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JL Respiratory > Respiratory Tract Infection > Flashcards

Respiratory Tract Infection Flashcards

1
Q

Name 4 conditions that affect the lower respiratory tract i.e. below the vocal cords?

A
  1. Acute bronchitis
  2. Acute exacerbation of chronic bronchitis
  3. Pneumonia
  4. Influenza
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2
Q

What condition is an acute viral infection of the nasal passages, often accompanied by sore throat, sometimes a mild fever, spread by droplets and fomites and complications can include sinusitis or acute bronchitis?

A

Common cold - coryza

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3
Q

What condition is preceded by a common cold and involves purulent nasal discharge?

A

Acute sinusitis

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4
Q

Name 3 special respiratory tract conditions?

A

Acute tonsillitis and quinsy
Diphtheria
Acute epiglottitis in children

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5
Q

Which special condition is life threatening due to toxin production, characteristic pseudo-membrane and is not seen in the UK due to vaccination?

A

Diphtheria

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6
Q

What is acute bronchitis preceded by?

A

The common cold

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7
Q

What is the term for “the cold which goes to the chest”?

A

Acute bronchitis

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8
Q

Give 5 clinical features of the common cold?

A
  1. Productive cough
  2. Fever - minority of cases
  3. Normal chest examination
  4. Normal CXR
  5. May have transient wheeze
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9
Q

Are antibiotics used to treat acute bronchitis?

A

No

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10
Q

What are these clinical features a sign of: usually preceded by upper respiratory tract infection, worsening of sputum production which is now purulent, more wheezy and breathless?

A

Acute exacerbation of chronic bronchitis

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11
Q

What is a sign of right heart failure?

A

Ankle oedema

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12
Q

In acute exacerbation of chronic bronchitis - what 5 features may you find on examination?

A
  1. Breathless
  2. Wheeze
  3. Coarse crackles
  4. May be cyanosed
  5. In advanced disease - ankle oedema
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13
Q

What are the three management methods of an acute exacerbation of chronic bronchitis in primary care?

A

Antibiotic e.g. deoxycycline or amoxicillin
Bronchodilator inhalers
Short course of steroids in some cases

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14
Q

How would you manage a patient with acute exacerbation of chronic bronchitis in hospital?

A

Measure arterial blood gases
CXR to look for other diseases

Give oxygen if has respiratory failure

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15
Q

What are cough, pleurisy, haemoptysis, dyspnoea, preceding URTI, abdominal pain and diarrhoea all a symptoms of?

A

Pneumonia

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16
Q

What are these clinical signs of - fever, rigors, herpes iabialis, tachypnoea, crackles, rub, cyanosis and hypotension?

A

Pneumonia

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17
Q

What are two investigaitons you would do for pneumonia?

A

Blood culture

Serology

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18
Q

What are 5 other tests you would do other than blood culture and serology for pneumonia?

A 
Arterial gases
FBC
Urea
Liver function
CXR
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19
Q

What is the scoring system used for pneumonia?

A

CURB65

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20
Q

Explain the CURB65 score?

A

C - New onset of confusion
U - Urea > 7
R - Respiratory rate >30/min
B - Blood pressure (systolic

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21
Q

What are 4 other severity markers for pneumonia?

A

Temperature 40
Cyanosis PaO2 30
Multi-lobar involvement

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22
Q

Name the top pathogen in pneumonia?

A

Strep pneumoniae (pneumococcus)

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23
Q

Name 7 other pathogens in pneumonia, other than Strep pneumoniae (pneumococcus)

A 
H. Influenzae
Mycoplasma pneumoniae
Influenza
Chicken pox - in adult smokers
Legionella
Coxiella burnetti
Chlamydia psittaci
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24
Q

What are the 5 management steps for community aquired pneumonia?

A
  1. Antibiotics
  2. Oxygen maintain SaO2 94-98%
  3. Fluids
  4. Bed rest
  5. No smoking
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25
Q

Give 4 complications of pneumonia

A
  1. Respiratory failure
  2. Pleural effusion
  3. Empyema
  4. Death
26
Q

What can be noted on a CXR for empyema?

A

D-shaped pleural opacity

27
Q

What do you need for hospital aquired pneumonia?

A

Extended gram negative cover

28
Q

What do you need for aspiration pneumonia?

