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respiratory tract infections Flashcards

1
Q

is stridor upper or lower respiratory tract infection ?

A

upper

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2
Q

expiratory wheeze or crackles - what type or RT

A

lower

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3
Q

what is the first sign of HIV

A

thrush - fungal infection in throw that can cause oesophagitis

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4
Q

Case 1 - Jarad , 49 , asthmatic - 10 day history of nasal congestion, green nasal discharge , headache which is frontal and constant and worse when he leans forward - what are your first thoughts

A

green - bacterial
sinuses - headache when you press over them which makes them worse - worse on leaning forward as you put pressure on that area

thinking could be rhino sinusitis

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5
Q

is normal viral sinusitis ( rhino sinusitis) self resolving

bacterial sinusitis is bi phasic illness meaning often they had viral leaving tissues more vulnerable to infection and bacterial will get in there causing a secondary infection - do these last more or less than 10 days

A

yes - viral less than 10 days

bacterial more than 10 days

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6
Q

sinusitis is where the sinuses become swollen and are usually caused by an infection - causing pain in face and nose- what bacteria most often cause this

A

streptococcus pneumonias
haemohilus influenza
mortadella catarrali ( pathogens that live there)

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7
Q

what are the red flags if someone with asthma comes in with headache and pain

A 
severe or persistent neck stiffness ( meningitis ) 
periorbital oedema ( cellulitis - visual change)

ophthalmoplegia - paralysis or weakens of the eye muscles
cranial nerve palsy
altered mental state and neck stiffness

Complications 
Periorbital- orbital cellulitis 
Subperiosteal abscess
Osteomyelitis of sinus 
Meningitis 
Intracranial abscess 
Septic cavernous sinus thrombosis
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8
Q

what supportive therapy can you have for viral rhinosinustiis

A

analgesics
intranasal steroids for over 10 days
decongestants

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9
Q

can you give antibiotics to treat bacterial rhinosinustiis

A

5-7 days if not resolving

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10
Q

case 2 lady 26 with 5 day history of dry cough, sore throat , tiredness ( malaise) and runny nose ( rhinorrhea(free discharge of a thin nasal mucus fluid))
how can it be transmitted

A

most common upper respiratory tract infection that is the common cold

Direct transmission - hand contact up to 2 hours on skin
Sneezing or coughing - tissues don’t support virus transmission
Large droplets from close contact or 8 hours on external surfaces

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11
Q

effective treatments for the common cold

A

supportive
nasal decongestants
analgesics

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12
Q

complications of common cold ( rhinovirus, coronavirus , infleuzna )

A

Acute rhinosinusitis
Lower RT infection
Asthma exacerbation
Acute otitis media

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13
Q

Case 3 - 31year old with 2w history of sore throat and difficulty swallowing what is most likely diagnosis

A

acute pharyngitis - tonsillitis

examination reveal swollen tonsils and lymph glands

nasal congestion and cough with a viral tonsillitis

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14
Q

in a bacterial tonsillitis what do you see on the tonsils

A

exudate/puss
pharyngeal oedema and tender anterior cervical lymphadenopathy

normally by Group A strep

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15
Q

what is the difference between tonsillitis and strep throat

A

tonsillitis is viral or bacterial and strep throat caused by specific type of bacteria - Group A strep

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16
Q

splenomegaly

A

enlarged spleen - caused by underlying illness such as liver diseases, cancers , inflammatory disease and infection

17
Q

if not viral tonsillitis what do you need to give the patient to treat them

A

penicillin

18
Q

feverapain score measures certain aspects of the illness and depending on this determines what treatment you get

A

for strep pharyngitis

centor score (ever >38.5°C, swollen, tender anterior cervical lymph nodes, tonsillar exudate and absence of cough) are an algorithm to assess the probability of group A β haemolytic Streptococcus (GABHS) as the origin of sore throat, developed for adults.)

19
Q

Case4 -LRT , 2 year old boy with 2 day history of sniffly cold and runny nose, presenting with fever and cough and wheezing and increased respiratory rate with poor feeding.

