respiratory tract infections Flashcards
TABLE
common cause of
a. upper RTIs
b. lower RTIs, pneumonia
a. upper RTIs: virus
b. lower RTIs, pneumonia: bacteria
name 2 life threatening URIs in children
acute epiglottitis
croup
what is the key symptom of these URIs in children
stridor (wheeze on inspiration)
why are these more dangerous in children than adults
smaller airways, easily blocked
which serious URI in children is now rare and why
acute epiglottitis, due to influenza vaccine
name lobes of L and R lung
L: upper and lower
R: upper, middle, lower
which bronchi is steeper and why
right, heart not in the way
what causes shadow on chest x ray in pneumonia
alveoli fill with organisms and inflammatory exudate –> consolidation
2 poss complications of pneumonia
impaired gas exchange (hypoxia)
bacteraemia
what can be used to identify organism responsible for pneumonia 4
pros/ cons of each
- sputum culture (high sensitivity, low specificity)
- blood culture (low sensitivity, high specificity)
- bronchoalveolar lavage/ percutaneous aspirate (rare)
- antibody titres (retrospective)
is tx for pneumonia usually started before or after organism is known
before
4 condtions that predispose to aspiration
- impaired consciousness (alcohol, seizures, GA)
- dysphagia (mechanical/ neurological)
- nasogastric and endotracheal tubes
- periodontal disease, gingivitis
describe bacterial flora of the mouth
90% anaerobes
10% aerobes- mainly gram positive cocci
name 4 types of pneumonia
community acquired
hospital acquired
aspiration
immunocompromised host
expected cure time for pneumonia
fever- few days
x ray- 4-6 weeks
what to suspect if pneumonia does not heal 3
- wrong antibiotic
- complication eg empyema, lung abscess
- additional underlying disease
tx of lung/ pleura abscess
drain
what is slowly resolving or recurrent pneumonia a sign of 3
- bronchogenic carcinoma
- myeloma
- unusual organisms caused by immunodeficiency eg P carinii in AIDS
Transfer to hospital if 4:
Transfer to hospital if 4:
- respiration rate >30/min
- cyanosis
- confusion
- hypotension (systolic BP
