LTRI in Adults Flashcards

1
Q

What does itis mean?

A

Inflammation

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2
Q

What is an abscess?

A

When bacteria in the lung form a pocket of infected fluid

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3
Q

What is acute bronchitis?

A

Inflammation of the bronchi

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4
Q

How does acute bronchitis last for?

A

It lasts less than 3 weeks

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5
Q

What are the main symptoms of acute bronchitis?

A

Cough and sputum

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6
Q

What is the definition of chronic bronchitis (COPD)?

A

A cough that lasts 3 months of the year for at least 2 years in a row.

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7
Q

What are the supportive ways to manage acute bronchitis?

A

Drinking lotrs of fluid and taking paracetamol.

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8
Q

What are the main symptoms of a COPD exacerbation?

A

Changes in the color and amount of sputum, fever, increased breathlessness, Wheeze and cough

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9
Q

What are the organisms that cause COPD exacerbations?

A

Streptococcus pneumonia, Haemophilus influenzae, moraxella catarrhalis,

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10
Q

What are the main treatments of COPD exacerbations?

A
  • Steroids ( to reduce the inflammation)
  • Antibiotics (depending on whether or not it is infectious) - Amoxycillin, doxycycline, co-trimoxazole, clarithromycin
  • +/- nebulisers
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11
Q

What is pneumonia?

A

Inflammation of the lung parenchyma (functional tissue of the lung)

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12
Q

What are the three types of pneumonia?

A

Lobar, intersitial and bronchopneumonia

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13
Q

What does consolidation mean?

A

Solidification due to cellular exudate in alveoli leads to impaired gas exchange

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14
Q

What are 8 risk factors of pneumonia?

A
  • Smoking
  • Alcohol in excess
  • Extremes of age
  • Preceeding viral illnesses (flu)
  • preexisting lung disease (COPD)
  • Chronic illness
  • Immunocompromised (HIV, CHEMOTHERAPY)
  • Hospitalisation
  • IV drug abusers
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15
Q

What are 7 symptoms of pneumonia?

A
  • Fever
  • Rigors (shivers)
  • Myalgia (pain in the muscles)
  • cough and sputum
  • Chest pain
  • Dysponea (breathlessness)
  • Haemoptysis
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16
Q

What does rusty brown sputum mean?

A

Streptococci pneumoniae

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17
Q

What are 7 signs that you expect to find on examination of someone with pneumoniae?

A
  • Tachypnea - raised RR
  • Tachycardia - increased HR > 90 bpm
  • Reduced lung expansion
  • Dull percussion note
  • Bronchial breathing
  • Crepitations (/snapping open of the alveoli)
  • Vocal resonance increases
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18
Q

What are the investigations to be carried out on community pneumoniae?

A

None but CXR if in doubt.

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19
Q

What are 6 investigations to carry out in hospital pneumonia?

A
  • Blood chemistry for the blood count, Full blood count, and an inflammatory marker called C reactive protein
  • Blood cultures
  • CXR
  • Throat swab
  • Sputum culture
  • Legionella urinary antigen
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20
Q

What are the differential diagnoses for pneumonia?

A
  • TB
  • Lung cancer
  • Pulmonary embolism
  • Pulmonary edema
  • Pulmonary vasculitis
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21
Q

What organisms cause typical community acquired pneumonia?

A

Strep pneumonia, H.influenzae, Mycoplasma pneumonia

22
Q

What kind of organism is strep pneumonia?

A

Purple streptococci, gram-positive and spherical organisms that tend to form spheres.

23
Q

what is the second commonest cause of death in the UK?

A

Pneumonia

24
Q

Is a CXR abnormal in pneumonia?

A

Always abnormal

25
Q

What is seen in a CXR of someone with pneumonia?

A

Pulmonary shadowing/consolidation

26
Q

What does the added sound of crackling usually indicate?

A

Infection

27
Q

What is bronchiectasis?

A

The dilation of bronchi producing sepsis in the chest

28
Q

What are 8 symptoms of bronchiectasis?

A
Daily cough
Daily copious purulent (yellow, green or opaque sputum indicating the presence of neutrophils)
Occasional haemoptysis
Frequent chest infections
Wheezing
Dyspnoea
Tiredness
Flitting chest pains
29
Q

What are the signs of bronchiectasis?

A

Finger clubbing

Lung crackles on inspiration and expiratoin

30
Q

Can bronchiectasis be cured?

A

No

31
Q

How is empyema distinguished from a simple effusion?

A

The fluid can be collected and sampled and is found to be pus

32
Q

Why does the infected fluid need to be drained and not treated with antibiotics?

A

Because antibiotics do not penetrate well into the pleural cavity

33
Q

What investigations are done for bronchiectasis?

A

Sputum culture
Spirometry
CXR
High resolution CXR are the main diagnostic tests

34
Q

What infects the fluid in empyema?

A

Micro-organism

35
Q

How is an abscess in the lung removed?

A

Long-term antibiotics, Sometimes the abscess must be drained by a surgeon or radiologist

36
Q

What are some of the common micro-organisms causes of LRTIs?

A

Streptococcus pneumonia (50%), staphylococcus aureus

37
Q

What are features of streptococcus pneumonia?

A
Abrupt onset
High pyrexia/rigors
Pleuritic chest pain
Cough with purulent (green) sputum
Hypotension and cyanosis
Septicaemia
38
Q

What is shown in CXR of streptococcus pneumonia?

A

Classically lobar and often patchy shadowing

39
Q

What is the treatment for streptococcus pneumonia?

A

IV benzyl penicillin, amoxicillin, oral ampicillin

40
Q

If the person is allergic to penicillin what antibiotics should be used?

A

Macrolide and Clarithromycin

41
Q

What is the treatment for empyema?

A

Chest drain, IV antibiotics

42
Q

What organisms are more likely to result in cavitating pneumonia?

A

Staph. aureus, Pseudomonas, Anaerobes

43
Q

What are the causes of Bronchiectasis?

A
Idiopathic
Immotile Cilia Syndrome
CF
Childhood infections such as measles
ABPA
44
Q

What is the treatment for bronchiectasis?

A

Chest physiotherapy
Prompt treatment of infections with appropriate antibiotics ,
May require inhaled therapy including beta2 agonist and inhaled corticosteroid

45
Q

What does CURB65 stand for?

A
C = confusion
U= blood urea>7

Respiratory rate >30
B = diastolic blood pressure <60
65 = age>6

46
Q

What are the main features of bronchiectasis?

A

Dilated and damaged bronchi

47
Q

What are the signs of pneumonia?

A
Pyrexia
Tachpnoea
Central cyanosis
Dullness on percussion of affected lobe(s)
Bronchial breath sounds
Inspiratory crepitations
Increased vocal resonance
48
Q

What bacteria can cause pneumonia?

A
Strep pneumoniae
H. Influenzae
Legionella
Staph aureus
Mycoplasma pneumoniae
Chlamydia psittac
49
Q

What treatment is given to pneumonia patients?

A

Oxygen
I.V fluids
CPAP
Intubation and ventilation

50
Q

What are the potential complications of pneumonia?

A
Septicaemia
Acute kidney injury
Empyema
Lung abscess
Haemolytic anaemia
ARDS