Respiratory Tract Infections Flashcards
How do each type of respiratory tract infections present?
Upper: cough, sneezing, runny nose, headache
Lower: productive cough, muscle ache, wheezing, fever, fatigue
Pneumonia: chest pain, blue tinting of lips, high fever
What are the risks of pneumonia?
Smoking
Poverty
Inhaled corticosteroids
COPD
Asthma
Contact with children
What are the most common viral and bacterial infections causing pneumonia?
Where are the bacteria that cause pneumonia commonly found?
What do they turn into?
Rhinovirus
Influenza A or B
Respiratory syncitial virus
Coronavirus
Streptococcus pneumoniae- opportunistic pathogen, gram +
Mycobacterium tuberculosis
Commensally in the microbiota but turns into pathobiont
What are the mechanisms of damage of pneumonia?
What two things can it lead to?
Inflammation of bronchioles- bronchitis
Pneumonia- inflammation of alveoli
Arterial hypoxia
Bacteremia- organ infection
Systemic inflammation
All end in organ disfunction
Sepsis or ARDS
What is the grading potential for pneumonia?
CURB65
C= confusion
U= urea
R = respiratory rate > 30bpm
B = blood pressure < 90 systolic
65 = 65 or older
0 can be treated at home
1-2 moderate severity consider hospital
3-4 high severity urgent hospital admission
What are the treatments for bacterial pneumonia?
How do penicillins and macrolides work?
CURB-65 0 = Amoxicillin (give clarithromycin if allergic to penicillin)
CURB 65 1-2 = Amoxicillin + clarithromycin
CURB 65 3-5 = Benzylpenicillin IV + clarithromycin
Amoxicillin - penicillin: bind to bacterial wall to prevent protein synthesis
Clarithromycin - Macrolides: bind to ribosomes to prevent protein synthesis
Oxygen and Fluids
What is the difference between an opportunistic pathogen and a pathobiont?
Opportunistic pathogen- microbe that takes advantage of change in environment
Pathobiont- microbe that starts commensal but if found in the wrong environment can cause pathology
How is the respiratory epithelium equipped for defence (5)?
Tight junctions- prevent systemic infection
Mucous lining- prevents microbe attachment
Antimicrobials- recognise and neutralise microbes
Pathogen recognition receptors
Interferon pathways- activated by viral infections and promote apoptosis
What is viral tropism?
Where are IgA and IgG most common in the nasobronchial tract?
How do these two relate?
Certain virus’ are more likely to infect certain part of the respiratory tract
Nose(epithelium)- IgA
Alveoli- IgG
Different virus’ need different antibodies
What is the most common cause of asthma and COPD exacerbation?
Rhonovirus
What are the two types of acquired pneumonia?
What is the most common type of bacteria that causes it?
Community acquired and Hospital acquired
Community- streptococcus pneumoniae
Hospital-staphylococcus aureus
What are the risk factors and presentation of RSV bronchiolitis in infants?
Risk factors: premature birth, congenital heart/lung disease
Presentation: wheezing, cyanosis, tachypnoea (rapid breathing), chest wall retraction
