Respiratory Illnessess 2 Flashcards
patients most likely to get severe resp. tract infections? (5)
infants <6 mo. frail elderly. immunocompromised. chronic organ dysfunction. smokers/alcoholics
laboratory ID of strep pneumoniae
optochin (quinine) susceptible. catalase negative but grows better with catalase. produces pneumolysin = alpha hemolysin so it breaks down Hb = green pigment
why is pneumococcus so virulent?
polysaccharide capsule = prevents phagocytosis, activates complement. pneumolysin is cytotoxic = inflammation = pt becomes sick.
treating strep pnemoniae: most strains susceptible to? if resistant? exception
penicillin. for resistant: higher dose of penicillin will still work - except meningitis with a resistant strain so use cephalosporin+ vancomcyin
what are the pathogens in acute otitis media + sinusitis?
viruses. strep pneumoniae, h. inflenzae + moraxella catarrhalis > GAS, staph aureus
otitis media + sinusitis: when to use antibiotics
reserved for those with lousy immune systems (infants <6 mo, immunocompromised), sever symptoms or failure to improve in 48 hours despite analgesics
otitis media + sinusitis: what antibiotic would you use
amoxillin, or amoxillin clavulanate if amoxillin on its own didn’t work
croup: aka? what?
laryngotracheitis = inflammation of larynx and trachea
croup: what type of infection? usually in who?
viral infection. usually in children 6 - 36 months of age
croup: main sign? worrying if?
barky cough + stridor (sound like a seal when they breathe). esp. worried if they have stridor at rest
croup: treatment
mild: moist air. severe: single dose of dexamethasone (corticosteroid) orally.
acute bronchitis: what? results in what?
inflammation of the bronchi. prolonged productive aka wet/moist cough that typically drags on for >10 days following a regular cold
acute bronchitis and antibiotics
most recover w/o. only people with chronic long problems like COPD need antibiotics
bronchioloitis: what? bacterial or viral? occurs in who?
inflammation of the bronchioles. viral infection that primarily occurs in children <2 yo.
bronchiolitis: cardinal feature? usually lasts how long?
wheezing, usually on expiration not inspiration. 3 - 7 days
pneumonia: usually have which symptoms? then do what to confirm diagnosis?
cough, fever, tachypnea. chest X ray (or ultrasound of the chest)
Pneumonia: most caused by?
viruses or bacteria (hard to know which is which). can also be due to fungi, parasites
clues that point to bacterial pneumonia
acute onset. high fever and chills. crackles + crepitations (vs. wheezing). large pleural effusion. empyema. lung abscess. higher WBC and C reactive protein.
lobar vs broncho vs. interstitial pneumonia: bacterial or viral?
lobar pneumonia on CXR = bacterial. interstitial = viral. bronchopnemonia can be both
