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CC2 - exam preparation > Respiratory infections > Flashcards

Respiratory infections Flashcards

1
Q

What are the classic symptoms of respiratory tract infections?

A

Coryza, rhinorrhea – Sore throat, sneezing, cough

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2
Q

Define coryza.

A

Acute inflammation of the mucous membranes, marked by sneezing, lacrimation, and profuse secretion of watery mucus; usually associated with infection by one of the common cold viruses of acute allergic rhinitis.

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3
Q

What are the treatments of the common cold?

A

Self-limiting – No role for cough syrup – Avoid antibiotics – Avoid aspirin in children (Reye’s syndrome)

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4
Q

What are some key features of pharyngitis?

A

90% (A-G)

90% viral

A group strep

Beta heamolytic

CENTOR score

Diptheria

Exudate

FeverPain

Glomerularnephritis post-strep

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5
Q

What are the complications of group A strep?

A
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6
Q

How is group A strep tested for?

A

Lancefield classification for capsular antigen

Beads on a string

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7
Q

What % of sore throat/ pharyngitis is viral?

A

90%

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8
Q

What is the 4 Ts centor score and feverpain score testing?

A

For bacterial infection = 4Ts

Temperature

Tonsilar exudate

Tender lymph nodes

Time

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9
Q

How to manage a sore throat?

A

Gargle salty water

Drink plenty of water

Eat cool and soft foods

Take paracetemol and aspirin (unless under 16 - Reye’s)

Avoid smoking

Rest

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10
Q

How else can you disntinguish between sore throat being viral or baceterial?

A

The virus will cause coryza

The bacteria just stays in the throat

Yellow sputum

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11
Q

What other bacteria cause pharyngitis?

A

 Corynebacterium diphtheria  Group C & G strep  Fusobacterium necrophorum

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12
Q

What is Lemierre’s syndrome?

A

Lemierre’s syndrome refers to infectious thrombophlebitis of the internal jugular vein.[2] It most often develops as a complication of a bacterial sore throat infection in young, otherwise healthy adults. The thrombophlebitis is a serious condition and may lead to further systemic complications such as bacteria in the blood or septic emboli.

Lemierre’s syndrome occurs most often when a bacterial (e.g., Fusobacterium necrophorum) throat infection progresses to the formation of a peritonsillar abscess.

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13
Q

What is a mneumonic for the FEVERpain score?

A

Tonsils purulent

Inflamed tonsils

Fever

In 3 days

No cough or coryza

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14
Q

What are the complications of strep throat?

A

PQRS. Post-streptococcal glomerulonephritis, quinsy, rheumatic fever, scarlet fever.

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15
Q
A
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16
Q

How can post-streptococcal glomerulonephritis be detected?

A

ASOtitre

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17
Q

What is ASOtitre?

A

anti-streptolysin O titre

18
Q

Where is diptheria more common?

A

Eastern Europe and Bangladesh

19
Q

What are some effects of diptheria?

A

Stridor

20
Q

How might diptheria be managed?

A

Penicillin or erythromycin

Tracheostomy

21
Q

What are some key features of infectious mononucleosis?

A

Caused by EBV

Lasts for + 1 month

No contact sports allowed for 6 months

Amoxicclin can cause rash

Malaise cough fever lymph nodes

EBV

22
Q

Differentials for sore throat?

A

Laryngotracheitis/ croup

Influenza

Mononucleosis

Strep throat

Diptheria

Whooping cough

23
Q

What causes croup?

A

RSV and parainfluenza

24
Q

What are some breathing sounds linked to croup?

A

Stridor - windy sound

Croup cough - barking seal

25
Q

How is croup treated?

A

Dexamethasone

26
Q

What is shown here?

A

Steeple’s sign

27
Q

What is bronchiolitis?

A

Inflammation of the bronchioles – Very common in childhood, mostly mild  Organism: viruses – 70% RSV  Epidemics in winter  Highest cause of admission 2 have antibodies (ie. have been infected)  Diagnosis – X-ray generally normal – Nasopharyngeal aspirate/swab  PCR for viral RNA

28
Q

What pathogens may cause exacerbation of COPD?

A

Organisms; – Viruses 20-40%  Rhino/RSV/flu/adeno – Bacteria 30-50%  Strep pneumo, haemophilus  Moraxella catarrhalis  Ecoli, klebsiella

29
Q

How do you treat an exacerbation of COPD?

A

Management – Bronchodilators: salbutamol & ipratropium – Steroids: prednisolone 5 days – Consider antibiotics  Amoxicillin, doxycycline  Prevention – Regular inhalers  Compliance and technique – Vaccines  Influenza  Pneumococcal – Smoking cessation  Even once COPD established

30
Q

What is bronchiolitis?

A

 Inflammation of the bronchioles – Very common in childhood, mostly mild  Organism: viruses – 70% RSV  Epidemics in winter  Highest cause of admission 2 have antibodies (ie. have been infected)

31
Q

How is early HAP treated vs late HAP?

A

 Early HAP: Co-amoxiclav  Late HAP: Piperacillin-tazobactam

32
Q

What are some causes of aspiration pneumonia?

A

Impaired swallow/gag reflex – Due to stroke, dementia, MND – Saliva, secretions, gastric contents – Chemical pneumonitis +/- infection – Recurrent: causes lobar bronchiectasis

33
Q

Features of bronchiectasis?

A
34
Q

Who is most at risk from bronchiectasis?

A
35
Q

What are the stages of whooping cough?

A
36
Q

What is pleural empyema?

A

Pleural empyema is a collection of pus in the pleural cavity caused by microorganisms, usually bacteria.[1] Often it happens in the context of a pneumonia, injury, or chest surgery.[1] It is one of the various kinds of pleural effusion. There are three stages: exudative, when there is an increase in pleural fluid with or without the presence of pus; fibrinopurulent, when fibrous septa form localized pus pockets; and the final organizing stage, Thoracentesis <7.2 USS gudance

37
Q

What are the most common HAP infections?

A

Staph/ step/ stenotrophomonas

Pseudomonas

Acinetobacter

Carbamenemases producing enterobacter (CPE)

E.coli and klebsiella

38
Q

What is the treatment for TB?

A
39
Q

What pathogen is stained with an inidian ink stain?

A
40
Q
A
41
Q

What are the treatments for (i) strep a, (ii) HAP, (iii) fungal infections and (iv) TB?

A

Strep - phenoxymethylpenicillin or clarithrumycin

HAP - Co-amxoclav or later tazozam and pioercillin

Fungal infections - co-trimexazole

TB - 2 months RIPE, 4 months RI

CC2 - exam preparation (76 decks)

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