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MBCHB 1 > respiratory pathology 4 > Flashcards

respiratory pathology 4 Flashcards

1
Q

acute bronchitis

A

temporary inflammation of the bronchi (3 weeks)

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2
Q

symptoms of acute bronchitis

A

Inflammation of bronchi
* Temporary <3 weeks
* Cough and sputum
* Usually viral

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3
Q

management of acute bronchitis

A

paracetamol
drinking of fluids

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4
Q

exacerbation of COPD

A

changes in the colour of the sputum
fevers
increased breathlessness
cough
wheeze

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5
Q

yellow purulent sputum

A

bacterial infection

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6
Q

treatment of COPD management

A

steroids
antibiotics - amoxicillin
- doxycycline
- co-trimoxazole
- clarithromycin

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7
Q

organisms that cause the exacerbation of COPD

A

Streptococcus pneumoniae
* Haemophilus influenzae
* Moraxella catarrhalis
* Viral

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8
Q

pneumonia

A

inflammation of the lung parenchyma that is the lung cells

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9
Q

risk factors for pneumonia

A

smoking and alcohol intake
age extremes
viral illness
pre -existent lung disease
chronic illness
immunocompromised
hospitalisation
Intravenous drug users

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10
Q

types of pneumonia

A

bronchopneumonia
lobar pneumonia
interstitial pneumonia

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11
Q

symptoms of pneumonia

A

.Fever, rigors, myalgia
* Cough and sputum
* Chest pain (pleuritic)
* Dyspnoea
* Haemoptysis

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12
Q

rusty brown sputum

A

pneumonia

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13
Q

signs of pneumonia

A

Tachypnoea
* Tachycardia- increased heart beat
* Reduced expansion- there is solidification of the alveoli fluid filled alveoli
* Dull percussion- more solid because of the consolidation of matter
* Bronchial breathing- listen over the trachea to check for this
* Crepitations
Rusty brown sputum * Vocal resonance

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14
Q

investigations of pneumonia in primary care setting

A

chest x ray

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15
Q

investigations of pneumonia in the hospital

A

Bloods – serum biochemistry, FBC, CRP
Blood cultures
CXR
Sputum culture, viral throat swab
Legionella urinary antigen

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16
Q

differential diagnosis of pneumonia

A
  • Tuberculosis
  • Lung cancer
  • Pulmonary embolism
  • Pulmonary oedema
  • Pulmonary vasculitis (Wegners granulomatosis)
17
Q

causative agents of pneumonia

A

Strep Pneumoniae 39%
* H. Influenzae 5.2%
* Legionella 3.6%
* Staph aureus 1.9%
* Moxarella catarrhalis 1.9%
* Mycoplasma pneumoniae 10.8%
* Chlamydophila pneumoniae 13.1%
* Chlamydophyla psittaci 2.6%
* Coxiella burnetii 1.2%
* All viruses

18
Q

classification of pneumonia

A

community acquired
hospital acquired

19
Q

community acquired pneumonia

A

typical- cause the normal signs of pneumonia
atypical -present with different ( not normal) symptoms of pneumonia

20
Q

typical pneumonia causing bacteria

A

Streptococcus pneumoniae
* Haemophilus influenzae
* Mycoplasma pneumoniae

21
Q

atypical pneumonia causing bacteria

A

Legionella pneumophilia- fresh water
* Chlamydia pneumoniae- sexually acquired
* Chlamydia psittaci- birds
* Coxiella burnetti- farm animals
* Moraxella catarrhalis- causes COPD
* Viruses- influenza , varicella , SARS

22
Q

nosocomial bacteria

A

acquired by staying in the hospital for more than 48 hours

23
Q

examples of nosocomial bacteria

A

Enterobacteria
* Staphylococcus aureus
* Pseudomonas aerigunosa
* Klebsiella pneumoniae

24
Q

organisms that cause a cavitation pneumonia

A

MRSA
Klebsiella pneumoniae
TB

25
Q

severity test for pneumonia

A

CURB 65

26
Q

negatives of CURB 65 score

A

Young people
- Hypoxia
- Multi-lobar consolidation

27
Q

score of pneumonia

A
  • 0-1 low risk - could be treated in community < 3%
  • 2 moderate risk - hospital treatment usually required 9%
  • 3-5 high risk of death and need for ITU
28
Q

complications of pneumonia

A
  • Sepsis
  • Acute Kidney Injury
  • Adult Respiratory Distress Syndrome
  • Parapneumonic effusion
  • Empyema
  • Lung Abscess
  • Disseminated infection
29
Q

lung abscess

A

More likely with Staph aureus,
pseudomonas, anaerobes…
* Purulent sputum, haemoptysis
* Screen for TB
* CT scan +/- bronchoscopy
* Prolonged antibiotics minimal of 4 weeks

30
Q

empyema

A

Thoracic ultrasound +/- aspirate
* Fluid parameters:
* Simple pH > 7.2
* Complicated pH < 7.2
* Empyema pus/Culture +ve
* May need drain + prolonged abx
* Surgery / intrapleural tPA + DNAse

31
Q

recovery period for pneumonia

A
  • Repeat CXR 6 weeks if >50yrs, smokers this is to check whether the infection has resolved
  • Smoking cessation
32
Q

recurrent pneumonia

A

HIV
cancer
bronchiectasis
aspiration pneumonia

33
Q

bronchiectasis

A

signet ring appearance

34
Q

causes of bronchiectasis

A

Idiopathic
* Childhood infection
* CF
* Ciliary dyskinesia
* Hypogammaglobulinaemia
* Allergic BronchoPulmonary Aspergillosis
(ABPA)

35
Q

symptoms of bronchiectasis

A

Chronic productive cough
* Breathlessness
* Recurrent LRTI
* Haemoptysis
* Finger clubbing
* Crepitations (coarse)
* Wheeze
* Obstructive spirometry

36
Q
A

MBCHB 1 (27 decks)

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