Respiratory Flashcards
1
Q
Inspiration stridor
A
High pitched wheezing noise when breathing in
2
Q
Define: pneumonia
A
General term attached to inflammation of the lung parenchyma
3
Q
Pneumonia pathogenesis
A
- Pneumococci temporarily colonise the pharynx - are usually cleared by alveolar macrophages but sometimes the macrophages ability to kill becomes overwhelmed
- Bacteria translocate to the distal airway where they overwhelm the host defences and develop an inflammatory response; neutrophils and inflammatory exudate (dead bacteria, dead neutrophils, inflammatory proteins + tissue fluid) fill the alveolar space
- Resolution phase where bacteria are cleared. Resolution leads to complete recovery
Severe disease if:
- excessive inflammation
- lung injury
- failure to resolve without lung damage
4
Q
Symptoms of pneumonia
A
Fever, sweats, rigor Cough Sputum (rusty sputum suggests strep pneumoniae) Shortness of breath Pleuritic chest pain Systemic features inc weakness/malaise Extra pulmonary features: - Neuro/GI with legionella - rash with mycoplasma
5
Q
What is pleuritic chest pain
A
Pain worse on deep breathing
6
Q
Signs of pneumonia
A
Abnormal vital signs: - raised heart rate - raised respiratory rate - low blood pressure - fever - dehydration Signs of lung consolidation on percussion or auscultation - dull to percussion - decreased air entry - bronchial breath sounds - crackles wheeze
Hypoxia and signs of respiratory failure especially if chronic lung disease or sever pneumonia
7
Q
What does CURB-65 stand for?
A
Confusion Urea >7mmol/L Respiratory rate >30 breaths/m BP systolic <90mmHg; diastolic <60mmHg Age >65
1 point for each of the above
2 = admit to hospital
3+ = ITU
8
Q
Markers of systemic inflammatory response
A
Pro-inflammatory cytokines Vasodilation Reduced cardiac contractility Reduced blood pressure Reduced organ perfusion Tissue hypoxaemia
9
Q
TB
A
Caseating illness
Bacteria in apex of lung burst through bronchus into cavity causing TB bacilli to be aspirated out of the lungs
Treatment:
6 months: rifampicin + isoniazad
first 2 months: pyrazinamide + ethambutol
