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Section 4F Respiratory Conditions > Respiratory Tract Infections > Flashcards

Respiratory Tract Infections Flashcards

1
Q

What are the 5 types of upper respiratory tract infections?

A
  1. Infective rhinitis (common cold)
  2. Influenza
  3. Pharyngitis (sore throat)
  4. Laryngitis
  5. Acute laryngotracheo-bronchitis (croup)
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2
Q

What are the 4 types of lower respiratory tract infections?

A
  1. Influenza
  2. Pertussis (whooping cough)
  3. Tuberculosis
  4. Pneumonia
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3
Q

What are the divisions of the upper and lower respiratory tracts?

A

Larynx & above: upper

Trachea & below: lower

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4
Q

Describe infective rhinitis

A

Common cold (URTI)

  • caused by many viruses
  • virus infects nasal epithelium and causes inflammatory reaction

SSX:

  • gradual onset
  • rhinorrhea
  • mild cold SSX
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5
Q

Describe pharyngitis

A

Sore throat (URTI)

  • usually viral (adenovirus or influenza)
  • sometimes bacterial (strep)

SSX:

  • sore throat
  • Cx lymphadenopathy
  • maybe pain and aches
  • bacterial: mucoprurulent discharge
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6
Q

Describe laryngotracheo-bronchitis

A

Croup (URTI)

Viral (influenza, parainfluenza, RSV in children)

Virus destroys epithelial cells, inflammatory reaction reduces lumen of airways

SSX:

  • barking cough becoming nocturnal
  • inspiratory stridor
  • cold SSX

Emergency SSX:

  • cyanosis
  • pallor

Common in young children 3 mths - 6 years

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7
Q

Describe pertussis

A

Whooping cough (LRTI)

Viral (bordetella pertussis)

Virus colonizes LRT epithelium, inhibiting immune response and paralyzing cilia (mucus buildup)

SSX:
Stage 1 (Inflammatory) - hacking night cough becoming diurnal

Stage 2 (Paroxysmal) - paroxysms of coughing followed by whoop

Stage 3 (Convalescent)

Highly contagious notifiable disease

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8
Q

Describe tuberculosis

A

TB / Consumption (LRTI)

Viral (mycobacterium tuberculosis)

Primary:
- TB causes caseous necrosis & granuloma formation (primary lesions)

Progressive Primary:

  • lesions become active
  • miliary TB

Secondary:

  • new infection
  • reactivation of lesions without miliary TB

Progressive Secondary

  • lesions active
  • miliary TB

Notifiable disease
Long latency period
Often asymptomatic

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9
Q

Describe pneumonia

A

Any condition involving inflammation of lung tissue

Viral / bacterial / aspiration

Classifications:
Typical (strep / staph)
Atypical (legionairre’s, mycoplasma / walking, viral)

Consolidation:

  • lung tissue fills with fluid
  • causes swelling / hardening of lung tissue, decreases compliance of lungs, decreases tidal volume, decreased gaseous exchange at respiratory membrane

SSX (typical):

  • fever
  • pain
  • tachycardia
  • facial flushing
  • dry cough becoming productive
  • dyspnoea
  • tachypnoea

Signs (typical):

  • dull percussion (consolidation)
  • increased vocal resonance
  • crepitations
  • pleural rub
  • high pitched bronchial sounds
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10
Q

Describe influenza

A

Can affect the upper or lower respiratory tract

Viral (influenza A, B, C)

Virus enters respiratory epithelium & replicates viral cells, causing cell necrosis & desquamation of respiratory tract

SSX:

  • acute onset
  • fever and chills
  • aches and pains
  • fatigue
  • maybe nausea, vomiting

Contagious
Virus mutates so vaccine not lasting

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11
Q

How is infective rhinitis spread?

A

Secretions (hands, coughing, sneezing)

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12
Q

What are the key differences between infective rhinitis and influenza?

A

Pathology:

  • influenza causes cell necrosis and desquamation of the respiratory tract, and can therefore be fatal
  • influenza virus enters respiratory epithelium and causes epithelial cells to replicate viral host cells

SSX:

  • influenza: acute onset
  • SSX much more severe in influenza
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13
Q

Is viral or bacterial pharyngitis more common? And which viruses and bacteria can cause pharyngitis?

