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Human Disease > Respiratory Tract Infections > Flashcards

Respiratory Tract Infections Flashcards

1
Q

Name three main groups of respiratory tract infections

A

Upper respiratory tract infections

Bronchitis

Pneumonia

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2
Q

What anatomy is affected in upper respiratory tract infections?

A

pharynx, larynx, trachea

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3
Q

Which are mainly caused by bacteria / viruses?

  • Upper respiratory tract infections
  • Bronchitis
  • Pneumonia
A

Upper respiratory tract infections

  • viral
  • if bacterial - may be quinsy, acute sinusitis

Bronchitis
- viral (90%)

Pneumonia
- bacterial

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4
Q

What treatment is recommended for viral upper respiratory tract infections?

A

No specific treatment. Rest

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5
Q

Which upper respiratory tract infections are more serious?

A

Bacterial ones, eg quinsy, acute sinusitis

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6
Q

What is quinsy?

A

upper respiratory tract infection
caused by bacteria
a peritonsillar abcess
follows tonsillitis

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7
Q

What are symptoms of quinsy?

A

unilateral sore throat
painful to swallow (odynophagia)
systemic upset / feel unwell
hot potato voice

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8
Q

What is treatment for quinsy?

A

surgical insertion and drainage (of abcess)

antibiotics

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9
Q

What causes acute sinusitis?

A

Often viral, sometimes bacterial

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10
Q

What are symptoms of acute sinusitis?

A

facial pain, headache, toothache

fever, malaise, nasal symptoms, post-nasal drip

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11
Q

What is a complication of acute sinusitis?

A

Brain abcess

therefore ensure acute sinusitis is treated properly

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12
Q

What is treatment for acute sinusitis?

A

Antibiotics is severe / persistant

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13
Q

What are common upper respiratory tract infections in children?

A

Acute epiglottitis

Croup

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14
Q

What causes acute epiglottitis?

A

Haemophilus influenzae B

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15
Q

What is prevention for acute epiglottitis?

A

vaccination for haemophilus influenzae B

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16
Q

What is croup?

A

acute obstructive laryngo-tracheo-bronchitis

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17
Q

What causes croup?

A

virus

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18
Q

Why are children more at risk of fatal respiratory tract infections?

A

they have narrower airways - easier to block if issue

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19
Q

What is main symptom in children with upper respiratory tract infections?

A

Stridor - inspiratory sound (because in upper airway, therefore sound made in larynx)

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20
Q

Which disease should you never examine the patient’s throat / mouth?

A

Children with acute epiglottitis

  • risk of actue fatal upper airway abstruction
  • ie block airway when airway tipped backwards
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21
Q

What should you do as a dentist if suspected acute epiglottitis?

A
  • admit to hospital

- DO NOT examine throat

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22
Q

What are symptoms of acute epiglottitis?

A

fever, drooling (hard to swallow), stridor

- in a child

23
Q

Name the lobes in left / right lung?

A

Left = upper and lower lobe

Right = upper, middle and lower lobe

24
Q

What is best treatment for bronchitis?

A

Rest and fluids
Takes 12-13 days to recover (same if AB taken)

If COPD, asthmatic:
- give AB

25
Q

Why should pt with COPD be given AB for bronchitis?

A

They have a lower respiratory reserve.

ie our airways are wider, therefore we have a higher reserve if we become ill and our airways narrow.

26
Q

What are main causes of bronchitis?

A

H. influenzae

S. pneumoniae

27
Q

What are symptoms of bronchitis?

A

cough and spit

28
Q

What medication is given for bronchitis?

A

Amoxycillin or Clarithromycin

If allergy, give Doxycycline

29
Q

Why aren’t AB given for all respiratory tract infections?

A
  • increase cost / resistance / side effects
30
Q

What is the main worry about NOT giving AB to treat a respiratory tract infection?

A

If it’s pneumonia - could be rapidly fatal if not diagnosed / treated

31
Q

What is pneumonia?

