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DPPT Unit 3 > Lung infections 2 > Flashcards

Lung infections 2 Flashcards

1
Q

What is acute bronchitis?

A

Inflammation of the trachea bronchi, and bronchioles

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2
Q

What type of infection is acute bronchitis typically associated with (bacterial or viral?)?

A

Viral

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3
Q

What bacterial agents may be responsible for acute bronchitis?

A

(1) Haemophilus influenzae
(2) Pneumococcus
(3) Mycoplasma pneumonia

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4
Q

How is acute bronchitis diagnosed (what clinical feature is absent)?

A

(1) Cough with purulent sputum
(2) Low-grade fever
(3) Chest discomfort
(4) Possible hemoptysis
(5) Dyspnea
(6) PMNs and bacterial organisms in sputum (usually from normal lung flora)

No infiltrate on chest x-ray

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5
Q

How is acute bronchitis treated?

A

Acute bronchitis is self-limiting
(1) Cough suppressants
(2) Anti-pyretics
Antibiotics not indicated in the majority of cases

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6
Q

What is post-infectious cough and what is its cause?

A

(1) Persistent dry cough and wheezing lasting 3-8 weeks after acute infection
(2) Damage to airway epithelium causes sensory nerves (C-fibers) to stimulate airway smooth muscle

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7
Q

What are the characteristics of chronic bronchitis?

A

(1) Patients have more mucus than normal because of increased production or decreased clearance
(2) Inflammation and extra mucus reduce air flow
(3) Mucus production and inflammation over time leads to progressive and permanent lung damage

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8
Q

What are the clinical features of acute exacerbation of chronic bronchitis?

A

(1) Increased volume or change in character of sputum
(2) Increased frequency or severity of cough
(3) Increased dyspnea
(4) Variable constitutional symptoms
(5) Unchanged chest radiograph
(6) Variable decrease in pulmonary function (FEV-1 and vital capacity)
(7) Increased respiratory rate
(8) Crackles, ronchi, or wheezes on lung exam

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9
Q

How is acute exacerbation of chronic bronchitis managed?

A

(1) Bronchodilators
(2) Corticosteroids
(3) Possible antibiotics

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10
Q

What are the bacterial causes of chronic bronchitis?

A

(1) H. influenzae
(2) S. pneumoniae
(3) M. catarrhalis

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11
Q

What are the clinical features of the flu?

A

(1) Temperature of 101F or above
(2) Cough
(3) Muscle ache
(4) Headache
(5) Sore throat
(6) Chills
(7) Tiredness
(8) Feeling lousy all over

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12
Q

When is the flu infectious?

A

One day before appearance of symptoms to 7 days after onset of illness

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13
Q

What drugs are used to treat influenza?

2

A

(1) Oseltamivir (Tamiflu)

2) Zanamivir (Relenza

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14
Q

What are the clinical features of pneumonia?

A

(1) Acute presentation (within 2 weeks)
(2) Fever, chills
(3) Dyspnea
(4) Purulent sputum, possible hemoptysis
(5) Pleuritic chest pain
(6) Tachypnea/tachycardia
(7) Rales, pleural rub on lung exam

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15
Q

What are clinical features of pneumonia in elderly patients?

A

(1) Fever, less common in younger patients
(2) Tachypnea - common feature
(3) Delerium and confusion
(4) Possible absence of cough, sputum, and pleuritic chest pain
(5) Incomplete radiologic signs

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16
Q

What pathogens are most commonly responsible for community acquired pneumonia?

A

(1) S. pneumoniae
(2) H. influenzae
Atypical pneumonias:
(3) M. pneumoniae
(4) C. pneumonia
(5) Legionella pneumophila

17
Q

What is CURB-65?

A

Criteria for patient hospitalization

1) C = confusion
(2) U = uremia (BUN >20
(3) R = RR > 30/min
(4) B = BP (S 65 yrs

18
Q

What are the three types of APs?