A

Anaerobic cover

29
Q

What can bacterial pneumonia be one of the presenting features of?

30
Q

What are these clinical features a sign of - incubation 1-4 days, abrupt onset fever, chills, headache, sore throat, myalgia, malaise, anorexia, dry cough, clear nasal discharge and signs of complications?

31
Q

What are 5 complications of influenza, excluding death?

A 
Primary viral pneumonia
Secondary bacterial pneumonia
Myositis (skeletal and cardiac)
Encephalitis
Depression
32
Q

What are the clinical features of primary viral pneumonia?

A

Dry cough, bloody sputum and respiratory failure within 24 hours of onset of initial fever

33
Q

Name a class of anti-viral drugs

A

Neuraminidase inhibitors

34
Q

Name 2 neuraminidase inhibitors

A

Zanamavir (Relenza) disc haler

Oseltamivir (Tamiflu) oral

35
Q

What are these benefits of - reduced duration of symptoms by one day, reduced use of antibiotics, might reduce infectivity, no data on mortality?

A

Oseltamivir

36
Q

Name 4 conditions that affect the upper respiratory tract i.e. above the vocal cords

A
  1. Common cold - coryza
  2. Sore throat - pharyngitis
  3. Sinusitis
  4. Epiglottitis
37
Q

What are these clinical symptoms of - fever (high, abrupt onset), malaise, myalgia, headache, cough (initially dry and painful, becomes productive and less painful) and prostration?

38
Q

What are the two causes of classical flu?

A

Influenza A virus

Influenza B virus

39
Q

How is influenza transmitted?

A

By droplets, or through direct contact with respiratory secretions of someone with the infection

40
Q

What are 4 complications of flu?

A
  1. Primary influenzal pneumonia
  2. Secondary bacterial pneumonia
  3. Bronchitis
  4. Otitis media
41
Q

Name a highly pathogenic avian flu that is a future threat?

A

Influenza A H5N1

42
Q

How is lab confirmation of influenza done?

A

Direct detection of virus - PCR

43
Q

How are samples of influenza virus taken?

A

Nasopharyngeal swabs

44
Q

What type of vaccine is given to healthcare workers to prevent flu?

A

Killed vaccine

45
Q

What vaccine for prevention of flu is more effective in children agen 2-17?

A

Live attenuated vaccine

46
Q

Name 3 other causes of CAP?

A

Mycoplasma pneumoniae
Coxiella burnetii
Chlamydia

47
Q

What do mycoplasma, coxiella and chlamydophila psittaci all respond to?

A

Tetracycline and macrolides

48
Q

What two methods are used for lab confirmation of mycoplasma, coxiella and chlamydophila psittaci?

A

By serology

By virus detection - PCR

49
Q

Name an atypical cause of pneumonia which is a common cause of CAP in older children and young adults, also with person to person spread?

A

Mycoplasma pneumoniae

50
Q

What does coxiella burnetii cause?

51
Q

Which bacteria is uncommon, sporadic zoonosis, sheep and goats and has a complication of culture negative endocarditis?

A

Coxiella burnetii

52
Q

What does Chlamydophila psittaci cause?

A

Psittacosis

53
Q

What bacteria is uncommon, sporadic zoonosis, caught from pet birds and the disease presents as pneumonia?

A

Chlamydophila psittaci

54
Q

What condition occurs in 1st or 2nd year of life, fever, coryza, cough and wheeze? In severe cases grunting, decreased PaO2 and intercostal/sternal indrawing?

A

Bronchiolitis

55
Q

What are >90% of cases of bronchiolitis due to?

A

Respiratory Syncytial Virus

56
Q

How do you lab confirm bronchiolitis?

A

PCR on throat or pernasal swabs

57
Q

What are most children antibody positive by age 5 for?

A

Metapneumovirus

58
Q

What may be second only to RSV in bronchiolitis?

A

Metapneumovirus

59
Q

How do you laboratory confirm metapneumovirus?

60
Q

What is Chlamydia trachomatis?

A

An STI which can cause infantile pneumonia

61
Q

How is Chlamydia trachomatis diagnosed?

A

By PCR on urine of mother or pernasal

62
Q

How is Chlamydophila pneumoniae transmitted?

A

Person to person

JL Respiratory (27 decks)

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