Resp Flashcards
Pneumonia common causative organisms
- Strep pneumoniae
- Haemophilus influenzae
Common causative organisms of pneumonia in people with underlying resp disease
- Staph aures: CF
- p. aeruginosa: CF
- Moraxella Catarrhalis: COPD, immunocomp
Atypical causative organsims of pneumonia
- legionella pneumophila: infected water/air con
- Chlamydia psittaci: birds
- Coxiella burnetii: animals
Presentation of pneumonia
- SOB
- Productive cough ±haemopytsis
- Pleurtic chest pain
- fever
- delirium
Examination findings of pneumonia
- Increased RR, HR and temp
- Decreased o2 and BP
- Bronchial breathing
- crackles
- dull to percuss
Investigations in ?pneumonia
- FBC: increased WCC
- CRP: increased
- U&E: urea
- CXR: consoliadatino
- Sputum/blood cultures
- Urine sample: legionella and pneumococcal urinary antigens
What is the CURB 65 score?
Confusion
Urea>7
RR>30
BP< 90/60
65
0-1: home
>2: hosp
>3: HDU/ITU
Management of pneumonia
Local guidelines
Mild: 5 days PO amox or macrolide
Mod/sev: 7-10 days dual Abx
What is asthma?
Paroxysmal and reversible obstruction of airways. inflammation and bronchial hyper-responsiveness
Pathology of asthma
Trigger (infection, exercise, animals, dust)
Bronchospasm
Excess secretions produced
Presentation of asthma
- SOB
- Wheeze
- dry cough
- chest tightness
examination finding in asthma
polyphonic widespread wheeze
Investigations in ?asthma
- Peak flow
- bronchodilator reversibility test (+ve if >400mls improvement in FEV1)
Management of asthma
- SABA e.g. salbutamol
- ICS e.g. beclomethasone
- LABA e.g. salmeterol or montelukas (LPI)
Additional steps include
- MART (ICS + LABA)
- thephylline
- LAMA e.g. tiotropium
Why do you need to be careful when prescribing theophylline?
has a narrow therapeutic range so can be toxic - needs monitoring
