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Physiology > Respiratory tract infections > Flashcards

Respiratory tract infections Flashcards

1
Q

baby?

A

:)

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2
Q

what bacteria are normally colonised in the upper respiratory tract

A 
staphylococcus
streptococcus pneumoniae
viridans steptococcus
haemophilus . 
anearobes 
the alveoli also contains a microbiome of normal microbes
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3
Q

Causes of rhinosinusitis

A 
viral mostly - rhinovirus, influenza and para-influenza
bacterial is less often 
streptococcus pneumoniae
haemophilus influenzae
moraxella catarrhalis
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4
Q

bacterial rhinosinusitis

A

bi-phasic illness
lasts more than 10 days
secondary to infection to allergic/ viral rhinitis

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5
Q

red flags of rhinosinusitis

A 
severe/ persistent headache
periorbital oedema
visual changes
opthalmoplegia 
cranial nerve palsy
altered mental state
neck stiffness
papilloedema
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6
Q

complications of rhinosinusitis

A 
pre-orbital/ orbital cellulitis 
subperiosteal abcess
osteomyelitis
meningitis
intracranial abcess
septic cavernous sinus
thrombosis
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7
Q

treatment for viral rhinosinusitis

A

will self-resolve
supportive therapy - analgesics, intranasal steroids if it lasts longer than 10 days
decongestants

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8
Q

treatment for bacterial rhinosinusitis

A

will self resolve
supportive therapy - can give back up antibiotics to be take if not resolving in 5-7 days
evidence is poor

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9
Q

symptoms of rhinosinusitis

A

nasal congestion
green nasal discharge
headache - frontal, constant and worse on leaning forward

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10
Q

common cold

A

benign self-limiting syndrome

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11
Q

causes of the common cold

A 
rhinovirus 
coronavirus
influenza
parainfluenza
respiratory syncytial virus
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12
Q

how is the common cold transmitted?

A

direct transmission
hand contact - up to 2 hours on skin
sneezing or coughing - tissues do not support virus transmission
large droplets from close contact or 8 hours on external surfaces

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13
Q

how much does the common cold cost per year?

A

$40 billion due to time off work

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14
Q

effective treatments for common cold

A

supportive
nasal decongestants
antihistamines combination
analgesics

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15
Q

Ineffective treatments for common cold

A 
antibiotics
antivirals
vitamin C
echinacea - herb
codeine
intranasal glucocorticoid
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16
Q

symptoms of common cold

A

dry cough
sore throat
tiredness - malaise
runny nose - rhinorrhea

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17
Q

symptoms of acute pharyngitis

A

sore throat
difficulty swallowing
swollen tonsils
swollen lymph nodes

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18
Q

acute pharyngitis

A

tonsilitis

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19
Q

causes of viral tonsilitis

A

adenovirus
rhinovirus
coronavirus

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20
Q

adenovirus

A

fatigue

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21
Q

rhinovirus

A

nasal congestion

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22
Q

coronavirus

A

cough

23
Q

bacterial tonsilitis

A

group A, C and G

streptococcus

24
Q

what are the symptoms of bacterial tonsilitis

A 
acute onset sore throat
fever
patchy tonsilar exudate
pharyngeal edema
tender anterior cervical lymphdenopathy
scarlatiniform rash
25
Q

less common causes of tonsilitis

A 
infectious mononucleosis (mono) 
Epstein-Barr Virus - EBV
26
Q

symptoms of infectious mononucleosis

A

high fever

prominent posterior cervical lymphdenopathy

27
Q

symptoms of EBV

A

splenomegaly and atypical lymphocytosis

28
Q

what is splenomegaly

A

abnormal enlargement of the spleen

29
Q

what tonsilitis needs antibiotics?

A

GBS

30
Q

prescribing antibiotics for acute sore throat

A

scoring systems depending on score of fever and pain

31
Q

back up antibiotics

A

not needed immediately

for use if no improvement of symptoms in 3-5 days or if the symptoms worsen .

