Respiratory tract infections Flashcards
1
Q
What is coryza?
A
The ‘common cold’
acute inflammation of the nasal cavities
2
Q
Describe ‘strep throat’?
A
- exudate
- pus
- sore throat
- dysphagia
- dysphonia
3
Q
Describe tonsilitis?
A
- swollen tonsils
- erythematous
- dysphagia
- dysphonia
- recurrent
- can undergo a tonsillectomy
4
Q
how can a FeverPAIN score be used?
A
- clinical scoring tool that helps determine wether or not a patient will benefit from antibiotic treatment
5
Q
What is quinsy?
A
- peri - tonsillar abscess
- results as a complication of tonsillitis
- IV antibiotics and drainage
6
Q
Describe epiglottitis?
A
- inflammation of the epigottis
- airway obstruction - can be fatal especially in children
- intubate and administer IV antibiotics
7
Q
How is coryza spread?
A
- droplets and fomites
8
Q
Describe acute sinusitis?
A
- normally preceded by a common cold
- purulent nasal discharge
- symptoms include: frontal headache, retro - orbital pain, discharge, tooth ache
9
Q
What are the treatment options for acute sinusitis?
A
- nasal decongestant: oxymetazoline
- nasal steroids
- pseudo - ephedrine
10
Q
Describe diphtheria?
A
- characteristic pseudomembrane at the back of the throat
- fever
- life threatening due to endotoxin production
- not seen in UK because of vaccination
11
Q
Describe acute bronchitis?
A
- often preceded by a common cold which ‘goes to the chest’
- symptoms include: productive cough, fever, normal chest examination and X-ray, may have transient wheeze
12
Q
Describe the treatment of acute bronchitis?
A
- in “normal” patients, normally self limiting and antibiotics are not indicate, pain relief and hydration
- can lead to morbidity in patients with chronic lung disease
13
Q
Describe some of the symptoms of pneumonia?
A
- malaise, anorexia, sweats, rigors, myalgia, arthralgia, headache, confusion, cough, pleurisy, haemoptysis, dyspnoea, preceding URTI, abdominal pain, diarrhoea
14
Q
Describe the signs of pneumonia?
A
- fever
- rigors
- herpes labialis
- tachypnoea
- crackles
- rub
- cyanosis
- hypotension
15
Q
Describe the investigations that can be carried out or the diagnosis of pneumonia?
A
- blood culture
- serology
- arterial gases
- full blood count
- urea
- liver function
- Chest X ray
16
Q
How is community acquired pneumonia treated?
A
- antibiotics: amoxicillin or deoxyclycline
- oxygen: maintain sats
- fluids
- bed rest
- no smoking
17
Q
How is hospital acquired pneumonia treated?
A
- extended gram negative cover
- amoxicillin and gentamicin
18
Q
How is aspiration pneumonia treated?
A
- need anaerobic cover
- amoxicillin and metronidazole
19
Q
describe the treatment of legionella pneumonia?
A
- Levofloxacin
- GI disturbance is common
- confusion
20
Q
When should IV antibiotics be given in the treatment of respiratory tract infections?
A
- oral route not available
- sensitivities - drug resistant organisms
- deep seated infections (abscess, bone, endocarditis, meningitis)
- first dose
21
Q
Describe the complications of pneumonia?
A
- respiratory failure
- pleural effusion
- empyema
- death
22
Q
How can pneumonia be prevented?
A
- influenza and pneumococcal vaccines
23
Q
What is pneumonia?
A
- infection involving the distal air spaces, usually with inflammatory exudation ‘localised oedema’
- fluid filled spaces leads to consolidation
24
Q
What is lobar pneumonia?
A
- confluent consolidation involving a complete lung lobe
- more often due to streptococcus pneumoniae
- but can also be seen with klebsiella or legionella
25
Describe the pathology of lobar pneumonia?
- a classic acute inflammatory response
- exudation of fibrin rich fluid
- neutrophil infiltration
- macrophage infiltration
- resolution
- immune system plays a part - antibodies lead to opsonisation, phagocytosis of bacteria
26
What are some of the complications of lobar pneumonia?
- organisation (fibrous scarring)
- Abscess
- bronchiectasis
- empyema
27
What is bronchopneumonia?
- infection starting in the airways and spreading to adjacent alveolar lung
- most often seen in the context of pre existing disease
28
What are the risk factors for developing chronic pulmonary infection?
- abnormal host response: immunodeficiency, immunosuppression
- Abnormal innate host defence: Damaged bronchial mucosa, abnormal cilia, abnormal secretions
- repeated insult: aspiration, indwelling material
29
What are some of the causes of immunodeficiency that can lead to the development of chronic infection?
- immunoglobin deficiency
- hypo-splenism
- immune paresis
- HIV
30
What are some of the causes of immune suppression that can lead to the development of chronic infection?
- steroids
- monoclonal antibodies
- chemotherapy
31
What can cause damage to the bronchial mucosa?
- smoking
- recent pneumonia or viral infection
- malignancy
32
What can cause abnormal cilia?
- Kartenagers syndrome
| - Youngs syndrome
33
What can cause abnormal secretions?
- cystic fibrosis
| - channelopathies
34
Describe the characteristics of an intrapulmonary abscess?
- indolent presentation
- weight loss common
- leathery, tiredness, weakness
- cough +/- sputum
- high mortality if not treated
- usually preceding an illness of some sort: pneumonic infection, post viral, foreign body
35
What pathogens are commonly associated with pulmonary abscess?
- bacteria: streptococcus, staphylococcus, Ecoli, Gram negatives
- Fungi: aspergillus
36
What is an empyema?
- body cavity filled with pus
| - commonly refers to pus in the pleural space
37
Why do patients develop empyema?
- after pneumonia
| - primary empyema, often iatrogenic
38
What is the difference between an effusion and an empyema in the pleural cavity?
- frank pus
39
What pathogens are commonly associated with empyema?
- more frequently aerobic
- gram positive: strep millers, strep aureus
- gram negative: Ecoli, pseudomonas, haemophilus influenza, kelbsiellae
40
In which patients may an anaerobe cause an empyema?
- in patients with severe pneumonia
| - in patients with poor dental hygiene
41
How is an empyema treated?
- broad spectrum IV antibiotics: amoxicillin and metronidazole
- oral antibiotics - directed towards cultured bacteria, usually 5 weeks of co - amoxiclav
42
What are some of the common causes of pneumonia in neonates?
- GBS
- E.coli
- Klebsiella
- staph aureus
43
What are some of the common causes of pneumonia in infants?
- strep pneumoniae
| - chlamydia
44
what are some of the common causes of pneumonia in school age children?
- strep pneumoniae
- staph aureus
- GR A strep
- bordetella
- mycoplasma
- legionella
