Respiratory Track Infection Flashcards
Name 4 conditions which affect the upper respiratory system?
Coryza - common cold
Sinusitis
Epiglottitis
Sore throat - pharyngitis
Name 4 lower respiratory tract infections?
Pneumonia
Acute exacerbation of COPD
Acute bronchitis
Influenza
What is Coryza and what are the symptoms?
Its an acute (highly infectious) viral infection of the nasal passages. Spread by droplets. Usually caused by adenovirus or rhinovirus
- sore throat
- sometimes mild fever
- tiredness
What are some complications of Coryza?
Sinusitis
Acute bronchitis
What is acute sinusitis and what are the symptoms?
Infection of the nasal sinuses usually bacterial. It is usually preceded by a common cold.
- nasal dischage
- frontal headache
Usually self limited and resolves in 10 days
In what area could sinusitis be very worrying?
In the ethmoid sinuses, go to the brain and eye
What is quinsy?
Quinsy, also known as a peritonsillar abscess, is a rare and potentially serious complication of tonsillitis. The abscess (a collection of pus) forms between one of your tonsils and the wall of your throat. This can happen when a bacterial infection spreads from an infected tonsil to the surrounding area.
What is diphtheria?
Diphtheria is a potentially fatal contagious bacterial infection that mainly affects the nose and throat, and sometimes the skin. Dont see it in the UK due to vaccination
What is acute epiglottis and what is it caused by?
Acute inflammation of the epiglottis, causes swelling and can interfere with breathing. Life threatening in children. (Usually caused by H.Influenza type b (His)
Need to call anaesthetist and intubate
What is acute bronchitis and what are its symptoms?
A cold that goes to the chest. Infection of the bronchi causing them to become inflamed. Usually due to strep.pneumonia /H.influenza or people with COPD.
- productive cough
- mild fever
- usually normal CXR and Chest examination
- transient wheeze
What is the treatment for acute bronchitis?
Usually self limiting and will resolve in a few weeks
No antibiotics unless there is an underlying chronic lung disease
What is an acute exacerbation of COPD?
Chronic cough production, bronchoconstriction, inflammation of the airways.
- In acute exacerbation
- increased sputum production and darker colour
- more wheezy and breathless
- usually preceded by a URTI
What would a sputum that is clear and green indicate?
Clear = okay Green = bacterial
On examination what would you find in an acute exacerbation of COPD?
Respiratory distress
Wheeze
Coarse crackles - due to infection or secretion retention due to COPD
Cyanosed (Maybe)
How would you treat acute exacerbation of COPD in primary care?
Antibiotics - amoxicillin (or doxycycline)
Bronchodilator inhalers
Steroids in some cases
Hospilitisation if - evidence of resp failure/not coping at home
How would you treat/investigate acute exacerbation of COPD in hospital?
Everything as you would in primary care AS WELL AS ABG's CXR - to look for other diseases O2 if you have resp failure
What is pneumonia?
Inflammation of the substance of the lungs. Usually caused by bacteria and viruses. Can get CAP, HAP etc
Pneumonia is defined in the UK as signs and symptoms of a lower respiratory tract infection, with a new infiltrate on a CXR
What are the symptoms of pneumonia?
Fever Rigors Malaise - general unwellness Anorexia Dyspnea - difficult or laboured breathing. Cough - purulent sputum Haemotpysis Pleuritic pain (pleurisy)
How would these change in pneumonia?
Chest expansion, Percussion note, breath sounds, added sounds, vocal resonance?
Chest expansion - reduced Percussion ote - dull Breath sounds - bronchial Added sounds - crackles Vocal resonance - increased
What investigations would you do for pneumonia?
CXR Blood culture Serology ABG Full blood count CURB
What is CURB 65 and describe it
It is a severity score for CAP C - new onset of confusion U - urea > 7 R - respiratory rate > 30/min B - blood pressure systolic < 90 or diastolic < 61 65 - age 65 or older
1 point for each
Can CURB 65 be used in patients with COPD?
Yes but the mortality rate increases by 10% for each score
What are some other severity markers for pneumonia?
Temp <35 or >40
Cyanosis PaO2 < 8 kPa
WBC <4 or >30
Multi-lobar involvement
What is the treatment for CAP?
Mild/mod (7days) - PO amoxycillin
Severe (10days) - IV co-amoxiclav + IV clarithromycin/ PO doxycycline
Fluids
Best rest
O2
