respiratory tract infections Flashcards
What are some URTI’s
coryza (common cold), pharyngitis, sinusitis, epiglottis, diphtheria
what are some LRTI’s
acute bronchitis, pneumonia, influenza
describe epiglottis and how to treat it
inflammation of the epiglottis, can obstruct airway and be life threatening, especially in children, endotracheal intubation and IV antibiotics
describe diphtheria
white-grey coating at back of mouth with other symptoms of infection. rare in UK but can be life-threatening due to toxin production
describe acute bronchitis
usually with COPD patients wheeze, productive cough and fever, usually self limiting, normal CXR and lung sounds, no antibiotics unless needed
which 4 viruses mainly cause common cold
adenovirus, rhinovirus, coronavirus
how does sinusitis present
runny nose, frontal lobal headache
who most commonly gets bronchiolitis and what are the symptoms
babies, coryza with fever, cough and wheeze, resp sinus virus (RSV)
what are the complications of bronchiolitis
respiratory and cardiac failure
what are the 4 main chronic RTI’s
intrapulmonary abscess, empyema, bronchiectasis (chronic bronchial sepsis), cystic fibrosis
what can cause chronic infections
immunodeficiency and immunosuppression, abnormal innate defence (damaged bronchial mucosa) and repeated insult (recurrent infection)
what can cause immunodeficiency
CVID, no lymphocytes (protected up to 3 months from IgG), Di George (no thymus T cells, hypogammaglobulin (No B), hyposplenism, HIV, cancer
what causes immunosuppression
mainly drugs eg steroids, chemo, azathioprine
what causes innate defence
damaged bronchial mucosa from smoking, pneumonia, malignancy etc, abnormal cilia (kotsmanns and youngs), abnormal secretions (CF)
what causes repeated insult
recurrent aspiration eg NG tubes
what are the symptoms of an intrapulmonary abscess and what is it
liquefactive necrosis –> cavities weight loss, lethargy, cough +/- sputum
what can cause intrapulmonary abscess, how do you identify it, how do you treat it
bacteria eg strep and staph, fungi eg aspirgillis, septic emboli, pneumonia, CT = orange, AB’s if needed
what is empyema
pus in pleural cavity
what can cause empyema
aerobic most frequent - pseudomans, strep milleri, staph A, e. coli, legionella
what is the diagnosis of empyema
USS best, CT, D sign on chest xray
what is the treatment for empyema
IV (amoxicillin, metronidazole), large effusion drain chest
what is bronchiectasis
irreversibly widened airways that can collapse easily and cause obstruction. often cause crackles and abnormal cilia
what can cause bronchiectasis
CF mainly
what are the symptoms of bronchiectasis
recurrent chest infections, cough + sputum, chest crackles and pain
what investigations are done for bronchiectasis
CT, hard to diagnose
what is the treatment for persistent bronchiectasis
ceftazimide
what is chronic bronchial sepsis
symptoms of bronchiectasis but no radiology results, positive sputum culture
what is cystic fibrosis
autosomal recessive disorder that can causes over-secretion and can lead to a failure to thrive. often low life expectancy
what is the brief mechanism of CF
CFTR defective, chlorine not pumped out of cell and builds up, sodium follows it causing dehydration and thick mucous. this blocks ducts and impairs mucosal defence causing infections and inflammation
how many people carry CF
1/25
where is the CF mutation
G55TD gene of chromosome 7, Del508 inheritance
what are the symptoms of CF
cough, infections, crackles, low BMI, trouble breathing, salty sweat - sweat test. is the main cause of bronchiectasis
what treatments are available with CF
lifelong and lots of antibiotics, physiotherapy, OPHAT
what is the problem with CF drugs
very expensive and not curative
