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Y1 RESPIRATORY > MicroBio and Respiratory Tract Infections > Flashcards

MicroBio and Respiratory Tract Infections Flashcards

1
Q

How can direct virus detection be done for PCR?

A

Nasopharyngeal swabs

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2
Q

Where does H. influenzae tend to colonise in the body?

A

Upper respiratory tract

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3
Q

H. influenza is a Gram positive bacillus. True/False?

A

False

Gram negative bacillus

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4
Q

Which organisms are most commonly associated with exacerbations of COPD?

A

H. influenzae
Strep pneumoniae
Moraxella catarrhalis

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5
Q

Which organism causes whooping cough? How is it treated?

A

Bordetella pertussis

Macrolides

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6
Q

Strep pneumoniae is a B-haemolitic cocci in clusters. True/False?

A

False

A-haemolytic cocci in chains

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7
Q

The majority of organisms that cause HAP are Gram what?

A

Negative

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8
Q

If CURB56 score 0-2, which antibiotics are given?

A

Amoxicillin (Doxycycline if penicillin allergic)

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9
Q

If CURB65 score 3-5, which antibiotics are given?

A

Co-amoxiclav + IV clarithromycin/PO doxycyline (IV levofloxacin if penicillin allergic)

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10
Q

In severe HAP, which antibiotics are given?

A

Amoxicillin (Co-trimoxazole if penicillin allergic), Metronidazole, Gentamicin

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11
Q

Which antibiotics are used for Legionnaire’s disease?

A

Erythromycin/Clarithromycin

Levofloxacin if penicillin allergic

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12
Q

Which organism particularly causes pneumonia in AIDS patients?

A

Pneumocystis jiroveci

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13
Q

Which organisms are most common in CAP?

A

Strep pneumoniae
HI
Mycoplasma pneumoniae

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14
Q

Which organisms are most common in viral pneumonia?

A 
Influenza
Parainfluenza
Measles
Varicella zoster
RSV
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15
Q

Give the two main classifications of pneumonia

A

Bronchopneumonia

Lobar pneumonia

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16
Q

List the main complications of pneumonia

A

Pleurisy
Empyema
Abscess
Bronchiectasis

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17
Q

List the main reasons for reactivation of TB

A

More virulent organism

Reduced T cell function - age, HIV, immunosuppression

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18
Q

What is the most likely source of infection in an immunocomprimised host? How is it typically treated?

A

Opportunistic pathogen e.g. aspergillus, candidas

Variconazole, amphotericin B

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19
Q

Give two methods for diagnosing lung infection

A

Broncho-alveolar lavage (bronchoscope passed through mouth and fluid squirted into lung and collected)
Biopsy with stains

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20
Q

What is coryza?

A

Common cold - acute inflammation of nasal passages

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21
Q

How does diphtheria present?

A

Sore throat, low fever and pseudomembrane on tonsils/pharynx/nasal cavity

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22
Q

Describe acute epiglottitis and give its classic symptom

A

Inflammation and swelling of the epiglottis obstructs the vocal folds/trachea: life-threatening in children
CONSTANT DROOLING, sore throat, stridor

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23
Q

What are some symptoms of acute bronchitis? How does it arise?

A

Productive cough (with fever in minority)
Transient wheeze
Cold which goes to the chest

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24
Q

CXR and chest examinations are usually normal in acute bronchitis. True/False?

A

True

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25
Q

Are antibiotics indicated in acute bronchitis?

A

No, unless there is underlying (chronic) lung disease (amoxicillin 1st line, doxycycline 2nd line)

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26
Q

Abdominal pain is not a symptom of pneumonia. True/False?

A

False

It could well be

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27
Q

What does CURB65 stand for? When is it used?

A 
Confusion
Urea more than 7
Resp rate more than 30
BP less than 90/61
65 yrs old
Used to assess community-acquired pneumonia
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28
Q

What is the commonest pathogenic cause of pneumonia?

A

Streptococcus pneumoniae

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29
Q

What is special about legionella-acquired pneumonia? Detected via…

A

Chest symptoms may be absent - usually more GI disturbance

Urine antigen testing

30
Q

How does influenza present?

A

High fever of abrupt onset
Malaise and myalgia
Headache
Cough (initially dry and painful)

31
Q

Haemophilus influenzae is the primary cause of flu. True/False?

A

False

May be secondary invader

32
Q

Which influenza virus is present in pandemics?

A

Influenza A

33
Q

When are antivirals given for flu?

A

When patient is at risk of complications (such as pneumonia)

34
Q

Give examples of 2 antivirals

A

Oseltamavir

Zanamivi

35
Q

Which disease(s) arises due to Coxiella burnetti? (3)

A

Pneumonia
Q fever
Endocarditis

36
Q

What is bronchiolitis? Who is mainly affected? What is the common sign?