A

most likely bronchiolitis
caused by viral infection (respiratory syncytial virus)

90% roscoe within 3 weeks

20
Q 
what are these risk factors for 
prematurity below 36weeks 
low brith weight 
under 12 weeks 
chronic lung disease 
congenital heart defects 
immunodeficiency
A

severe disease

21
Q

treatment for bronchiolitis is

A

nothing normally as should self resole

discharge when
clinically stable
taking oral fluids
Sp02 start are above 92%

22
Q

what should you not use when treating bronchiolitis

A 
antibiotics
hypertonic slaine 
adrenaline - nebuliser 
salbutamol 
ipratropium bromide - COPD 
montelukast - good efficacy is asthma 
inahled or systemic corticosteroids
23
Q

in broniectasis why is hypertonic saline good ?

A

airway clearance by increasing hydration or the airway surface layer and mucus making it easier to cough and breast up the phlegm

24
Q

In Respiratory failure - lungs cease capacity to exchange oxygen for CO2 - if you get to much C02 blood turns to acid - non invasive ventilation - push air in and out of lungs to make lungs exchange co2 for oxygen so makes blood less acidic
what are two primary methods for this

A

CPAP ( continuous pressure - opens up respiratory failure good in type 1 respiratory failure) and then BiPAP( bi level - two levels of ventilation of air being forced into lungs at two different pressures - opens up then more again going to help exchange - type 2 respiratory failure)

25
Q

what the difference between type 1 and type 2 respiratory failure

A

type 1 involves low oxygen and normal or low carbon dioxide levels. Type 2 involves low oxygen with high carbon dioxide levels

26
Q

Case 5 - LRT - 67yr with 4 day history with worsening cough and green sputum , lower right sided chest pain with breathing in and fatigue and confusion
most likely?

A

pneumonia

27
Q

what are the Sx of pneumonia

A 
headaches 
loss of appetite 
high fever and chills
clammy and blue skin 
low blood pressure 
cough with sputum 
SOB 
pleuritic chest pain 
hemoptysis 
muscle fatigue 
high heart rate 
vomiting 
high temp and repsriaotry rate
28
Q

how can you score pneumonia

A 
CURB65 
confusion 
urea above 7.0mmol 
respiratory rate
blood pressure below 90 systolic or below 60 diastolic 
above 65 years old 
if you have a crib score below 1 - ambulatory 
1-2 is asdmit 
above 3 - ITU 40% risk of death
29
Q

GCS

A

glasgow coma scale
used to measure a person level of consciousness after a brain injury
eyes verbal and motor responses assessed

30
Q

cause of CAP

A

no cause normally found
typical - viewed as stain , atypical cannot be viewed

strep penuomoa 
haemophilus influenza 
mortadella catarrhlais 
staph aureus 
group a strep 
rhinovirus 
chlamydia pneumonia
31
Q

HAP pneumonia occur over 48 hours after admission

what pathogens can accuse this

A

S-aureus
pesodomonus aeruginosa
e-coli

32
Q

VAP - mechanical ventilation infections - in ICU
CAP - penicillin or macrocodes like clarithromycin
HAP - penicillin
what are the complications

A 
pleural effusion 
empyema( pus in the pleura) 
repsriaotry failure 
acute RDS 
caveating disease 
access
33
Q

what is the curb 65 score

A

The CURB-65 calculator can be used in the emergency department setting to risk stratify a patient’s community acquired pneumonia. The CURB-65 Score includes points for confusion and blood urea nitrogen, which in the acutely ill elderly patient, could be due to a variety of factors.

34
Q

what is antibiotic stewardship

A

Antibiotic stewardship is the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing and use is critical to effectively treat infections, protect patients from harms caused by unnecessary antibiotic use, and combat antibiotic resistance.

35
Q

what is the R number

A

R is the number of people that one infected person will pass on a virus to, on average
If the R value is higher than one, then the number of cases increases.
But if the R number is lower the disease will eventually stop spreading, because not enough new people are being infected to sustain the outbreak.
An R value between 0.7 and 1.1 means that, on average, every 10 people infected will infect between 7 and 11 other people.

Respiratory (22 decks)

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