Respiratory Tract Infections Flashcards

1
Q

Conditions of URT?

A

Common cold - AKA coryza (nose is less effective at filtering out pathogens in cold weather so viruses can multiply)
Sore throat - pharyngitis
Sinusitis
Epiglottitis

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2
Q

Conditions of LRT?

A

Acute bronchitis
Acute exacerbation of chronic bronchitis
Pneumonia
Influenza

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3
Q

What is the common cold, spread and symptoms?

A

Acute viral infection of nasal passages and is often accompanied by a sore throat and a mild fever; no treatment and is self-limiting
Spread by droplets and fomites

Complication - sinusitis, acute bronchitis

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4
Q

Causes of common cold?

A

Adenovirus
Rhinovirus
Respiratory Syncytial Virus

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5
Q

Describe acute sinusitis

A

Preceded by a common cold and produces purulent nasal discharge (mostly viral aetiology)
Usually self-limited and resolve in 10 days but some need antibiotics

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6
Q

What is quinsy?

A

AKA peritonsillar abscesss

A serious complication of acute tonsillitis

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7
Q

What is diphtheria?

A

Life threatening due to toxin production

CHARACTERISTIC PSEUDO-MEMBRANE that can suffocate people

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8
Q

What is acute epiglottitis?

A

In children, life threatening due to obstruction and can be caused by Haemophilus influenza B (do not use laryngoscope as it can irritate epiglottis further)

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9
Q

What is acute bronchitis and features?

A
Cold which "goes to the chest" and is preceded by a common cold
Clinical features:
Productive cough
Fever - minority of cases
Normal chest examination
Normal CXR
May have a transient wheeze
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10
Q

Treatment of acute bronchitis?

A

Usually self-limiting and antibiotics are not indicated in most people
But can lead to significant morbidity in patients with chronic lung disease

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11
Q

Intubation times for URTIs?

A

Rhinoviruses - 1-5 sayd
Group A streptococci - 1-5 days
Influenza and parainfluenza viruses - 1-4 days
RSV - 7 days
Pertussis (whooping cough) - 7-21 days
Diphtheria - 1-10 days
Epstein-Barr virus (glandular fever) - 4-6 weeks

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12
Q

Characteristics and clinical features of COPD?

A
Bronchoconstriction, inflammation of airways and chronic sputum production
Clinical features:
Usually preceded by URT infection
Increased sputum production
Increased sputum purulence
More wheezy
Breathless
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13
Q

COPD examination finds?

A
Respiratory distress
Wheeze
Coarse crackles
May be cyanosed
In advanced disease - ankle oedema
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14
Q

Management of acute COPD exacerbations in primary care and referrals?

A

Primary care:
Antibiotics, e.g: Doxycycline or Amoxicillin
Bronchodilatory inhalers
Short steroid course sometimes

Refer to hospital if:
Evidence of respiratory failure
Not coping at home - AKA acopia

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15
Q

Managing acute COPD exacerbations in hospital?

A

Same as in primary care and measure ABGs (to determine if they have Type I or II respiratory failure), CXR to look for other disease, give O2 if they have respiratory failure

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16
Q

Pneumonia definition?

A

Signs and symptoms of LRT infection with a new infiltrate on a CXR

17
Q

Pneumonia clinical features?

A

Consolidation on CXR

Red hepatisation - lung may begin to resemble liver tissue, due to release of rbcs

18
Q

Pneumonia symptoms?

A
Malaisa
Anorexia
Sweats
Rigors
Myalgia - muscle pain
Arthralgia - joint pain
Headache
Confusion
Cough 
Pleurisy - visceral pain have no pain receptors so must reach parietal pleura
Haemoptysis
Dyspnoea
Preceding URTI
Abdominal pain
Diarrhoea
Herpes labialis
Tachypneoa
Rub
Crackles
Hypotension - oral herpes due to reactivation of herpes simplex virus
19
Q

Pneumonia presentation on examination?

A
Chest expansion - reduced
Percussion note - dull
Breath sounds - bronchial
Added sounds - crackles
Vocal resonance - increased
20
Q

Pneumonia investigations?

A
Blood culture
Serology
Arterial gases
Full blood count
Urea
Liver function
CXR
21
Q

Severity score for CAP determination?

A
CURB65 - only works if patient has pneumonia
C - new onset of Confusion
U - Urea >7
R - Respiratory Rate >30/min
B - Blood pressure; systolic
22
Q

COPD effect on CURB65?

A

Each score increases in mortality by 10%

23
Q

Markers of severity in pneumonia?

A

Temp 40
Cyanosis - PaO2 30
Multi-lobar involvement

24
Q

Main cause of pneumonia?

A

Strep. pneumoniae

25
Q

Dangers of chicken pox in adults?

A

Adult smokers can get chicken pox pneumonia

26
Q

Pets in pneumonia?

A

Birds can carry Chlamydia psittaci

27
Q

Mycoplasma pneumonia patterns?

A

Peaks of activity every 4 years

28
Q

Difference between pneumonia types in young and elderly?

A

Young - Mycoplasma pneumonia

Elderly person - almost everything more common in elderly, including S. pneumoniae and H. influenzae

29
Q

Management of CAP?

A

Antibiotics like Amoxicillin and Doxycycline

Oxygen - maintain SaO2 between 94-98% or 88-92% (never 100%)
Fluids
Bed rest
No smoking

30
Q

Pneumonia complications?

A

Respiratory failure
Pleural effusion - fluid in pleural space
Empyema - pus in pleural cavity
Seath

31
Q

Management of other types of pneumonia?

A

HAP - need extended gram -ve cover
Aspiration pneumonia - need anaerobic cover
Legionella - chest symptoms may be minimal, GI disturbance is common, confusion is common

32
Q

Pneumonia prevention?

A

Influenza and pneumococcal vaccines for all over 65, those with chronic chest/cardiac disease, diabetics, immunocompromised/suppressed, e.g: splenectomy
Also, for health care workers