Respiratory Flashcards
ACUTE BRONCHITIS
1) vira or bacterial?
2) how can it cause whooping cough?
3) what % develop cough?
4) Tx?
5) why do you worry for children?
1) mostly viral ( if bacterial: influenza, RSV in children)
2) by bordetella pertussis
3) 98%
4) self-limiting (can take weeks)
5) worry for children as airways are smaller and can become occluded by inflammation.
COPD
1) def regarding cough + time?
2) pathophysiology?
4) Tx of infective exacerbation?
1) 3 months of productive cough for at least 2 years
2) emphysema + bronchitis
4) Abx (amoxicillin/tetracycline)
CAP PNEUMONIA
1) Common what time of year?
2) Common in men or women?
3) what makes it community acquired?
4) how do you assess severity in hospital and GP?
6) cause of typical CAP pneumonia?
7) Tx of typical CAP pneumonia
1) winter
2) men>females 2:1
3) spent less than 48 hours in hosp
4) curb 65 + crb 65 in GP
confusion
raised urea >7
resp rate >30
BP <90mmHg
>65
6) Strep. pneuomonia
7) Amoxicillin sensitive
Hospital acquired pneumonia (HAP)
1) what makes it HAP?
2) features of HAP?
3) due to multi-resistant ‘hospital flora’ which are?
1) acquired >48 hours in hospital
2) same as CAP
3) S. aureus, P. aeruginosa, legionella
Aspiration pneumonia
1) what is it?
2) commonly occurs in what type of patient?
3) Tx?
1) inhalation of material
2) pt with neuro problem - unconscious or coma, MND with bulbar symptoms
3) cefuroxime + metronidazole
Bronchiectasis
1) type of bacteria that cause it? (same as COPD)
2) pathophysiology?
1) S. aureus, P. aeruginosa, H. influenzae
2) abnormal structure of bronchi leading to inflammation, obstruction and increased risk of infection.
• What is TB caused by?
Mycobacterium tuberculosis
• What is a tubercle bacillus?
Are they Gram +ve or –ve?
A bacterium that causes TB (i.e. M. tuberculosis)
They rarely take up Gram stain and instead use ZN staining. In the rare occasion they do take up Gram stain, they are Gram +ve.
• How do you stain for TB?
- Using special Ziehl–Neelsen staining.
• What is M. bovis used for?
The BCG vaccination (which protects you against M. tuberculosis because they share many antigens)
• What does M. bovis infect?
cattle
• How is M.tuberculosis transmitted?
Respiratory droplets (although it’s quite hard to catch and you need to spend a significant amount of time with someone who is infected to be at risk of getting it)
• What is a Ghon focus?
The primary lesion causes by M. tuberculosis It is usually in mid/lower zone of lung .
• What things, if you have latent TB, put you at higher risk of developing the active disease?
what drug increases risk by 12x?
o Immunosuppression: - HIV - Steroids - Infliximab (⇑risk by 12x) o Extremes of age
• How do we know if someone has latent TB?
- heaf test?
- what replaced the heaf test?
- Heaf test - A Heaf gun was used to inject multiple samples of testing serum under the skin at once. The needle points were dipped in tuberculin (a.k.a. purified protein derivate, PPD) and pricked into the skin. A severe reaction suggests you have immunity and therefore have had TB at one point.
- Mantoux test – replaced the heaf test in 2005. You inject tuberculin/PPD subcutaneously and look for a reaction. A severe reaction suggests you have immunity and therefore have had TB at one point.
➢ Unfortunately, the tests aren’t that sensitive or specific for diagnosing latent TB. This is partly because these tests will not distinguish well enough between latent TB and someone who has had the BCG vaccination
