LRTIs - Empyema, Lung Abscess and Bronchiectasis Flashcards

1
Q

What is empyema

A

infection of pleural space

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2
Q

When does empyema often occur?

A

following pneumonia

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3
Q

What organism causes the majority of empyema?

A

Streptococcus

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4
Q

What other organisms cause empyema?

A

Staph aureas

Anaerobes

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5
Q

Symptoms of empyema

A

Chest pain
Absence of cough
High swinging fever

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6
Q

Investigations for empyema

A

CT thorax

Pleural ultrasound

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7
Q

How do you diagnose empyema?

A

Diagnostic pleural aspiration (pH <7.2)

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8
Q

Treatment of empyema

A

Chest drain and prolonged antibiotics
Sometimes t-PA/DNase required to improve drainage
Surgery if above don’t work

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9
Q

Definition of lung abscess

A

Destruction of tissue leaving hole in the lung where pus gathers

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10
Q

What other diseases can lead to a lung abscess?

A
Infection distal to obstructed bronchus
Aspiration pneumonia
Pyaemia
Obstructed bronchus by tumour
Second degree infection of necrotic lung
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11
Q

What organisms are most likely to result in a cavitating pneumonia?

A

Staph aureus
Pseudomonas
Anaerobes

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12
Q

What organisms can cause a lung abscess?

A
Staph aureus
Pneumococci
Klebsiella
Pseudomonas
Anaerobes
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13
Q

Symptoms of lung abscess

A

Lethargy
High swinging fever
Weight loss

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14
Q

Investigations for lung abscess

A

CT thorax

Sputum culture

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15
Q

Treatment for lung abscess

A

Prolonged antibiotics

Drainage, usually by bronchial tree but may be percutaneously

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16
Q

What is bronchiectasis?

A

Chronic condition where there is abnormal dilatation of bronchi
Excessive inflammatory response which breaks down airways and they can’t clear secretions

17
Q

What are the causes of bronchiectasis?

A
Idiopathic - usually
Immotile cilia syndrome
Cystic fibrosis
Childhood infection eg measles
Hypogammaglobulinaemia (no IgG)
ABPA (allergic bronchopulmonary aspergillosis)
18
Q

Definite symptoms of bronchiectasis

A

Chronic cough

Abundant, purulent foul sputum

19
Q

Symptoms sometimes seen with bronchiectasis

A
Haemoptysis
Wheeze
Dyspnnoea
Tiredness
Flitting chest pain
20
Q

Signs of bronchiectasis

A

clubbing

inspiratory crepitations

21
Q

Investigations for bronchiectasis

A
HRCT thorax
Sputum culture
Serum immunoglobins (test antibodies in blood)
Total IgE and aspergillus precipitans
CF genotyping
22
Q

Treatment for bronchiectasis

A

Chest physiotherapy
Antibiotics
Surgery
Inhaled beta 2 agonists / ICS if wheeze