Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory System > Pneumonia + Lower Respiratory Tract Infections > Flashcards

Pneumonia + Lower Respiratory Tract Infections Flashcards

1
Q

What is pneumonia?

A

Inflammation of the alveoli in which they fill up in fibrin rich fluid e.g. mucous + pus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs + symptoms of pneumonia

A
  • cough: dry > mucous
  • dyspnoea
  • pleuritic chest pain
  • pleurisy fever + chills
  • tachycardia
  • organ dysfunction e.g.mental dysfunction
  • crackles
  • bronchial breathing
  • confusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Clinical findings of pneumonia

A
  • dull to percussion
  • fine crackles
  • decreased breath sounds
  • bronchial breathing
  • increased vocal resonance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Investigations of pneumonia

A
  • chest X ray
  • sputum sample
  • blood culture
  • nose + throat swab (for viruses)
  • urine (legionella + strep pneumococcus)
  • ABG
  • C reactive protein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What four tests should you always do in a patient with suspected pneumonia?

A

Sputum
Blood culture
Nasal and throat swab
Urine antigens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Complications of pneumonia

A

Emphysema
Lung abscess
Bacteraemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is empyema?

A

Collection of pus in pleural cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is bacteraemia?

A

Presence of bacteria in the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the types of pneumonia?

A
  • community acquired pneumonia
  • healthcare acquired pneumonia : > 48 hours post admission
  • ventilated acquired pneumonia: > 48 hours post intubation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the gold standard for diagnosing pneumonia?

A
  • presence of infiltrate + consolidations on imaging
  • alongside symptoms + other findings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does ventilator associated pneumonia occur?

A
  • develops when a person is connected to a ventilator
  • biofilm can cover the endotracheal tube + infect the lung
  • person can’t cough + already ill so infection builds up > pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Common microbiota of the respiratory tract

A

Viridans streptococci
Neisseria
Anaerobes
Candida
Strep pneumoniae + pyogenes
Haemophilia influenzae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

List lower respiratory infections

A

Acute bronchitits
Empyema
Lung abscess
Pneumonia
Bronchiectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is acute bronchitits?

A

Inflammation of medium sized airways of the lungs (bronchi)
Normal chest X ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is bronchiolitits?

A

Viral infection of the bronchioles
Most commonly in children <12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What causes bronchiolitis?

A

Respiratory syncytial virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a lung abscess?

A
  • Localised collection of pus within the lung
  • Leads to cavity formation with a thick wall
  • due to microbial infection causing necrosis of lung parenchyma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is seen on imaging of a patient with a lung abscess?

A

Presence air-fluid levels in cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is an air fluid level?

A

Occurs when air rises above a fluid in a contained space (lungs) + there is a flat surface at the air fluid interface

20
Q

Defences of the respiratory tract

A
  • mucociliary clearance: nasal hairs + ciliated columnar epithelium of respiratory tract
  • coughing + sneezing
  • alveolar microbiota
  • respiratory mucosal immune system: tonsils, alveolar macrophages, secretary IgA + IgG
21
Q

Describe the responses to an infection in the lungs

A
  • alveolar macrophages fails to stop the pathogen
  • cytokines recruit more macrophages
  • inflammation > increased permeability
  • more WBCs to aid the macrophages
22
Q

Describe the responses to a infection outside the lungs

A
  • inflammatory mediators enter systemic circulation
  • activates bone marrow,increases cardiac output + increases body temp
  • dysregulation causes damage to surrounding tissues
23
Q

What demographic are more at risk of lower respiratory tract infections?

A
  • > 65 years old
  • smoking (abnormal ciliary function)
  • alcohol/drugs
  • chronic lung diseases
  • dysphagia
  • immunocompromised
  • malnutrition
  • co-infection with viruses (abnormal ciliary function)
24
Q

What are upper respiratory tract infections most commonly caused by?

A

Viruses
e.g. rhinovirus, coronavirus, influenza, RSV

25
Q

Symptoms of community acquired pneumonia

A
  • cough
  • dyspnoea
  • pleuritic chest pain
  • mucopurulent sputum
  • myalgia
  • fever
26
Q

What are 3 common causative organism of community acquire pneumonia?

A
  • Streptococcus pneumoniae (most common)
  • haemophilius influenzae
  • moraxella catarrhalis
27
Q

Treatment of community acquired pneumonia

A

Mild-moderate:
- Amoxicillin
- Or doxycycline or clarithromycin

Moderate-severe:
- hospital admission
- co-amoxiclav AND doxycycline/clarithromycin (to cover atypical organisms)

28
Q

What is acute bronchitis most commonly caused by?

A

Viruses

29
Q

Treatment of acute bronchitits

A

Bronchodilation
Physiotherapy
(Antibiotics if bacterial)

30
Q

What atypical organisms may cause community acquired pneumonia?

A
  • Mycoplasma pneumoniae (commonest): lacks peptidoglycan bacterial cell wall
  • Chlamydia pneumoniae
  • Legionella pneumophila (at contamined water sources)
  • Chlamydophila psittaci (exposure to birds)
31
Q

History suggestive of atypical cause of pneumonia

A
  • contaminated water sources (travel)
  • farm animals (>hepatitis)
  • exposure birds (>rash, splenomegaly, haemolytic anaemia)
32
Q

What is the significance of the lack of a peptidoglycan cell wall in the management of mycoplasma pneumoniae?

A
  • Penicillins kill bacterial by inhibiting the synthesis of peptidoglycan cell wall
  • no cell wall = no bacterial death
  • penicillins are ineffective to mycoplasma pneumoniae
  • macrolides are used instead e.g. erthyromycin, clarithromycin
33
Q

How does atypical pneumonia present on a CXR?

A

Concentrated in perihilar region

34
Q

What is hospital acquired pneumonia?

A

Infection of the lower respiratory tract in hospitalised patients > 48 hours after admission

35
Q

What organisms cause hospital acquire pneumonia?

A
  • staph aureus + MRSA
  • E. coli
  • pseudomonas aeruginosa
  • Candida
36
Q

First line treatment of hospital acquired pneumonia

A

Co-amoxiclav

37
Q

Second line treatment of hospital acquired pneumonia

A

piperacilin/taxobactam or meropenem

38
Q

What do you use to score the severity of pneumonia?

A

CURB-65

39
Q

Outline CURB-65 score

A

One point for each:
- Confusion
- Urea: >7mmol/l
- Respiratory rate: >30
- Blood pressure: <90 systolic <60 diastolic
- >65 years old

Score 2 = mild, admit or mange
Score 2-5 = severe

40
Q

What is the use of CURB-65?

A
  • used to guide management + risk stratify
  • ITU if CURB-65 score is high
41
Q

Prevention of pneumonia

A
  • Flu vaccine
  • Pneumococcal vaccine
  • covid 19 vaccine
  • Chemoprophylaxis (oral penicillin/erythromycin)
  • Smoking advice
42
Q

Demographic of patients affected with aspiration pneumonia

A
  • neurological dysphagia (stroke)
  • epilepsy
  • alcoholics
  • drowning
43
Q

Treatment of aspiration pneumonia

A

co-amoxiclav

44
Q

Causes on non resolving pneumonia

A

CHAOS
- Complication: emypema, lung absess
- Host: immunocompromsied
- Antibiotic: inadequate dose, poor oral absorption
- Organism: resistant or unexpected organism non covered by antibiotics given
- Secondary diagnosis: PE, cancer

45
Q

Pneumonia follow up

A
  • repeat imaging
  • follow up appointment in 6 weeks in clinic
  • HIV test
  • immunoglobulins

Respiratory System (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions