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Respiratory System > Respiratory Tract Infections > Flashcards

Respiratory Tract Infections Flashcards

1
Q

A hot feverish drooling child is a medical emergency because they may have?

A

Epiglottitis

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2
Q

Symptoms of sinusitis is?

A
  • Frontal headache
  • Retro-orbital pain
  • Maxillary sinus pain
  • Tooth ache
  • Discharge
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3
Q

Characteristic sign of diphtheria?

A

Pseudo-membrane at back of throat

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4
Q

In what people can acute bronchitis cause problems

A

Those already with lung diseases for example it can cause an exacerbation of COPD

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5
Q

Management of an exacerbation of COPD?

A 
Ipatropium
Salbutamol
Oxygen 
Amoxicillin
Prednisolone
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6
Q

List some symptoms and signs of pneumonia?

A
  • Cough (usually productive but can be dry)
  • Breathlessness
  • Fever
  • Chest Pain
  • Myalgia, arthralgia and malaise
  • Headache
  • Abdo pain, diarrhea and vomiting (ATYPICAL SIGNS)
  • Can get herpes simplex reactivation in Strep Pneumonia
  • Skin rashes in Mycoplasma
  • In elderly may become confused
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7
Q

Explain CURB65

A 
C  	New onset of confusion
U  	Urea >7
R  	Respiratory rate >30/min
B  	Blood pressure Systolic <90  OR  Diastolic <61
65 	age 65 years or older
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8
Q

Management of CURB65 0-2 Pneumonia?

A

Amoxicillin orally

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9
Q

In hospital acquired pneumonia what bacteria are you more likely to get?

A

Gram negative

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10
Q

Two antivirals given for the flu?

A

Oseltamivir and zanamivir

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11
Q

Pneumonia is….

A

a lower respiratory tract infection with new consolidation on X-ray

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12
Q

Lobar pneumonia is ____ and is usually caused by _______

A

• Confluent consolidation involving a complete lung lobe

Streptococcus pneumoniae

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13
Q

Bronchopneumonia is ____ and is most often seen as _____

A

Infection starting in airways and spreading to adjacent alveolar lung
Complication of pre-existing lung or cardiac disease

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14
Q

A lung abscess is _____, it leads to _______ and is difficult to treat because ______

A

Localised collection of pus, tumour like
Chronic malaise and fever
Antibiotics don’t penetrate very well

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15
Q

Bronchiectasis is _____ usually due to ____ and can cause __________

A

Abnormal fixed dilatation of the bronchi
Fibrous scarring following infection
Chronic Infections and pus

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16
Q

What type of bacteria causes TB?

A

Mycobacteria Tuberculosis

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17
Q

Primary TB occurs in?

A

Patients, usually children who have not been previously exposed to TB or vaccinated against it.

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18
Q

Tissue changes in primary TB include?

A

Small focus (Ghon focus) in periphery of mid zone of lung and large hilar nodes (granulomatous)

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19
Q

Secondary TB is ____ and results in ____

A

This is a recurrence of TB in later life- either reactivation or reinfection.
The patients have immunity to TB and develop a cellular response leading to caseation.

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20
Q

Typical pneumonia is caused by ____ this bacteria is ______ its key virulence factor is its ___

A

Strep pneumoniae
Alpha haemolytic, gram positive cocci
Capsule

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21
Q

CURB65 score 3-5 treatment?

A

Co-amoxiclav + doxycycline orally

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22
Q

One of the very few times you can use a quinolone (ends in floxacin) is? Two other antibiotics used are?

A

Legionella infection

Clarithromycin and erythromycin

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23
Q

Walking pneumonia is caused by _____ and _____ is not used as the bacteria don’t have cell walls

A

Mycoplasma pneumoniae

Amoxicillin

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24
Q

Although less common than strep pneumoniae the bacteria _____ can also occur post influenza and is treated with _______

A

Staph pneumoniae

flucloxacillin

25
Q

HAP pneumonia non severe treatment?

A

Amoxicillin orally

26
Q

MTB are ….

A

rod shaped gram positive bacilli

27
Q

Describe Primary TB infection

A
  • Primary infection occurs in those who have not been previously exposed to TB or vaccinated against it
  • A small Ghon focus at the periphery of the lung is the site of infection and there is lymphatic spread to the hilar lymph nodes, some caseous masses may form
  • In most patients the lesions undergo fibrosis or calcification and heal
  • Spread however can occur
28
Q

Risk factors for TB?

A
  • Babies, young adults, old people.
  • Immigrants
  • People who live in deprivation
  • Immuno-supressed people
29
Q

Lymph node TB is _____ controlled and on scan you will see ____ Miliary TB is _____ controlled and on scan you will see ____

A

well
enlarged lymph nodes
poorly
little dots all over lungs

30
Q

Name two stains that can be used in the identification of mycobacteria

A

Auramine

Zhiel Neelson will turn acid fast bacilli red

31
Q

Treatment of active TB?

