Respiratory Tract Infection Flashcards

1
Q

What organisms cause the common cold

A

Rhinovirus

Coronoviruses

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2
Q

What are the clinical features of the common cold

A
Coryza 
Rhinnorhea
Sore throat 
Cough
Sneezing
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3
Q

What is the management of the common cold

A

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

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4
Q

What is the medical term for sore throat

A

Pharyngitis with or without tonsilits

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5
Q

Which organism can cause pharyngitis

A

Viruses

Bacteria

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6
Q

What are the important bacterial causes of pharyngitis

A

A beta haemolytic streptococcus\

Strep pyogenes

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7
Q

How do we diagnose group a strep pharyngitis

A

Throat swab

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8
Q

What happens to the throat swab

A

Gets placed onto a blood agar and is cultured

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9
Q

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

A

Haemoltysis of the blood

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10
Q

What colour would strep a stain with gram stain

A

Purple due to it being a gram positive cocci

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11
Q

How do we decide who to treat with pharyngitis

A

Feverpain score - people with high score are giving antibiotics

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12
Q

What is the managemnet of group a strep pharyngitis

A

Phenoxymethylpenicillin

Or macrolide if allergic to penicillin

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13
Q

What are the complications of strep a pharyngitis

A

Quinsy
Scarlet fever
Rheumatic fever
Post strep glomerulonephritis

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14
Q

What are the 2 main problems diptheria causes

A
  1. Airway obstruction

2. Toxin mediated disease so it causes myocarditis and neuropathy

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15
Q

How is diptheria treated

A

Penicillin

Anti toxin agents

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16
Q

What is glandular fever caused by

A

Ebstein barr virus (EBV)

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17
Q

What are the clinical features of glandular fever

A
Fever
Malasia
Sore throat
Lymphadenopathy 
Splenomegaly 
Rash with amoxicillin
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18
Q

Which test do we use to diagnose glandular fever

A

Monospot test

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19
Q

What does monospot test look for

A

Antibodies for any virus

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20
Q

What is the specific test to diagnose glandular fever

A

Serology- igm, igg, EBNA

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21
Q

What does igm + mean

A

Patient has had the infection previously

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22
Q

What is the EBNA antibody positive

A

After 2 months

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23
Q

What is the management of glandular fever

A

Symptomatic

Avoid contact sport due to splenomegaly rupture risk

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24
Q

Which ogranism can cause otitis media and sinusitis

A

Virus
Step pneumonia
Haemophilus infleunza

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25
Q

What are the clincal features of otitis media and sinuisitis

A

Fever

Pain and tenderness over sinuses

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26
Q

What are the management of otitis media and sinusitis

A

Decongestants

Grommets to drain the pus out

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27
Q

What are the complications of otitis media and sinusitis

A

Mastoiditis

Meningitis due to streptococcus pneumonia

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28
Q

Which organism causes acute epiglottitis

A

Haemophilus influenza type b

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29
Q

What are the features of acute epiglottitis

A

Drooling
Dysphagia
Dysphonia

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30
Q

What is the management of acute epiglottitis

A

Intubation

Iv ceftriaxone

31
Q

What are the 3 phases of whooping cough

A

Catarrhal phase
Paroxysomal phase
Convalescent phase

32
Q

What occurs in the catarrhal phase

A

Person is highly infectious for 2 weeks

33
Q

What occurs in the paroxysomal phase

A

2-6 weeks of intense coughing

34
Q

What occurs in the convalescent phase

A

Chronic cough

35
Q

What is the management of whooping cough

A

Macrolide

36
Q

What is the diagnosis of whooping cough by

A

Serology

Pcr on throat swab

37
Q

What is laryngotrachetitis (croup)

A

Inflammation of the larynx and the trachea

38
Q

What are the symptoms of croup

A

Stridor
Barking cough
Hypoxia and tachynpnea

39
Q

What is the management of croup

A

Paracetamol and oxygen
Dexamethasone
No antibiotics

40
Q

Which type of people does bronchiolitis occur in

A

Children (6 months)

41
Q

What are the symptoms of bronchiolitis

A

Snuffling
Fever and mild cough
Worse at night
Difficulty feeding

42
Q

What is brocnhiolitis

A

Inflammation of the bronchioles

43
Q

What is the diagnosis of bronchiolitis by

A

CXR

Nasopharyngeal aspirate or swab for pcr

44
Q

What is the management for bronchiolitis

A

Fluid, nutrition and anti pyretics

Hypoxic if not feeding

45
Q

What is an exacerbation of COPD

A

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

46
Q

What organism can cause an exacerbation of COPD

A

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

47
Q

What is the management of exacerbation of COPD

A

Salbutamol
Ipratropium
Prednisolone
Amoxicillin, doxycycline (antibiotics)

48
Q

How can we prevent exacerbation of COPD

A

Vaccination
Regular inhalers
Smoking cessation

49
Q

What are the features of pneumococcal pneumonia

A
Fever 
Productive cough
Sob 
Sepsis: shock, hypoxia
Focal crepitations
50
Q

How do we diagnose pnuemococcal pneumonia

A

Blood and sputum culture

Urinary pneumomoccal antigens

51
Q

What is the treatment of pneumococcal pneumonia

A

Benzypenicillin

52
Q

How do we assess the severity of pneumococcal pneumonia

A

CURB65 score

53
Q

Which organism can cause atypical pneumonia

A

Legionella
Mycoplasma
Chlaymdia

54
Q

What are the symptoms of bronchiectasis

A
Daily cough 
Thick sputum production
Multiple course of antibitoics 
Worsening sob
Weight loss
55
Q

What are the causes of bronchiectasis

A

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

56
Q

How do we diagnose bronchiectasis

A
  • clinical picture as described

- High resolution ct

57
Q

What is pleural empyema

A

Pus in the pleural cavity

58
Q

What are the causes of pleural empyema

A

Post pnuemonia

Post surgery

59
Q

What is the diagnosis of pleural empyema by

A

Culture

Ultrasond and pleural aspiration

60
Q

What is the treatment of pleural empyema

A

Chest drain
Broad sprectum antibiotics
Then target cultured antibiotics

61
Q

What is lung abscess

A

Pus within the lung tissue

62
Q

What are the causes of lung abscess

A
Post pneumonia
Surgery 
Foreign body aspiration
Malignancy
Emboli from elsewhere
63
Q

What are the causes of hospital acquired pneumonia

A

Ventilator associated pneumonia on ITU

Immunocompromised patients

64
Q

What happens to the organism of the normal flora

A

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

65
Q

What is the treatment for early HAP

A

Co-amoxiclav

66
Q

What is the treatment for late HAP

A

Piperacillin

67
Q

What is aspiration pneumonia

A

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

68
Q

What organism cause aspiration pneumonia

A

Anareobes

Gram negative e.g e.coli

69
Q

What are the treatment for aspiration pneumonia

A

Co-amoxiclav
Peg feeding tube
Speech and language therapy

70
Q

What group of people is fungal pneumonia common in

A

Immunocompromised

71
Q

What are the features of fungal pneumonia

A

Severe pneumonia
Lack of response to antibiotics
Atypical pattern on imaging

72
Q

What organism can cause fungal pneumonia

A

Candida
Aspergillosis
Cyrptoccocus

73
Q

What is the diagnosis if fungal pneumonia by

A

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