Respiratory Infections Flashcards
What things can compromise respiratory defences?
Poor swallow (stroke patients, muscle weakness) Abnormal ciliary function, cystic fibrosis, brnchiectasis, HIV, immunosuppression
What are the upper respiratory tract infections?
Rhinitis, pharyngitis, epiglottitis, laryngitis, sinusitis, otitis media (commonly caused by viruses)
What is pneumonia?
Infection of lung parenchyma
What are the lower respiratory tract infections?
Bronchitis, bronchiolitis, pneumonia
What are the symptoms of acute bronchitis?
Cough, fever, increased sputum production, increased SoB
What organisms are most likely to cause acute bronchitis?
Viruses, Strep pneumoniae, Haemophilus influenzae
How does pneumonia present?
Fever, cough, pleuritic chest pain, shortness of breath
What are the typical organisms that cause community acquired pneumonia?
Strep pneumoniae, H influenzae
What are some atypical organisms that can cause community acquired pneumonia?
Legionella, mycoplasma, chlamydia psittaci
What could be found on examination of a patient with pneumonia?
Pyrexia, tachycardia, tachypnoea, cyanosis, dullness on percussion, bronchial breathing, crackles
What investigations would be carried out if pneumonia is suspected?
FBC, U&E, CRP, ABG, CXR
What samples can be taken for microbiological investigation of pneumonia?
Sputum, blood culture, nose and throat swabs, urine, serum
What scoring system is used when deciding how to manage pneumonia?
CURB65
How does CURB-65 work?
Confusion Urea > 7 mmol/l Respiratory rate >30 BP <90 systolic or <60 diastolic >65 years old
Each score 1 point, if score is >2 manage as severe
Suggest an antibiotic for mild-moderate community acquired pneumonia
Amoxicillin or doxycycline
Suggest an antibiotic for severe community acquired pneumonia
Co-amoxiclav and clarithromycin
What are some complications of acute bacterial pneumonia?/
Lung abscess, bronchiectasis, empyema
What is the gram stain of strep pneumoniae?
Gram positive diplococci
What is unique about atypical organisms that cause pneumonia?
No cell wall - penicillins don’t work
Suggest an antibiotic to treat pneumonia caused by an atypical organism
Clarithromycin, doxycycline
What is the aetiology of hospital acquired pneumonia?
Staph auerus, psudomonas spp, H influenzae, fungi, enterobacteriaciae
What is the first line treatment for hospital acquired pneumonia?
Co amoxiclav
What antibiotics are used for ITU patients with hospital-acquired pneumonia?
Tazocin, meropenem
