Respiratory Tract Infection Flashcards by selcan icli

What organisms cause the common cold

Rhinovirus

Coronoviruses

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What are the clinical features of the common cold

Coryza 
Rhinnorhea
Sore throat 
Cough
Sneezing

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What is the management of the common cold

Self limiting
No role for cough syrup
Avoid antibiotics
Avoid aspirin in children

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What is the medical term for sore throat

Pharyngitis with or without tonsilits

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Which organism can cause pharyngitis

Viruses

Bacteria

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What are the important bacterial causes of pharyngitis

A beta haemolytic streptococcus\

Strep pyogenes

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How do we diagnose group a strep pharyngitis

Throat swab

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What happens to the throat swab

Gets placed onto a blood agar and is cultured

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What happen around the bacteria colony for it to be classed as beta haemolysis

Haemoltysis of the blood

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What colour would strep a stain with gram stain

Purple due to it being a gram positive cocci

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How do we decide who to treat with pharyngitis

Feverpain score - people with high score are giving antibiotics

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What is the managemnet of group a strep pharyngitis

Phenoxymethylpenicillin

Or macrolide if allergic to penicillin

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What are the complications of strep a pharyngitis

Quinsy
Scarlet fever
Rheumatic fever
Post strep glomerulonephritis

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What are the 2 main problems diptheria causes

Airway obstruction

2. Toxin mediated disease so it causes myocarditis and neuropathy

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How is diptheria treated

Penicillin

Anti toxin agents

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What is glandular fever caused by

Ebstein barr virus (EBV)

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What are the clinical features of glandular fever

Fever
Malasia
Sore throat
Lymphadenopathy 
Splenomegaly 
Rash with amoxicillin

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Which test do we use to diagnose glandular fever

Monospot test

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What does monospot test look for

Antibodies for any virus

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What is the specific test to diagnose glandular fever

Serology- igm, igg, EBNA

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What does igm + mean

Patient has had the infection previously

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What is the EBNA antibody positive

After 2 months

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What is the management of glandular fever

Symptomatic

Avoid contact sport due to splenomegaly rupture risk

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Which ogranism can cause otitis media and sinusitis

Virus
Step pneumonia
Haemophilus infleunza

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What are the clincal features of otitis media and sinuisitis

Fever | Pain and tenderness over sinuses

What are the management of otitis media and sinusitis

Decongestants | Grommets to drain the pus out

What are the complications of otitis media and sinusitis

Mastoiditis | Meningitis due to streptococcus pneumonia

Which organism causes acute epiglottitis

Haemophilus influenza type b

What are the features of acute epiglottitis

Drooling Dysphagia Dysphonia

What is the management of acute epiglottitis

Intubation | Iv ceftriaxone

What are the 3 phases of whooping cough

Catarrhal phase Paroxysomal phase Convalescent phase

What occurs in the catarrhal phase

Person is highly infectious for 2 weeks

What occurs in the paroxysomal phase

2-6 weeks of intense coughing

What occurs in the convalescent phase

Chronic cough

What is the management of whooping cough

Macrolide

What is the diagnosis of whooping cough by

Serology | Pcr on throat swab

What is laryngotrachetitis (croup)

Inflammation of the larynx and the trachea

What are the symptoms of croup

Stridor Barking cough Hypoxia and tachynpnea

What is the management of croup

Paracetamol and oxygen Dexamethasone No antibiotics

Which type of people does bronchiolitis occur in

Children (6 months)

What are the symptoms of bronchiolitis

Snuffling Fever and mild cough Worse at night Difficulty feeding

What is brocnhiolitis

Inflammation of the bronchioles

What is the diagnosis of bronchiolitis by

CXR | Nasopharyngeal aspirate or swab for pcr

What is the management for bronchiolitis

Fluid, nutrition and anti pyretics | Hypoxic if not feeding

What is an exacerbation of COPD

Change in volume of sputum: more, changed colour Character of sputum Breathlessness and wheeze

What organism can cause an exacerbation of COPD

Viruses: rhinovirus Bacteria: strep pnuemonia, hamophilus, e.coli, klebsiella

What is the management of exacerbation of COPD

Salbutamol Ipratropium Prednisolone Amoxicillin, doxycycline (antibiotics)

How can we prevent exacerbation of COPD

Vaccination Regular inhalers Smoking cessation

What are the features of pneumococcal pneumonia

``` Fever Productive cough Sob Sepsis: shock, hypoxia Focal crepitations ```

How do we diagnose pnuemococcal pneumonia

Blood and sputum culture | Urinary pneumomoccal antigens

What is the treatment of pneumococcal pneumonia

Benzypenicillin

How do we assess the severity of pneumococcal pneumonia

CURB65 score

Which organism can cause atypical pneumonia

Legionella Mycoplasma Chlaymdia

What are the symptoms of bronchiectasis

``` Daily cough Thick sputum production Multiple course of antibitoics Worsening sob Weight loss ```

What are the causes of bronchiectasis

Post infection: tb, pneumonia, whooping cough Cystic fibrosis Alpha 1 antitrypsin deficiency Antibody deficiency

How do we diagnose bronchiectasis

- clinical picture as described | - High resolution ct

What is pleural empyema

Pus in the pleural cavity

What are the causes of pleural empyema

Post pnuemonia | Post surgery

What is the diagnosis of pleural empyema by

Culture | Ultrasond and pleural aspiration

What is the treatment of pleural empyema

Chest drain Broad sprectum antibiotics Then target cultured antibiotics

What is lung abscess

Pus within the lung tissue

What are the causes of lung abscess

``` Post pneumonia Surgery Foreign body aspiration Malignancy Emboli from elsewhere ```

What are the causes of hospital acquired pneumonia

Ventilator associated pneumonia on ITU | Immunocompromised patients

What happens to the organism of the normal flora

They change and are selected by use of antibiotics, you can get colonisation or pathogens

What is the treatment for early HAP

Co-amoxiclav

What is the treatment for late HAP

Piperacillin

What is aspiration pneumonia

Patients with impaired swallowing can aspirate on their own saliva and gastric secretions which can cause pneumonia

What organism cause aspiration pneumonia

Anareobes | Gram negative e.g e.coli

What are the treatment for aspiration pneumonia

Co-amoxiclav Peg feeding tube Speech and language therapy

What group of people is fungal pneumonia common in

Immunocompromised

What are the features of fungal pneumonia

Severe pneumonia Lack of response to antibiotics Atypical pattern on imaging

What organism can cause fungal pneumonia

Candida Aspergillosis Cyrptoccocus

What is the diagnosis if fungal pneumonia by

Sputum culture Bronchoscopre for deep sample Blood markers for galctomannan (aspergillus antigen)