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MRCP Master > Resp Infection > Flashcards

Resp Infection Flashcards

1
Q

In CF Organisms which may colonise Pts (4)

A
  • Staphylococcus aureus
  • Pseudomonas aeruginosa
  • Burkholderia cepacia*
  • Aspergillus
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2
Q

Pancreatic & Liver sx of CF

A
  1. pancreatic insufficiency- preventing digestive reaching the gut = fat isn’t absorbed, causing steatorrhea & vitamin A, D, E, and K, deficiencies
  2. avitaminosis A= pancreatitis= insulin-dependent DM.
    biliary cirrhosis
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2
Q

Genes effected in CF
Pathology of CF

A

AR Chrom 7 , ∆F508
resulting
CFTR mutation –> misfolded protiens –> Chloride channel dysfuntion in the mucus and sweat-producing cells= increased viscosity of secretions= Blockage

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2
Q

bilateral absence of vas deferens & infertile occurs in what disease

A

CF

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2
Q

Labs in CF (2)

A
  1. HYPOkalemia
  2. contraction ALKalosis in those with symptoms suggestive of hypovolemia.
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2
Q

DX of CF

A

pilocarpine sweat test

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2
Q

Respiratory sx in CF (4)

A
  1. Bronchiectasis- obstructive pattern
    2.Pneumonias : Stap. A or MRSA; Pseudomonas aeruginosa
    3.Allergic bronchopulmonary aspergillosis, or ABPA (Hypersensitivity to Aspergillus fumigatus that can live in the sinus or lung cavity)
    4 Nasal polyps
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3
Q

FEV1 in CF

A

decrease

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4
Q

Rx CF (6)

A
  1. Chest physio
  2. Mucolytic
  3. Bronchodilators
  4. Anti-inflammatory
  5. abx azithromycin
  6. CFTR modulators- ivacaftor, tezacaftor
    and lumacaftor,
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5
Q

Explain action of CFTR modulators ivacaftor, and lumacaftor

A

Lumacaftor-can correct the misfolded protein & bring it to the cell membrane,
Ivacaftor-which opens the chloride channels & improves the ion’s transport.

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6
Q

Allergic Bronchopulmonary Aspergillosis (ABPA)
Labs
RAST
Ig

A
  • eosinophilia
  • flitting CXR changes
  • positive radioallergosorbent (RAST) test to Aspergillus
  • +ve IgG precipitins (not as positive as in aspergilloma)
  • raised IgE
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7
Q

Rx Allergic Bronchopulmonary Aspergillosis (ABPA)

A
  • oral glucocorticoids
  • itraconazole is sometimes introduced as a second-line agent
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8
Q

Ix Aspergilloma

A

Investigations
1. Chest x-ray containing a rounded opacity. A crescent sign may be present
2. high titres Aspergillus precipitins

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9
Q

Bronchiectasis on imaging & PFTS

A

tram-track and signet ring signs
Obstructive picture

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10
Q

Pneumonia, particularly following influenza or Ass. w/
IV drug

A

Staphylococcus aureus

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11
Q

Pneumonia ass w/ cold sores

A

Cold sores
Most common cause of CAP

12
Q

Pneumonia ass. w/ bronchiectasis exacerbations

A

Haemophilus influenzae

13
Q

Most common organisms isolated from patients with bronchiectasis:

A

Haemophilus influenzae (most common)
Pseudomonas aeruginosa
Klebsiella spp.
Streptococcus pneumoniae

14
Q

Pneumonia ass. w/ Aspiration, Alcoholic and Diabetics
Outcomes

A

Klebsiella pneumoniae
* commonly causes lung abscess formation and empyema & lung necrosis

15
Q

What are Atypicals of lung infection

A
  1. Mycoplasma pneumoniae
    2.Legionella pneumophilia
    3.Chlamydia psittaci
    4.
16
Q

Chlamydia psittaci rx

A

doxycycline or erythromycin

17
Q

Pneumonia ass. w/ deranged LFT & HYPONa
RX

A

Legionella
erythromycin/clarithromycin

18
Q

Pneumonia ass w/
bullous myringitis
cold agglutins (IgM)
ITP
& RX

A

Mycoplasma pneumoniae
doxycycline or a macrolide

19
Q

Pneumocystis jiroveci/ Pneumocystis pneumonia rx & Prophylaxis

A

have few chest signs and develop exertional dyspnoea
trimethoprim/sulfamethoxazole is usually used for treatment and dapsone as a prophylaxis for HIV+ people with a CD4+ count under 200 cells per microliter

20
Q

common infective causes of COPD exacerbations

A
  • Haemophilus influenzae (most common cause)
  • Streptococcus pneumoniae
  • Moraxella catarrhalis
20
Q

Ventilator-associated pneumonia,

A

Pseudomonas aeruginosa and Staph. aureus

21
Q

Pneumonia : Cavitation develop in (5)

A
  1. S. aureus
  2. Klebsiella
  3. Legionella
  4. Pseudomonas aeruginosa
  5. Mycrobactum tuberculosis
22
Q

Primary tuberculosis vs secondary TB (reactivation )

A

Primary TB - Ghon focus is composed of tubercle-laden macrophages. The combination of a Ghon focus and hilar lymph nodes is known as a Ghon complex. Type 4 hypersensitivy

23
Q

Secondary TB is usually found where in the lung

A

upper lobes

24
Q

How does rifampin work

A

preventing transcription
Not being able to generating mRNA, the bacteria will die.

25
Q

SE isoniazid (6) & what should it be prescribed with

A
  1. Hepatotoxicity,
  2. P- 450 inhibition,
  3. drug-induced lupus,
  4. anion gap metabolic acidosis,
  5. seizures that are refractory to benzodiazepines.
  6. vitamin B6 deficiency= peripheral neuropathy and sideroblastic anemia. Thus administered w/ pyridoxine which is B6 vitamin.
26
Q

SE of Pyrazinamide (2)

A

can cause
1. hyperuricemia and
2. hepatotoxicity.

27
Q

ethambutol SE

A

optic neuritis,

28
Q

Ix aspergillosis

A

Fungal infection
Galactomannan
Halo sign on HR CT
BAL = fungal hyphea

29
Q

A cause of massive hemoptysis

A

Aspergilloma
may require bronchial art embolism

30
Q

people where a tuberculin test may be falsely negative :
*

A

miliary TB
* sarcoidosis
* HIV
* lymphoma
* very young age (e.g. < 6 months)

31
Q

causes of bilateral hilar lymphadenopathy

A

Sarcoidosis and tuberculosis.

Other causes include:
lymphoma/other malignancy
pneumoconiosis e.g. berylliosis
fungi e.g. histoplasmosis, coccidioidomycosis

32
Q

what is Kartagener’s syndrome/ primary ciliary dyskinesia sx (4)

A

Features
1. dextrocardia or complete situs inversus
2. bronchiectasis
3. recurrent sinusitis
4. subfertility (secondary to diminished sperm motility and defective ciliary action in the fallopian tubes)

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