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phase2a medicine > respiratory infections > Flashcards

respiratory infections Flashcards

TB, pneumonia, upper respiratory tract infections, influenza, and bronchiectasis.

1
Q

how can someone catch bovine TB?

A

drinking unpasteurised milk from cows

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2
Q

risk factors for TB

A 
diabetes mellitus
immunocompromised (incl. HIV +ve)
poor nutrition 
homelessness
alcoholics
viral hepatitis B/C
pathophysiology
born in high prevalence area
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3
Q

organisms responsible for TB

A

Mycobacterium tuberculosis
Mycobacterium bovis
Mycobacterium africanum
Mycobacterium microti

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4
Q

pathology of TB

A

TB survives inside phagolysosome –> macrophage recruits T cells –> granuloma

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5
Q

what is the time frame for primary TB?

A

within 2 years of infection

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6
Q

in what percentage of people will latent TB not do anything?

A

90%

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7
Q

signs of pulmonary TB

A 
productive cough
haemoptysis
weight loss
night sweats
malaise
fever
anorexia
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8
Q

signs of lymph node TB

A

non-tender lymphadenopathy + systemically unwell

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9
Q

signs of CNS TB

A

symptoms of meningitis
raised intracranial pressure (and its associated symptoms)
systemically unwell

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10
Q

signs of bone TB

A

osteomyelitis + systemically unwell

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11
Q

signs of abdominal TB

A

ascites + systemically unwell

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12
Q

how many deaths per year worldwide are due to TB?

A

1.6 million

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13
Q

complications of TB

A 
consolidation 
collapse
pleural effusion
pericardial effusion 
extra pulmonary TB
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14
Q

which part of the lung is TB most likely to affect?

A

the apex

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15
Q

diagnostic tests for TB

A

CXR

Ziehl-Neelson test with sputum

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16
Q

how to test for active TB

A 
microbiology
microscopy
culture
sputum
urine
CSF
pleural fluid
biopsy
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17
Q

how to test for latent TB

A 
Mantoux test (type 4 hypersensitivity)
interferon gamma release assay 
test for memory T cells
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18
Q

disadvantages of Mantoux test for latent TB

A

won’t distinguish infection from disease

false negative for immunocompromised and military TB

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19
Q

risk factors for pneumonia

A 
immunocompromised
elderly
infants
COPD
nursing home
impaired swallow
diabetes
congestive heart failure
alcoholics
IVDU
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20
Q

which organism is responsible for 40% of community acquired pneumonia?

A

S.pneumoniae

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21
Q

causes (organisms) of community acquired pneumonia

A

S.pnuemoniae
H.influenzae
S.aureus

atypical:
Legionella pneumophila
Chlamydia pneumoniae

22
Q

most common cause (organism) of hospital acquired pneumonia

A

P.aeruginosa

23
Q

organisms that are responsible for hospital acquired pneumonia

A

P.aeruginosa
S.aureus
K.pneumoniae

24
Q

methods of spread of pneumonia

A

inhalation
aspiration of gastric contents
haematogenous spread

25
Q

pathology of pneumonia

A

alveolar macrophages release cytokines –> attract neutrophils –> build up of pus, fluid, and cells

26
Q

signs of pneumonia

A 
pyrexia
cyanosis
dehydration 
confusion 
tachypnoea
hypotension 
dull percussion note
high respiratory rate
tachycardia
27
Q

symptoms of pneumonia

A 
fever
rigors
anorexia
dyspnoea
sputum/cough
pleuritic pain
haemoptysis
28
Q

signs of lung consolidation

A 
dull percussion 
decreased air entry 
bronchial breath sounds
crackles ± wheeze
increased vocal resonance
29
Q

how will inflammation lower lung manifest?

A

irritation in back of throat –> cough

30
Q

mortality of pneumonia

A

CAP 1%
HAP 10%
ITU 30%

31
Q

diagnostic tests for pneumonia

A 
bloods - FBC, U&E, CRP
endoscopy
biopsy 
CXR
O2 sats (<92%)
urine, blood, and sputum culture
ECG - tachycardia and arrhythmia
32
Q

CURB65
what does it stand for?
when to admit someone to hospital?

A 
Confusion
Urea >7 mmol/L
RR >30/min
BP - systolic >90 or diastolic <60
65 or older

score of 3 or more is severe
score of 2 or more –> admit patient to hospital
score of 4 or 5 –> ITU admission

33
Q

CURB65 and antibiotic treatments

A

0-1 –> amoxicillin
2 –> amoxicillin and clarithromycin
3-5 –> IV co-amoxiclav and clarithromycin

34
Q

how to treat P.aeruginosa pneumonia in patients with CF?

A

ceftazidine

35
Q

incubation period of Bordetella pertussis

A

5-21 days

36
Q

what percentage of cases of pharyngitis are viral?

A

70-80%

37
Q

sign of diphtheria

A

thick grey membrane on tonsils produced by WBCs

38
Q

complications of sinusitis

A

brain abscess
sinus vein thrombosis
orbital cellulitis

39
Q

complications of whopping cough

A

pneumonia
encephalopathy
subconjunctival haemorrhage

40
Q

treatment of whooping cough

A

clarithromycin

41
Q

proper name for croup

A

acute laryngo-tracheobronchitis

42
Q

what causes epiglottitis?

A

Haemophilus influenzae type B (Hib)

43
Q

signs of influenza

A 
high fever
runny nose
sore throat
muscle pains
headache
coughing
fatigue
weakness
44
Q

complications of influenza

A

viral pneumonia
secondary bacterial pneumonia
sinus infection

45
Q

how do neuraminidase inhibitors (oseltamivir) target the influenza virus?

A

inhibits virus from cutting loose from infected cells

inhibits virus’ ability to stop clumping together

46
Q

bronchiectasis definition

A

permanent dilatation of bronchi and bronchioles, obstruction and severe inflammation usually of the lower lobes

destruction of bronchial and alveolar walls

47
Q

main organisms responsible for bronchiectasis

A

H.influenzae
Strep. pneumoniae
S.aureus
P.aeruginosa

48
Q

signs of bronchiectasis

A

reduced VC
chronic cough
foul smelling sputum
dyspnoea

49
Q

complications of bronchiectasis

A 
pneumonia
lung abscess
emphysema
metastatic abscesses
amyloid
pulmonary fibrosis
cor pulmonale
chronic infection 
fungal colonisation 
septicaemia
meningitis
50
Q

diagnosis of bronchiectasis

A

sputum culture
cystic shadows on contrast XR
obstructive pattern on spirometry
bronchoscopy shows haemoptysis

51
Q

treatment of bronchiectasis

A

antibiotics
physiotherapy
bronchodilators (ß2 agonists)
surgery if advanced

phase2a medicine (53 decks)

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