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The respiratory system > Respiratory tract infections > Flashcards

Respiratory tract infections Flashcards

1
Q

What is coryza?

A

The ‘common cold’

acute inflammation of the nasal cavities

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2
Q

Describe ‘strep throat’?

A
  • exudate
  • pus
  • sore throat
  • dysphagia
  • dysphonia
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3
Q

Describe tonsilitis?

A
  • swollen tonsils
  • erythematous
  • dysphagia
  • dysphonia
  • recurrent
  • can undergo a tonsillectomy
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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
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5
Q

What is quinsy?

A
  • peri - tonsillar abscess
  • results as a complication of tonsillitis
  • IV antibiotics and drainage
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6
Q

Describe epiglottitis?

A
  • inflammation of the epigottis
  • airway obstruction - can be fatal especially in children
  • intubate and administer IV antibiotics
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7
Q

How is coryza spread?

A
  • droplets and fomites
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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
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9
Q

What are the treatment options for acute sinusitis?

A
  • nasal decongestant: oxymetazoline
  • nasal steroids
  • pseudo - ephedrine
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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
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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

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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
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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
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14
Q

Describe the signs of pneumonia?

A
  • fever
  • rigors
  • herpes labialis
  • tachypnoea
  • crackles
  • rub
  • cyanosis
  • hypotension
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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
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16
Q

How is community acquired pneumonia treated?

A
  • antibiotics: amoxicillin or deoxyclycline
  • oxygen: maintain sats
  • fluids
  • bed rest
  • no smoking
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17
Q

How is hospital acquired pneumonia treated?

A
  • extended gram negative cover

- amoxicillin and gentamicin

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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
Q

Describe the pathology of lobar pneumonia?

A
  • 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
Q

What are some of the complications of lobar pneumonia?

A
  • organisation (fibrous scarring)
  • Abscess
  • bronchiectasis
  • empyema
27
Q

What is bronchopneumonia?

A
  • infection starting in the airways and spreading to adjacent alveolar lung
  • most often seen in the context of pre existing disease
28
Q

What are the risk factors for developing chronic pulmonary infection?

A
  • abnormal host response: immunodeficiency, immunosuppression
  • Abnormal innate host defence: Damaged bronchial mucosa, abnormal cilia, abnormal secretions
  • repeated insult: aspiration, indwelling material
29
Q

What are some of the causes of immunodeficiency that can lead to the development of chronic infection?

A
  • immunoglobin deficiency
  • hypo-splenism
  • immune paresis
  • HIV
30
Q

What are some of the causes of immune suppression that can lead to the development of chronic infection?

A
  • steroids
  • monoclonal antibodies
  • chemotherapy
31
Q

What can cause damage to the bronchial mucosa?

A
  • smoking
  • recent pneumonia or viral infection
  • malignancy
32
Q

What can cause abnormal cilia?

A
  • Kartenagers syndrome

- Youngs syndrome

33
Q

What can cause abnormal secretions?

A
  • cystic fibrosis

- channelopathies

34
Q

Describe the characteristics of an intrapulmonary abscess?

A
  • 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
Q

What pathogens are commonly associated with pulmonary abscess?

A
  • bacteria: streptococcus, staphylococcus, Ecoli, Gram negatives
  • Fungi: aspergillus
36
Q

What is an empyema?

A
  • body cavity filled with pus

- commonly refers to pus in the pleural space

37
Q

Why do patients develop empyema?

A
  • after pneumonia

- primary empyema, often iatrogenic

38
Q

What is the difference between an effusion and an empyema in the pleural cavity?

A
  • frank pus
39
Q

What pathogens are commonly associated with empyema?

A
  • more frequently aerobic
  • gram positive: strep millers, strep aureus
  • gram negative: Ecoli, pseudomonas, haemophilus influenza, kelbsiellae
40
Q

In which patients may an anaerobe cause an empyema?

A
  • in patients with severe pneumonia

- in patients with poor dental hygiene

41
Q

How is an empyema treated?

A
  • broad spectrum IV antibiotics: amoxicillin and metronidazole
  • oral antibiotics - directed towards cultured bacteria, usually 5 weeks of co - amoxiclav
42
Q

What are some of the common causes of pneumonia in neonates?

A
  • GBS
  • E.coli
  • Klebsiella
  • staph aureus
43
Q

What are some of the common causes of pneumonia in infants?

A
  • strep pneumoniae

- chlamydia

44
Q

what are some of the common causes of pneumonia in school age children?

A
  • strep pneumoniae
  • staph aureus
  • GR A strep
  • bordetella
  • mycoplasma
  • legionella

The respiratory system (13 decks)

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