RESPIRATORY INFECTIONS Flashcards
types of resp infections
- upper vs lower
upper- common cold, pharyn/laryngitis
lower- croup, bronchitis, pleuritis
RED = VIRAL
high surface area allows
lots of gas exchange across alveoli
Acute Bronchitis is
inflammation of tracheobronchial tree (bronchioles)
Bronchiolitis is
lung infection common in children and infants
- swelling and irritation, build up of mucus in bronchioles
- almost always caused by a virus
Pneumonia is
inflammation and consolidation of DEEP lung tissue
- alveoli filled with WBC and inflammatory debris
CAN EFFECT GAS EXCHANGE
How does gas exchange work
occurs across alveolar capillary membrane
- maintain clear surface for high volume gas exchange and guard against systemic infection
risks (in the environment) for infection
- loss of heat and moisture (ventilated pt)
- allergens
- aspiration of stomach content/oral secretions
- particulate matter (breath in cough)
- viruses, bacteria, fungi
how do we determine bacterial vs. fungal
- clinical presentation/PE
- diagnostic studies (galactomannan, crp biomarkers, CBC differential, chest imaging, culture sputum, PCR swab)
what is procalcitonin
precursor peptide from hormone calcitonin
released in response to bacterial toxins and pro inflamm mediators
in what type of infection is procalcitonin NOT released
viral infections do not promote PCT release
Common Cold- S+S and duration
self-limited
rhinorrhea, sore throat, cough, malaise, chills, headache, low grade fever or afebrile
duration: 9-10 days
Common Cold- etiology
viruses: rhinovirus, coronavirus, INFLUENZA VIRUS, RSV, adenovirus
Common cold- diagnosis
clinical diagnosis does usually not require diagnostics/tests
- PCR nose swab, upper resp swab culture (strep), rapid strep, influenza, covid test
Common cold- treatment
- antihistamines
- anticholinergics
- NSAID, ACETAMINOPHEN (pain management)
- topical decongestants
- cough suppressants
Influenza- S+S
- abrupt onset fever and chills
- sore throat
- dry cough
- CLEAR runny nose
- myalgias, headaches
Influenza- diagnosis
PCR Nasopharyngeal swab
- can differentiate between subtypes of A
- RAPID can only differentiate between type A and B
Influenza- treatment
Oseltamivir/TAMIFLU (PO)
Zanamivir
Peramivir (IV)
Baloxavir Marboxil (PO)
Influenza Neuraminidase Inhibitors
- different forms
- to what pts do you give
- peramivir is IV
- Inhaled and IV for people who cannot take oral medication
- Oseltamivir to pts >2 weeks of age (only PO)
- Zanamivir contraindicate with ASTHMA AND COPD (inhaled)
RSV
presents as common cold in healthy adult
- common cause of viral pneumonia
RSV treatment
RIBAVIRIN- supportive care
Glucocorticoids and bronchodilators for bronchial reactivity
IVIG (IV immunoglobulin) if they are VERYYY ILL/unique situation
RSV prevention
Palivizumab AND Nirsevimab (mABs)
- used in young children
NEW VAX FOR OLDER ADULTS/PREGO WOMEN*
COVID transmission
RESPIRATORY DROPLETS- cough, sneeze, singing, talking, breathing
Endothelitis- how does it occur
SARS-CoV-2 binds to host cells via ACE2 receptor in the epithelial cells
Covid- symptoms
congestion, runny nose, loss taste/smell, headache, sore throat/cough, fatigue, muscle/body ache, shortness of breath, nausea/vom
Covid- antigen test
rapid antigen test can be done, if negative repeat in 3-5 days
Covid- treatments in order of preference
Nirmatrelvir + ritonavir (boosting agent) within 5 days symptom onset
Remdesivir within 7 days onset
DO not have to know alternative (molnupiravir)