A

(1) CAP - community-acquired pneumonia
(2) VAP - ventilator-associated pneumonia
(3) HCAP - health care-associated pneumonia

19
Q

How do organisms responsible for CAP and HCAP differ?

A

CAP - Strep pneumonia, H. influenzae, atypicals

HCAP - Pseudomonas aeruginosa, Staph aureus, Klebsiella, Enterobacter

20
Q

What antibiotics can be used to treat outpatient CAP?

A

Either:

(1) Azithromycin
(2) Doxycycline
(3) Levaquin

21
Q

What antibiotics can be used to treat inpatient CAP?

A

Either:

(1) Ceftriaxone + azithromycin
(2) Levaquin

22
Q

What antibiotics can be used for to treat HCAP?

A

(1) Vancomycin + (2) coverage for pseudomonas

23
Q

What is important to confirm the clearance of pneumonia?

A

Chest x-ray about 6-8 weeks after treatment

24
Q

How will pneumonia caused by Legionella present?

A

(1) GI symptoms
(2) Bradycardia
(3) Confusion
(4) Renal and liver manifestations

25
Q

What organism is commonly responsible for post-influenza pneumonia?

A

Staph aureus

26
Q

What organisms should be considered for pneumonia in aspiration or alcoholism?

A

Mouth anaerobes

27
Q

What organisms can cause pneumonia in sickle cell patients?

A

Encapsulated organisms

28
Q

What organisms can cause pneumonia in cystic fibrosis patients?

A

(1) Staph aureus

(2) Pseudomonas

29
Q

What is bronchiectasis?

3

A

(1) An acquired disorder of (2) the major bronchi and bronchioles that (3) is characterized by permanent abnormal dilatation and destruction of bronchial walls

30
Q

What is required for bronchiectasis to occur?

4

A

(1) Infectious insult with

(2) impairment of drainage, (3) airway obstruction, and/or (4) defect in host defense

31
Q

What is the etiology of bronchiectasis?

A

(1) Post-infectious
(2) Congenital (primary ciliary dyskinesia (PCD) and cystic fibrosis)
(3) Immunodeficiency
(4) Systemic illness (rheumatoid arthritis)
(5) Sequelae of aspiration

32
Q

What are the clinical features of bronchiectasis?

A 
Shared features with COPD:
(1) Cough with sputum production
(2) Dyspnea
(3) Hemoptysis
Physical findings:
(4) Crackles > rhonchi > wheezing
(5) Digital clubbing
Lung function:
(6) Inflamed and easily collapsible airways
33
Q

What are the most commonly isolated organisms in sputum in patients with bronchiectasis?
(2)

A

(1) Gram-negative bacteria

(2) Non-tuberculous mycobacteria

34
Q

What is Lady Windermere Syndrome?

A

Middle lobe bronchiectasis and Mycobacterium avium complex (MAC) infection due to voluntary cough suppression

35
Q

What are the diagnostic criteria for cystic fibrosis?

4

A

(1) Positive sweat test (Cl > 60 mEq/L)
(2) Chronic obstruction to flow of air
(3) Exocrine pancreatic insufficiency
(4) Family history

36
Q

What are some common clinical features of CF?

4

A

(1) Pulmonary disease
(2) Pancreatic insufficiency
(3) Intestinal symptoms
(4) Nasal polyps

37
Q

What is the genetic defect involved in CF?

3

A

(1) Abnormal gene on the long arm of chromosome 7
(2) Defective CF transmembrane regulator (CFTR)
(3) Decreased Cl- permeability due to lack of Cl- channel, leading to dehydration of secretions

38
Q

How is CF treated?

8

A

(1) Mucolytics
(2) Postural drainage/physiotherapy
(3) Anti-inflammatory agents
(4) Bronchodilators
(5) Antibiotics when needed
(6) Pancreatic enzymes
(7) Immunizations
(8) Gene therapy

DPPT Unit 3 (15 decks)

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