Respiratory Tract Infections

Question 1

Types of RTI include….

Answer 1

1) Upper Vs Lower RTI
2) Virus Vs Bacteria Vs Fungus Vs Parasite
3) Atypical Vs Typical (pneumonia)

Question 2

Features of the healthy normal state…

Answer 2

Upper resp tract is NOT sterile

Lower resp tract is normally sterile

Question 3

Features of upper respiratory tract infection….

Answer 3

Common
Short lived, rarely serious
Usually viral

ONLY require antibiotics is:

1) Bacterial aetiology known
2) Systemically unwell
3) High risk features or complications

Question 4

What are the potential complications of pharyngitis (sore throat/ tonsillitis)?

Answer 4

Scarlet fever
Rheumatic fever
Post-strep glomerulonephritis

Question 5

What causes whooping cough?

Answer 5

Caused by Bordetella pertussis bacteria.

Contagious- Notifiable
Characteristic BARKING cough that can persist for weeks.

Question 6

1) Pneumonia is….
while
2) Acute bronchitis/ bronchiolitis is….

Answer 6

1) Infection of the lung tissues
2) Inflammation of bronchi

Primary difference is pneumonia has radiological changes (abnormal CXR)

Question 7

What is Kartagener syndrome?

Answer 7

Also known as Primary Ciliary Dyskinesia (PCD).

A rare ciliopathic, autosomal recessive genetic disorder.

It causes defects in the action of cilia lining the respiratory tract, fallopian tube, and flagellum of sperm.

Question 8

What common pathogen causes infection of the epiglottis?

Answer 8

Haemophilus influenzae

Nearly completely disappeared due to vaccine.
Can cause respiratory distress –> must avoid manipulation of throat.

Question 9

Three main viruses in upper respiratory tract infections are…

Answer 9

1) Influenza/ parainfluenza
2) Respiratory Syncytical Virus
3) Novel coronavirus

Question 10

What are the two main types of novel coronaviruses?

Answer 10

1) Severe Acute Respiratory Syndrome (SARS)

2) Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

Question 11

What is Bronchopneumonia?

Answer 11

Inflammation of the lungs, arising in the bronchi or bronchioles.

Diffuse/patchy, bilateral, asymmetric usually affects both lower lobes.

Question 12

Streptococcus pneumoniae is…

Answer 12

Gram positive cocci in pairs.

Most common cause of community acquired pneumonia.

Question 13

What is CURB-65?

Answer 13

Confusion of new onset 
Urea >7mmol/l
Respiratory rate > 30 breaths/min 
Blood pressure <90mmHg systolic or <60mmHg diastolic 
65 years older

Question 14

What do you need to consider when prescribing antibiotics for 1) the initial prescription 2) review at 24 hours?

Answer 14

1) Reason, Route, Dose, Duration

2) Continue, Cancel, Convert to oral