A

LRTI common in babies and young children
Similar symptoms to a cold - cough, wheeze, fever
STERNAL INDRAWING

37
Q

Which virus is responsible for 90% of bronchiolitis?

A

RSV

38
Q

What is an abscess? What name is given for an abscess in the tonsils?

A

Local collection of pus

Quinsy

39
Q

Which 3 main types of virus cause coryza?

A

Rhinoviruses, RSV, adenoviruses

40
Q

How does sinusitis present?

A

Frontal headache, facial pain
Purulent rhinorrhoea
Fever

41
Q

What does xylometazoline do?

A

Nasal decongestant

42
Q

Which group of viruses most commonly cause pharyngitis?

A

Adenoviruses

43
Q

What is laryngotracheobronchitis? Who is it most severe in? What is its classical sign? How is it treated?

A

Inflammatory oedema that can affect vocal cords, usually following parainfluenza infection (CROUP)
Most severe in kids under 3yrs
BARKING COUGH
Oral steroid

44
Q

What common organism causes epiglottis? How would acute epiglottitis be treated?

A

Haemophillus influenza type B

Urgent endotracheal intubation
IV antibiotics - CEFTRIAZONE

45
Q

How quickly can influenza viruses incubate?

A

3 days

46
Q

Which patients are at risk of acute bronchitis?

A

Bacterially infected

COPD

47
Q

Antibiotics would immediately be given to acute bronchitis patients. True/False?

A

False

Only given if underlying lung disease present

48
Q

Describe chest pain in pneumonia

A

Usually pleuritic

49
Q

Describe treatment for mild/moderate CAP

A

Amoxicillin IV for 7 days

Doxycycline if pen-allergic

50
Q

Describe treatment for severe CAP

A

Co-amoxiclav IV + Clarythromicin IV
(Levofloxacin if pen-allergic)
Step down to Doxycycline
Total duration = 10 days

51
Q

Describe treatment for non-severe HAP

A

moxicillin + Metronidazole for 7 days

52
Q

Describe treatment for severe HAP

A

Amoxicillin + Metronidazole + Gentamicin for 10 days

53
Q

What is bronchiectasis?

A

Abnormal fixed dilation of bronchi, resulting in inflammation and build-up of mucus

54
Q

What is the most common cause of bronchiectasis?

A

Cystic fibrosis

55
Q

What is halitosis?

A

Bad breath

56
Q

What happens clinically in bronchiectasis?

A

Recurrent bacterial infections

Productive cough

57
Q

Which antibiotic is given for mild bronchiectasis?

A

Cefaclor/Ciprofloxacin

Flucloxacillin if S. aureus

58
Q

Which antibiotic is given for persistent bronchiectasis?

A

Ceftazidime

59
Q

Erythema marginatum is present in sarcoidosis. True/False?

A

FalseErythema nodosum, not marginatum

60
Q

What happens to calcium and ACE levels in sarcoidosis?

A

They are raised

61
Q

What is cystic fibrosis?

A

Autosomal recessive disorder in which there is a defect in the CFTR gene of chromosome 7

62
Q

List some symptoms of CF

A 
Thick sputum
Recurrent infections
Malabsorption
Steatorrhoea
Abnormal teenage milestones
63
Q

What are the clinical features of an acute exacerbation of COPD? How is it treated?

A

Increased sputum production and purulence
Increased SOB/ wheeze
Productive cough
Coarse crackles

Antibiotics if increased sputum purulence - amoxicillin 1st line, doxycycline 2nd line

64
Q

What is pneumonia?

A

Complete filling of alveolar spaces with inflammatory cells leading to impaired gas exchange

65
Q

List some signs of pneumonia

A 
Hypotension
Fever and rigors
SOB
Productive cough
Haemoptysis
Pleurisy
66
Q

How is pneumonia investigated?

A 
CXR
ABG/ O2 sats
Sputum culture
Bronchoscopy
Blood test - urea
Viral PCR
67
Q

When is Klebsiella usually identified in pneumonia?

A

In alcoholics, described as ‘red jelly sputum’

68
Q

What are the common complications of flu?

A

Pneumonia
Pericarditis
Bronchitis
Otitis media

69
Q

What is advised in the management of pneumonia?

A 
Antibiotics
Vaccination
Fluids
Bed rest
No smoking
70
Q

What is advised in the management of flu?

A

Vaccination
Paracetamol
Bed rest
Fluids

71
Q

When in the vaccination of flu is live attenuated vaccine preferred over the killed form?

A

In young children

Y1 RESPIRATORY (12 decks)

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