Resp Flashcards
what re some clinical signs of pneumonia?
Vital signs: tachypnoea, hypoxia, and tachycardia may all be present
Course crackles and/or decreased breath sounds: on auscultation of the chest
Dullness to percussion: over the affected area of the chest wall
Wheeze:
what investigation would you like to do if you suspect a patient may have pnemonia?
Bloods: FBC. u&ES, cCRP, ABG
blood cultures
sputum culture
LFTS
CXR
(Legionella and pneumococcal urinary antigen: this should be requested in those with moderate or high-severity CAP or where other risk factors exist).
What is the management of CAP?
Amoxicillin: 500 mg – 1 g three times a day
Alternative oral antibiotics:
Doxycycline: 200 mg on day one, then 100 mg a day
Clarithromycin: 500 mg twice a day
What is the the manage of HAP?
Co-amoxiclav: 500/125 mg three times a day orally
Alternative oral antibiotics:
Co-trimoxazole: 960 mg twice a day
Doxycycline: 200 mg on day one, then 100 mg a day
Name some complication of pneumonia
Sepsis
Pleural effusion
Empyema
Lung abscesses (Klebsiella or Staphylococcal pneumonia)
Post-infective bronchiectasis:
ARDS
What are the microorganism can be found in HAP?
Escherichia coli, Klebsiella pneumoniae, Streptococcus pneumoniae, Staphylococcus aureus (including MRSA).
Name some risk factors of TB
1)close contact with infected person,
2) demographic factors (ethnic minorities, high prevalence areas(India, Indonesia), age, homelessness),
medical conditions (HIV, immunosuppression, diabetes, malignancy, long-term steroid use, renal disease).
what are some clinical findings you will find with a patient with TB?
1)purulent/blood-stained sputum
2) enlarged lymph nodes, 3)crackles
4) dullness to percussion 5)extra-pulmonary (depends on affected organ).
What are some symptoms of TB?
General: fever, lethargy, anorexia, weight loss, enlarged and tender lymph nodes
Pulmonary: cough (usually chronic), sputum (initially dry, then purulent or blood-stained), breathlessness, pleuritic chest pain
Extra-pulmonary: genitourinary (urinary symptoms), musculoskeletal (joint pain), neurological (headache, reduced GCS, focal neurology), cardiac (chest pain), gastrointestinal (abdominal pain, bloating), rash
What are the investigations for TB?
Bloods
Viral sceen
Sputum MCS
Inferon gamma &Mantoux (Latent)
what is the management for TB?
Ripmafcin
Isonazid
Pyrazinamide
Ethambutol
FOR 2 MONTHS
Ripmafcin
Isonazid
FOR 4 MONTHS
if there is CNS involvement 10 months instead
How is latent TB is treated?
Latent TB is treated with three months of isoniazid and rifampicin or six months of isoniazid only
Why is pyridoxine given with isonaizd?
To prevent vitamin B6 defenciency
Mention some of the complications of TB infection
pleurisy
pleural effusions
empyema
pneumothorax
bronchiectasis
respiratory failure.
what is the causative agent of TB?
Mycobacterium tuberculosis