A

Viral more common:

  • adenovirus, influenza
  • Epstein Barr (EBV)

Bacterial less common:

  • strep
  • pertussis (whooping cough)
  • diptheria, gonorrhea, clamydia
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14
Q

What are the observable differences between croup and whooping cough?

A

Croup:

  • URTI
  • cough begins diurnal and then becomes nocturnal
  • cough barking but doesn’t occur in paroxysms
  • inspiratory stridor, but not in the pattern of a ‘whoop’ following paroxysmal coughing

Whooping Cough / pertussis:

  • LRTI
  • cough begins nocturnal then becomes diurnal
  • paroxysms of coughing followed by an inspiratory ‘whoop’ (key observable pattern)

Whooping cough a notifiable disease: highly contagious with an incubation period of 7-17 days

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15
Q

What are signs warranting emergency referral in croup?

A
  • intercostal retraction
  • cyanosis
  • pallor
  • stridor at rest
  • extreme lethargy
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16
Q

What are the 3 stages of pertussis?

A
  1. inflammatory
    - insidious onset of symptoms
  2. paroxysmal
    - nature of cough changes to distinctive paroxysms / whoop pattern
  3. convalescent
17
Q

How does bordetella pertussis (B pertussis) affect the body in pertussis / whooping cough?

A
  • colonizes lower respiratory tract epithelium
  • inhibits neutrophils and macrophages from performing immune function
  • paralyzes cilia
18
Q

What are causes of aspiration pneumonia?

A

inflammation secondary to entry to the lungs of food, fluid, vomit

19
Q

What are the different types of typical and atypical pneumonia?

A

Typical (bacterial) - caused by strep, staph

Atypical

  • mycoplasma (walking)
  • legionella
  • viral (influenza, parainfluenza, RSV)
20
Q

What are the 4 clinical signs of pneumonia?

A
  1. Percussion: dull in affected area
  2. Tactile fremitus: increased in affected area
  3. Auscultation: pleural friction, bronchial breath sounds, crackles
  4. Unilateral reduction in Tx cage expansion
21
Q

Briefly describe the 3 atypical pneumonias:

A
  1. Myocplasma
    - walking pneumonia
    - few respiratory SSX
    - mild fever, malaise
  2. Legionella / Legionnaire’s
    - sudden onset
    - fever, malaise
    - abdo pain, diarrhea
    - productive cough, pleuritic pain
    (virus associated with watery environments)
  3. Viral
    - fever first symptom
    - mild respiratory SSX after a few days
    - self limiting < 10 days
22
Q

Describe the pathophysiology of primary TB

A
  1. TB microbe inhaled and settles in upper lobe of lungs

2. formation of granulomatous Ghon’s lesions is body’s immune response to limit spread of TB

23
Q

What causes TB to progress to miliary TB?

A

The spread of TB through the blood stream (enters bloodstream via pulmonary veins)

24
Q

What is a Ghon’s lesion and a Ghon complex?

A

Ghon’s lesion:

  • granuloma with a caseous necrotic core that may calcify
  • found in the foci of TB tubercles, in the bottom of upper lobes, or top of lower lobes

Ghon complex
- a Ghon’s lesion that also includes a mediastinal or hilar lymph node

25
Q

What is the testing for TB?

A

Mantoux skin testing

  • injection of dead bacilli under skin
  • Grade 3 positive = active infection
  • positive = previous exposure or vaccination
  • negative = indication to vaccinate
26
Q

What is the vaccine for TB?

A 
BCG vaccination (Bacille Calmette - Geurin)
- protects for 7 years
27
Q

What are the SSX of TB?

A

Primary: usually asymptomatic

SSX:

  • insidious onset of productive cough
  • maybe pleuritic pain
  • anorexia and weight loss
  • night sweats
28
Q

How is influenza spread?

A

Via droplets (sneezing, coughing, talking)

29
Q

How is pertussis spread?

A
  • highly contagious
  • spread by droplets
  • incubation period 7-17 days

Adults a reservoir for disease (50% of cases) as immunity not lasting - recommendation that pregnant women are vaccinated

30
Q

What is Pott’s disease?

A

Spinal tuberculosis

  • affects vertebral bodies and discs
  • causes vertebral collapse, severe kyphosis, canal stenosis
  • combination of osteomyelitis and arthritis

Section 4F Respiratory Conditions (4 decks)

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