Respiratory Tract Infection Flashcards
Give four upper respiratory tract infections
- Coryza
- Pharyngitis
- Sinusitis
- Epiglottits
What is the term for the common cold?
Coryza
Give four lower respiratory tract infections
- Acute bronchitis
- Acute exacerbation of of chronic bronchitis
- Pneumonia
- Influenza
Give three viruses that cause the common cold
- Adenovirus
- Rhinovirus
- Respiratory syncytial virus
How is infection from the common cold physically spread?
- Droplets - small moisture particles
- Formites - objects or materials that can carry infection (hospital blanket)
Complications of coryza may include what?
- Sinusitis
- Acute bronchitis
What does acute sinusitus entail?
- Nasal discharge
- Usually infection into the ethmopid sinuses which can spread to the eyes or brain
What is diptheria?
Usually caused by Corynebacterium diphtheriae
This bacterium can be stread via droplets or physical contact
Some strains can release toxin which can cause obstruction of the airways
The condition is vaccinated against in the UK
In which age demographic is acute epiglottitis most dangerous?
Young children
The key symptom is drooling - the child cannot swallow properly
What are the main clinical features of acute bronchitis?
- Productive cough - mucous build-up in bronchi
- Fever
- Normal chest Xray
- Normal chest exam
- Transient wheeze
What are the three main symptoms of COPD?
- Chronic sputum production
- Bronchoconstriction
- Inflammation of airways
Give four clinical features of COPD
- Increased sputum production
- Increased sputum purulence (contains pus)
- More wheezy
- Breathless
What may be found on on a COPD physical examination?
- Wheeze
- Coarse crackles
- Potential cyanosis
- Ankle oedema
How can COPD be managed in primary care?
- Antibiotics (doxycycline or amoxicillin)
- Bronchodilator inhalers
- Short course of steroids to reduce inflammation
In which two instances would a COPD patient be referred to hospital?
- Evidence of respiratory failure
- Acopia - unable to cope at home alone
How is management of COPD different in hospital versus primary care?
- Arterial blood gases are taken
- CXR
- Oxygen is given in the instance of respiratory failure
Give 6 symptoms of pneumonia
- Malaise
- Anorexia
- Sweats
- Rigors - cold/shivering despite temperature rise
- Myalgia - muscle pain
- Arthralgia - joint pain
- Headache
- Confusion - determine with CURB65
- Cough
- Pleurisy
- Haemoptysis
- Dyspnoea
- Preceding URTI
- Abdominal pain
- Diarrhoea
What are some signs of pneumonia?
- Fever
- Rigors
- Herpes labialis
- Tachypnoea
- Crackles
- Rub
- Cyanosis
- Hypotension
How can pneumonia be investigated?
- Blood culture
- Serology (blood and sputum)
- Arterial gases
- Full blood count
- Urea
- Liver function
- CXR
Describe the CURB65 severity score
Each of the criteria below account for one point
As the score increases, mortality increases
If COPD is also present, mortality is increased by 10%
- C - new onset of confusion
- U - urea > 7mmol/l
- R - respiratory rate > 30/min
- B - blood pressure systolic < 90 or diastolic <61
- 65 - aged 65+
Score: 0 (0.6%), 1 (2.7%), 2 (6.8%), 3 (14.0%), 4 (27.8%), 5 (27.8%)
What is likely to cause death in a patient with pneumonia?
Bacteraemia and sepsis
What are severity markers for pneumonia besides the CURB65 score?
Temperature <35 or >40
Cyanosis PaO2 < 8kPa
WBC <4 or >30
Multi-lobar involvement
Whcih pathogens may be involved in pneumonia?
- Streptococcus pneumonia
- Haemophilus influenzae
- Staph aureus
- Legionella pneumophilia
- Gram negative bacteria
- Mycoplasma pneumonia
What are some complications of pneumonia?
- Respiratory failure
- Pleural effusion
- Empyema
- Death
If pneumonia is classified based on location of infection, what are the three categories?
- Community acquired
- Hospital acquired
- Aspiration
What is the most common bacterial pneumonia?
Pneumococcal pneumonia
Caused by streptococcus pneumoniae
How is pneumococcal pneumonia treated?
- Amoxicillin
- Benzylpenicillin
- Cephalosporin
What will a chest X-ray likely show for pneumococcal pneumonia?
Lobar consolidation
What is staphylococcal pneumonia?
Caused by staph aureus
Affects young, old, IV drug users or patients with an underlying condition most
How is staphylococcal pneumonia treated?
Flucloxacillin and potentiall rifampicin
If MRSA is present consider vancomycin