32
Q

symptoms of bronchiolitis

A 
fever
cough
wheezing
increased respiratory rate
poor feeding
33
Q

bronchiolitis

A

viral infection of the small airways
prodromal upper respiratory tract infection followed by secondary inflammation of bronchi/ bronchioles
caused by respiratory syncytial virus
seasonal outbreaks in autumn and winter
leading cause of admission for 0-5 year olds
peak incidence at 2 years old .

34
Q

clinical course of bronchiolitis

A 
day 0 - upper respiratory symptoms
day 2 - lower respiratory symptoms
day 3-5 - peak illness
day 15 - cough resolves
90% fully resolved within 3 weeks
35
Q

risk factors for severe disease from bronchiolitis

A 
apnoea
respiratory failure
prematurity
low birth weight
age - less than 12 weeks]chronic lung disease
anatomical defects
congenital heart disease
immunodeficiency
neurological disease
36
Q

treatment for bronchiolitis

A

NICE guidance promotes supportive care and non-invasive ventilation in acute respiratory failure .

37
Q

when to discharge someone with bronchiolitis?

A

clinically stable
taking oral fluids
oxygen sats greater than 92%

38
Q

what treatments should not be used?

A 
antibiotics
hypertonic saline
adrenaline 
salbutamol
montelukast
ipratropium bromide
systemic or inhaled corticosteroids
39
Q

symptoms of pneumonia

A 
worsening cough with green sputum
lower right sided chest pain with inhalation
fatigue
confusion
high fever
chills
clamminess
blueness skin
SOB
pleuritic chest pain
hemoptysis - coughing up blood
aches
headaches
loss of appetite
mood swings
low BP
nausea
vomiting
pain in joints
40
Q

what is used to measure the severity of pneumonia?

A

CURB 65

41
Q

CURB 65

A 
confusion
urea - >7mmol
respiratory rate over 30
blood pressure less than 90/60
older than 65
42
Q

classification of CURB 65 scores

A

less than 1 = <3% risk of death - ambulatory
1-2 = 9% risk of death - admit
more than 3 = 40% risk of death - HDU/ITU

43
Q

Causes of community acquired pneumonia

A

typical - viewed on a gram stain and sensitive to beta-lactams
atypical - cannot be viewed on gram stain, require other antibiotics
other causes

44
Q

typical causes of CAP

A 
streptococcus pneumoniae
haemophilus influenzae 
moraxella catarrhalis
staphylococcus aureus
group A strep 
aerobic gram -ve
anearobes - associated with aspiration
45
Q

Atypical causes of CAP

A 
legionella spp
mycoplasma pneumoniae
chlamydia pneumoniae
chlamydia psittaci
coxiella burnetii
46
Q

other causes of CAP

A 
viral
funcgal
TB
influenza A and B
rhinovirus
parainfluenza 
RSV
47
Q

Hospital acquired pneumonia

A

occurs more than 48hrs after admission to hospital . Increased risk by mechanical ventilation as the tube provides a surface for bacteria to live/ reproduce

48
Q

pathogens that cause HAP

A 
Staphylococcus aureus
pseudomonus aeruginosa
klebsiella
enterobacter
acinetobacter
E coli
49
Q

Treatment of pneumonia

A

antibiotic therapy based on local guidance

50
Q

treatment for CAP

A

penicillin
tetracyclines
macrolides
e.g. clarithromycin

51
Q

treatment for HAP

A

broad spectrum penicillin or Carbopenum e.g. co-amoxiclav

Aminoglycosides - gentamicin

52
Q

complications of pneumonia

A 
pleural effusion
empyema 
respiratory failure
acute respiratory distress syndrome
cavitating disease
abscess
53
Q

what is epyema?

A

collection of pus in the pleural cavity

Physiology (46 decks)

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