A

acute respiratory illness
involving alveoli - fill with organisms, exudate = lung consolidation
often bacterial

32
Q

What are lower respiratory tract infections?

A

Bronchitis

Pneumonia

33
Q

Why can pneumonia be rapidly fatal?

A

Impaired gas exchange

Bacteraemia - sepsis - kidney / lung damage

34
Q

What does histology look like in pneumonia?

A

alveoli filled with cells, not air

35
Q

What does xray look like in pneumonia?

A

White clouds where alveoli filled
Air filled bronchi still visible
Shadowing

36
Q

What are symptoms of pneumonia?

A

Cough, PLUS:

  • tachypnoea
  • pleuritic pain (esp on inhalation, sharp pain)
  • new focal signs in chest (abnormal sounds)

esp if systemically unwell (fever, rigor, tachycardia, sweating)

37
Q

Why can pleuritic pain be an issue in pneumonia?

A

Bacteria has travelled from

alveoli - pleura - pleuritic space

38
Q

When should treatment for respiratory tract infections start?

A

ASAP (before organism is known - tests may not be conclusive)

39
Q

How can organisms be identified in respiratory tract infections?

A
  • sputum culture (high sensitivity, low specificity)
  • blood culture (high specificity, low sensitivity)
  • bronchoalveolar lavage / percutaneous aspirate - rare
  • antibody titres (retrospective)
40
Q

What is bronchoalveolar lavage?

A
  • insert bronchoscopy tube into lungs
  • squirt fluid into small part of lung
  • collect this fluid for analysis
  • rare, but used in lung disease diagnosis
41
Q

What is percutaneous aspirate?

A
  • needle access via skin into lungs
  • aspirate sample of lung using needle
  • analysis sample to diagnose lung disease
42
Q

What is an antibody titre?

A
  • test that measures antibodies in blood

- used in lung disease diagnosis

43
Q

What specific symptoms relate to different organisms causing pneumonia?

A

NONE!
There are no symptoms / signs / xray changes associated with different pneumonia-causing organisms.

Organisms present often depends on method of disease contraction

  • community acquired
  • hospital acquired
  • aspiration pneumonia
  • immunocompromised
44
Q

How can pneumonia be acquired?

A
  • community acquired
  • hospital acquired
  • aspiration pneumonia
  • immunocompromised
45
Q

What is aspiration pneumonia?

A

If pt is unconscious, they can inhale vomit.

  • no cough reflex
  • organism often from oral cavity
46
Q

What % bacteria / viruses cause community acquired pneumonia?

A 
Streptococcus pneumoniae 60-75%
Haemophilus influenzae 4-5%
Legionella Sp 2-5%
Chlamydia Sp 7-16%
Mycoplasma pneumoniae 5-18%

Viruses 4-12%

47
Q

Is streptococcus pneumoniae gram +ve / -ve?

A

gram +ve

48
Q

Which community acquired organisms can penicillin combat?

A

Strep. pneumoniae

Haemophilus influenzae

49
Q

Which community acquired organisms can clarithromycin combat?

A

Atypical organisms:
Legionella Sp
Chlamydia Sp
Mycoplasma pneumoniae

50
Q

Which groups of antibiotics and specific antibiotics are used in treatment of community acquired pneumonia?

A

Penicillin

  • benzylpenicillin
  • amoxycillin

Macrolides

  • erythromycin
  • clarithromycin
51
Q

Which bacteria are penicillins most effect against?

A

Streptococcus pneumoniae

52
Q

Which bacteria are macrolides most effect against?

A

Atypical organisms:
Legionella Sp
Chlamydia Sp
Mycoplasma pneumoniae

53
Q

What type of antibiotic would you give a young child with respiratory tract infection?

A

Macrolides (clarithromycin / erythromycin)

- young ppl usually have atypical organisms.

54
Q

What is a good combination of antibiotics to give in community acquired pneumonia treatment and why?

A

amoxycillin and clarithromycin

  • covers range of bacteria causing community acquired pneumonia
  • amoxycillin is well absorbed and has a broader spectrum

Human Disease (10 decks)

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