A
  • 4 drugs for 2 months: Rifampicin, Isoniazid Pyrazinamide, ethambutol
  • 2 drugs for a further 4 months: rifampicin, isoniazid.
  • All these drugs have side effects so need good reason to give out these drugs.
32
Q

Treatment of latent TB?

A
  • 2 drugs for 3 months: rifampicin, isoniazid
  • For further 3 months: isoniazid
  • Problem with convincing people to take these drugs as they have no symptoms and can’t take the pill etc.
33
Q

Every time you see someone with chronic infections you should check for?

A

HIV

34
Q

What does intrapulmonary abscess usually precede?

A

Illness of some sort such as pneumonic infection, post viral infection, inhaled a foreign body

35
Q

Empyema is…

A

pus in the pleural space

36
Q

How do you detect empyema?

A

Patients will have a slow to resolve pneumonia
Then need CXR
USS- preferred investigation but not always needed
CT to differentiate between empyema and abscess
Detection of complicated pleural effusion requires sampling

37
Q

Treatment of empyema?

A
  • IV antibiotics, broad spectrum- amoxicillin and metronidazole
  • Oral antibiotics directed towards cultured bacteria 5 weeks usually co-amoxiclav (here you can give it!!!)
38
Q

Bronchiectasis is and can lead to?

A
  • Localised irreversible dilation of the bronchial tree
  • Involved bronchi are dilated, inflamed and easily collapsible
  • Can lead to airflow obstruction and impaired clearance of secretions
39
Q

How will patients with bronchiectasis present?

A
  • Recurrent chest infections
  • Recurrent antibiotic prescriptions
  • Short lived response to antibiotics
  • Persistent sputum
40
Q

Explain chronic bronchial sepsis?

A

There are recurrent infections but no bronchiectasis. Often younger patients, mainly women, often involved in childcare. Others are older with COPD, or airways disease
Same work up as bronchiecstasis

41
Q

Treatment options for bronchiectasis?

A
  • Stop smoking
  • Flu vaccine
  • Pneumococcal vaccine
  • Reactive antibiotics
  • When colonised with persistent bacteria- most successful seems to be low dose macrolides clarithromycin, azithromycin.
42
Q

Systemic signs of CF?

A
  • Salty Sweat
  • Intestinal Blockage
  • Fibrotic Pancreas
  • Failure to Thrive
  • Recurrent Bacterial Lung Infections
  • Congenital Bilateral Absence of Vas Deferens (male infertility)
  • Filled Sinuses
  • Gallbladder and Liver disease
43
Q

What is the most common mutation in CF patients?

A

delta F508

44
Q

Treatment of severe HAP?

A

IV Amoxicillin + Gentamicin

45
Q

5 categories you test for CF?

A
  • Anyone who has bronchiecstasis and under the age of 40
  • Anyone presenting with upper lobe bronchiecstasis
  • Colonisation with staph
  • Infertility
  • Low weight
46
Q

What is a potential drug treatment for Cf that is very expensive?

A

Ivacaftor

47
Q

Is it okay to prescribe broad spectrum antibiotics to those with CF?

A

Yes!

48
Q

Right sided endocarditis is associated with?

A

Drug users

49
Q

Coxiella burnetti causes….

A

pneumonia and pyrexia of unknown origin

50
Q

Mycoplasma pneumonia is….

A

community acquired and seen in older children and young adults

51
Q

Haemophilus influenzae…

A

causes pneumonia, acute epiglottis, exacerbations of COPD and is gram neg and cultured on chocolate agar.

52
Q

Infects children, with peak incidence in winter. May be secondary to another infection, and can cause mild to severe illness, which may be flu-like. Diagnosis is confirmed by PCR.

A

Metapneumovirus

53
Q

Fungal lung infections are …

A

Often opportunistic, these organisms tend to affect immunocompromised patients and are usually caused by inhaled spores or reactivation of latent disease.

54
Q

Tuberculosis drug side effects

A

Rifampicin stains body secretions pink-orange
Pyranzamide- joint pain
Isonnizaid- peripheral neuropathy
Ethambutol- problems with eyesight

All four can have bad effect on the liver

55
Q

Describe secondary TB infection?

A
  • This is a recurrence of TB in later life due to reactivation or reinfection
  • Reactivation can occur due to subtle immunosuppression such as old age, or other health conditions or due to immunosuppressive medication or HIV
  • Patients with secondary infection already have immunity to TB and develop and cellular response and caseation
56
Q

What is aspiration pneumonia? Why does it occur?

A
  • This occurs due to inhalation of food or infected material from the mouth or oropharynx
  • May be a complication of anaesthesia, coma or occur in conditions where there is frequent reflux e.g. oesophageal obstruction or poor swallowing due to motor neurone disease or stroke
57
Q

Treatment of non severe aspiration pneumonia?

A

Amoxicillin and Metranidazole orally

58
Q

Treatment of severe aspiration pneumonia?

A

IV Amoxicillin, Gentamicin and Metranidazole

Respiratory System (16 decks)

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