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Clinical Pathology > Respiratory Tract infections > Flashcards

Respiratory Tract infections Flashcards

1
Q

Which bacterial pathogens can cause upper respiratory tract infections?

A
  • Bordetella pertussis
  • Corynebacterium diptheriae
  • Haemophilus influenzae
  • Moraxella catarrhalis
  • Strep pneumoniae
  • Strep pyogenes
  • Staph aureus
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2
Q

Which viruses can cause upper respiratory tract infections?

A
  • Adenovirus
  • Epstein-Barr virus
  • Herpes simplex
  • Respiratory syncytial virus
  • Rhinovirus
  • Enteroviruses
  • Coronaviruses
  • Human metapneumovirus
  • Influenza & parainfluenza
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3
Q

What viruses can cause the common cold/coryza? With treatment what should you not do?

A
  • Mainly rhinovirus
  • Coronoviruses
  • Parainfluenza viruses
  • Enteroviruses
  • Adenovirus
  • RSV
  • DON’T GIVE ANTIBIOTICS
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4
Q

Describe Rhino-sinusitis

A
  • Facial pain, nasal blockage, smell reduction
  • From post viral infection
  • Complications: Osteomyelitis, meningitis, cerebral abscess
  • Strep pneumoniae, Haem influenzae, Strep milleri group, fungal, anaerobes
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5
Q

How is Rhino-sinusitis diagnosed & treated?

A
  • imaging for severe/ suspected complications: X-ray, CT, MRI to see air fluid levels
  • Sinus washout
  • If viral-no antibiotics
  • Amoxicillin if severe disease
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6
Q

What can cause pharyngitis/tonsillitis?

A
  • Viral= RSV, influenza, adeno, EBV, HSV1
  • Bacterial= strep pyogenes, corynebacterium diptheriae, chlamydophila pneumoniae
  • Throat swab
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7
Q

What are the symptoms of pharyngitis/tonsillitis

A
  • Dysphagia
  • Fever
  • Headache
  • Red tonsillar/uvular area
  • +/- exudate
  • Lymphadenopathy
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8
Q

Describe Group A strep infection leading to pharyngitis/tonsillitis

A
  • Common children
  • Complications: acute glomerulonephritis, rheumatic fever/scarlet fever
  • Aim to prevent rheumatic fever by giving penicillin & prevent suppurative complications
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9
Q

Describe infectious mononucleosis/glandular fever/kissing disease leading to pharyngitis/tonsillitis

A
  • Epstein barr virus
  • Teenagers & older
  • Often asymptomatic
  • Complications= splenic rupture
  • Avoid ampicillin (mac-pap rash confused with penicillin allergy)
  • Serology= IgM, IgG
  • Fever & cervical lymphadenopathy
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10
Q

What can tonsillitis/ pharyngitis lead to?

A
  • Diptheria
  • Corynebacterium diptheriae
  • Malaise, fatigue, fever, sore throat
  • Immunisation, travel history
  • Erythromycin, penicillin, antitoxin
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11
Q

What other problem can occur after using broad spec antibiotics for pharyngitis/tonsillitis?

A

Thrush

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12
Q

Describe epiglottitis

A
  • Medical Emergency
  • Cellulitis of epiglottis
  • Airway obstruction
  • Child 2-4
  • Lateral neck x-ray
  • Fever, irritable, difficulty speaking/swallowing, leans forward, drools, stridor, hoarse
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13
Q

How is epiglottitis diagnosed/ treated?

A
  • Must send blood cultures
  • Don’t swab/examine unless intubated
  • Treatment mainly airway- cefotaxime
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14
Q

What is the cause of epiglottitis?

A
  • Mainly H.influenzae type B prior to immunisation

- Rarer resp bacteria & S.aureus

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15
Q

Describe acute laryngitis

A
  • Hoarse voice, globes pharynges, fever, myalgia, dysphagia
  • Viral occasionally bacteria
  • Self-limiting
  • No use of antibiotics
  • Airway patency is stridor
  • Non infective causes-voice abuse & malignancy
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16
Q

What is croup?

A
  • Acute laryngotracheobronchitis
  • Inflammation of larynx & trachea after infection
  • Children
  • Viral= parainfluenza type 2= no antibiotics only symptomatic
17
Q

Describe whooping cough

A
  • Bordetella pertussis
  • Incubation period 1-3wks
  • Initially catarrhal phase-runny nose, fever, malaise
  • Later dry non productive cough
  • PCR & pernasal swab
18
Q

What is the treatment & potential complications of whooping cough?

A
  • Supportive & erythromycin
  • Otitis media, pneumonia, often secondary infection or aspiration, convulsions, subconjunctival haemorrhage
  • Immunisation
19
Q

What is Otitis external?

A
  • Infection of external auditory canal
  • Pain, itch, swelling & erythema, otorrhoea
  • Acute OE, chronic OE, malignant OE
20
Q

Describe acute otitis externa

A
  • Skin types S.aureus & pseudomonas

- Toilet with saline & alcohol & acetic acid, topical drops contain antibiotics

21
Q

Describe chronic otitis externa

A
  • Irritation from drainage from perforated tympanic membrane
  • Itchy
  • Treat underlying cause
  • Avoid aminoglycosides if perforation
  • Resistance may form & sensitisation occurs with prolonged course
22
Q

Describe malignant otitis externa

A
  • Severe necrotizing
  • Spread from local area more deeply
  • May invade bone, cartilage, blood vessels
  • Life-threatening spread to temporal bone, base of skull, meninges & brain
  • Often pseudomonas aeruginosa
  • Severe pain, drainage of pus from canal, elderly, diabetes, immunosuppressed
  • Treat with iv ceftazidime then ciprofloxacin
23
Q

What is Otitis Media?

A
  • Middle ear inflammation
  • Fluid present in middle ear
  • Common in children
  • Fever, pain, impaired hearing, red bulging tympanic membrane
  • Viral= H. influenzae, S. pneumoniae, M.catarrhalis
  • Swab any pus discharge
  • Unwell= amoxicillin/erythromycin not unwell= symptomatic
24
Q

What is mastoiditis?

A
  • Inflammation of mastoid air cells after middle ear infection
  • Pus collects in cells and may proceed to necrosis of bone
  • Signs= pain/swelling over mastoid
  • Lower incidence after introduction of antibiotics
25
Q

How is mastoiditis diagnosed?

A
  • CT help to assess extent
  • Similar to acute OM unless gram negatives are suspected
  • Leeds first line treatment= co-amoxiclav
26
Q

What are other important features of mastoiditis?

A
  • Vincent’s angina
  • Deep fascial space infections of head & neck (ludwig’s angina, limeade’s syndrome)
  • Gingivitis/ peridontal infections
27
Q

How is mastoiditis diagnosed?

A
  • Send pus/throat swab/blood cultures
  • Gram stain
  • Culture
  • Sensitivity testing
  • Serology & antibody detection
28
Q

What is the treatment for tonsillitis?

A

Fluids
Analgesia
Strep infection: Penicillin V

29
Q

What is the centor criteria? What is it used for?

A

-Tonsillar exudate
-Absence of cough
-Hx of fever >38
-Tender anterior cervical lymphadenopathy
3/4 = empirical Abx treatment

30
Q

What is glue ear?

A

Otitis media with effusion

90% of cleft palate kids

Clinical Pathology (56 decks)

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