Respiratory tract infections Flashcards
What is the clinical presentation of influenza?
Fever Malaise- feeling uneasy Myalgia- muscle pain headache Cough Prostration
What are the types of ‘classical’ flu viruses?
Influenza A
Influenza B
What is a type of ‘Flu-like’ illnesses?
parainfluenza viruses
How can flu be transmitted?
Droplets/direct contac
when is influenzal pneumonia likely to be seen?
In pandemic years
What pneumonia are associated with flu?
Primary influenzal pneumonia
secondary bacterial pneumonia
who is at risk of primary influenzal pneumonia?
yound adults
who is at risk of secondary bacterial pneumonia?
infants, elderly, debilitated, pre-existing disease, pregnant women
What is the symptomatic treatment of flu?
bed rest
fluids
paracetamol
what are some antivirals for flu?
Osetamivir
Zanamivir
when do NICE say antivirals should be given?
to patients at risk of complications when flu is circulating/ early in disease
What is the main cause of epidemics?
antigen shift
What is the genome of influenza like?
multiple segments
what factors can bring about new flu strains?
Antigenic shift
segmented genome
animal reservoir
which flu is associated with birds?
Avian flu
How do you confirm flu in a lab?
mostly by PCR
antibody detection
What types of vaccines can be used to prevent flu?
Killed vaccine
Live attenuated vaccine (Given to children aged 2-17)
Antivirals
What bacteria are associated with community acquired pneumonia?
Mycoplasma pneumoniae
Coxiella burnetii
Chlamydophila psittaci
What caused Q fever?
coxiella burnetii
which bacteria is associated with sheep and goats?
coxiella burnetii
what is a complication of coxiella burnetii?
Culture negative endocarditis
what animals can spread pneumonia?
parrots, budgies, cockatiels
what are the clinical presentations of brochiolitis?
age 1 or 2 fever coryza cough wheeze
(sometimes grunting, decreased PaO2, intercostal/sternal indrawing)
what age groups have the highest incidence of mycoplasma pneumoniae?
Children
Young adults
what are complications of bronchiolitis?
Resp/cardiac failure
what causes 80% of bronchiolitis?
Resp. syncytial virus
what are some good ways to prevent nosocomial spread?
Cohort nursing
Hand washing, gowns, gloves
what virus affects most children by age of 5?
metapneumovirus
What’s is chlamydia trachomatis?
STI causing infantile pneumonia
diagnosed by PCR on urine/ throat swabs on child
What’s the difference between colonisation and infection?
Colonisation= presence of organism Infection= inflammation as a result of colonisation
What are some URT defences?
Nasal hairs Cilliated epithelia IgA Saliva Cough
What are some Gram +ve colonisers in URT?
Strep pneumoniae
Strep pyogenes
Staphylococcud aureus
What are some Gram -ve colonisers in URT?
Haemophilus influenzae
moraxella catatrrhalis
what are some conducting airway defences?
mucocilliary escalator
cough
AMPs
When can conducting airways occur?
Large ammount of bugs
strong bugs
immunity low
trauma
What are clinical findings of Acute bronchitis?
Normal CXR
infection and inflammation of bronchi
productive cough
possible wheeze/fever
What are microbiological findings of acute bronchitis?
preceded by UTR infection
normal chest examination and CXR
sometimes whooping cough
What bacteria is associated with whooping cough?
Bordetella Pertussis
How long does pertussis cause a cough for?
3 weeks.
post bacterial afterwards
How would you describe a whooping cough?
Paroxysmal coughing
How would you diagnose whooping cough?
bacterial culture
PCR
Serology
Clinical signs and symptoms
What is FFP3?
Filtering face piece 3
Which RTIs are associated with airborn transmition?
TB
some viruses
What bugs are associated with CF?
Staph. aureus, haemophilus influenzae, strep. pneumonae, pseudomonas aeruginosa, burkholderia cepacia etc.
What are some LRT defences?
alveolar lining fluid
alveolar macrophages and neutrophils
What are clinical presentations of community acquired pneumonis/
cough increased sputum chest pain dyspnoea fever CXR with infiltrates
what is the most common bug for community acquired pneumonia?
Strep. pneumoniae
how would you diagnose community acquired pneumonia?
Sputum culture
purulence
viral PCR
What increases risk of pneumonia?
smoking
age
immunocompromise
What is typical pneumonia?
Quick onset
symptoms all in the lung
strep. pneumoniae
what is atypical pneumonia?
not strep. pneumoniae
rash/diarrhea/headache
What’s aspiration pneumonia?
when bugs from the mouth get infected in the lungs
What’s the best way to diagnose Legionella?
PCR
What treatments are available for legionella pneumonia?
Clarythromycin
Erythromycin
Ouinolones (C antibiotic)
Where is legionella likely to be found?
warm water
Who’s at risk of legionella?
over 55 diabetes smoking malignancy altered immunity
What is walking pneumonia?
usually young person, non productive cought, malaise, myalgia
CXR shows pneumonia but they don’t feel too sick
can get a rash (TARGET LESSION)
why can’t amoxicillin be used for walking pneumonia?
organism has no cell wall
What group of people are more likely to get staph aureus pneumonia?
Iv drug abusers
What is relative bradycardia associated with?
Legionella
mycoplasma
tularaemia
chlamydia
What are some pulmonary infiltrates with eosinophilia?
Parasites Brucella Endemic mycoses Psittacosis TB
