viral and lasts for less than 3 weeks

Question 2

what are clinical features of pneumonia ?

Answer 2

inflammation of lung parenchyma

Question 3

what are symptoms of pneumonia ?

Answer 3

fever
rigor
myalgia
cough
sputum
chest pain (increased of deep ventilation)
dyspnoea

Question 4

what are signs upon examination of pneumonia ?

Answer 4

tachypnoea 
tachycardia
dull percussion
bronchial breathing 
vocal resonance
reduced expansion

Question 5

what investigations would be needed in order to diagnose pneumonia?

Answer 5

bloods and blood cultures
chest xray 
sputum culture
viral throat swab
legionella urinary antigen

Question 6

what are causes of recurring pneumonia ?

Answer 6

immunocompromised patients
underlying structural lung disease
aspiration

Question 7

what typical organisms lead to community pneumonia ?

Answer 7

streptococcus pneumoniae
haemophilus influenzae
mycoplasma pneumoniae

Question 8

what atypical organisms lead to community pneumonia ?

Answer 8

legionella pneumophilia (caused from fresh water and A/C)
chlamydia pneumoniae (common in patients with coronary artery disease)
chlamydia psittaci (from birds)
moraxella catarhalis (common in patients with COPD)
coxiella burnetti (from farm animals)

Question 9

what are common organisms that cause nosocomial pneumonia?

Answer 9

enterobacteria
staphylococcus aureus
pseudonomas aeruginosa (produces green sputum)
klebsiella pneumoniae

Question 10

what does CURB65 stand for?

Answer 10

Confusion
blood Urea >7mmol/L
systolic BP <90mm/Hg and diastolic BP <60mm/Hg
older or 65

Question 11

how is CURB65 scored?

Answer 11

0/1- low risk, treat at community
2- moderate risk, hospital treatment
3/5- high risk of death and ITU needed

Question 12

what antibiotics would be used for a score of 0/1 in regards to CURB65?

Answer 12

5 days amoxicillin, if allergic to penicillin use clarithromycin or doxycycline

Question 13

what antibiotics would be used for a score of 2 in regards to CURB65?

Answer 13

5-7 days amoxicillin+clarithromycin, if allergic to penicillin use levofloxacin

Question 14

what antibiotics would be used for a score of 3-5 in regards to CURB65?

Answer 14

7-10 days co-amoxiclav+clarithromycin, if allergic to penicillin use levofloxacin or co-trimoxazole