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Respiratory > Lung infections > Flashcards

Lung infections Flashcards

1
Q

What is pneumonia?

A

It is an infection that results in lung inflammation

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2
Q

What are the two main groups of pneumonia?

A
  • community acquired

- hospital infection (nosocomial)

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3
Q

What causes community acquired pneumonia?

A
  • viruses
  • bacteria
  • fungal
  • unknown (lot of the causing agents are not known)
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4
Q

Give examples of pathogens causing community acquired pneumonia

A
  • Strep. Pneumoniae
  • Myxoplasma pneumoniae
  • Staph. Aureus
  • Chlamydophila pneumoniae
  • Haemophilus influenzae
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5
Q

Give examples of pathogens causing hospital acquired pneumonia

A
  • Staphylococcus aureus
  • Pseudomonas aeruginosa
  • Klebsiella species
  • E. Coli
  • Acinetobacter species
  • Enterobacter species
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6
Q

Why is it important to distinguish between typical and atypical pathogens in community acquired pneumonia?

A
  • Atypical bacteria are not covered by penicillin so a different antibiotic is required (macrolides)
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7
Q

What factors increase the likelihood of developing pneumonia?

A
  • age (also higher mortality from pneumonia)
  • social factors (e.g. overcrowding, poverty)
  • medication (inhaled corticosteroids, immunosuppressants)
  • medical history (COPD, asthma, heart disease, diabetes, HIV)
  • demographic/lifestyle factors (excess alchohol consumption, age less than 2 and over 65, smoking)
  • risk factors for certain pathogens (animal contact, healthcare contacts)
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8
Q

What can be seen in a chest x ray of a person with pneumonia?

A
  • more white areas caused by inflammation
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9
Q

What things indicate that a person has pneumonia?

A
  • New respiratory symptoms/signs
  • Pleuritic chest pain
  • Usually febrile
  • Hypoxic
  • Confused
  • New X ray changes
  • Severe enough to be admitted
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10
Q

What things suggest that a person has acute bronchitis?

A
  • Cough
  • Tracheal pain
  • No new X ray changes
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11
Q

What are the BTS guidelines for diagnosing pneumonia?

A
  • Acute lower respiratory tract symptoms
  • New focal chest signs and, if in hospital, new CXR changes
  • More than 1 systemic feature (fever, shivers, aches and pains, temperature >38)
  • No other explanation for illness
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12
Q

How is it decided whether a person is admitted to hospital for CAP?

A

CRB65 severity score - confusion, respiratory rate, blood pressure and age over 65. Points given for each thing and 3-4 is high severity and 1-2 suggest referral should be considered.

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13
Q

How is pneumonia treated?

A
  • antibiotics
  • oxygen
  • fluids
  • analgesia
  • nebulised saline (help expel phlegm)
  • chest physiotherapy
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14
Q

What factors are considered when giving an antibiotics for pneumonia?

A
  • CAP or HAP
  • time of administration: for every hour delay in septic shock survival chance reduced by 7%
  • treatment usually a week long
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15
Q

How do viruses affect the lungs?

A
  • loss of cilia
  • bacterial growth
  • poor barrier to antigens
  • loss of chemoreceptors
  • local immune response
  • cellular inflammation
  • mediator release
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16
Q

Bird flu: what is it, symptoms and what caused it?

A
  • close exposure to poultry (only human to bird transmission)
  • Influenza A H5N1
  • cough, shortness of breath, muscle pain, abdominal pain, vomiting, diarrhoea, renal failure
  • deaths in 2-4 weeks despite antivirals from respiratory failure
17
Q

What caused swine flu?

A
  • Influenza H1N1

- Much more inflammation in those with severe disease

18
Q

What factors affect the severity of disease?

A
  • host, pathogens and the co-pathogens
  • some people have genetics which mean they produce a particular type of cytokine in response to a pathogen which maximises damage
  • some pathogen have more successful RNA
  • If person has other pathogens may affect also
19
Q

What factors are known to cause a more severe flu?

A
  • Highly pathogenic strain of flu
  • Absence of prior immunity: innate immunodeficiency, B cells and T cells
  • Weakened host immune response: elderly, COPD/asthma etc.
20
Q

RSV brochilitis

A
  • viral infection can provide oppurtunity for bacteria - oppurtunistic
  • ## some bacteria can make it easier for viruses to cause disease by causing viral entry receptor upregulation,
21
Q

Why are commensal bacteria important?

A

Normally healthy microbiome help prevent infection as pathogens must compete with them

Respiratory (23 decks)

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