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Respiratory Anatomy & Disease Mechanisms > Respiratory Tract Infections (DISEASE MECHANISMS) > Flashcards

Respiratory Tract Infections (DISEASE MECHANISMS) Flashcards

1
Q

What is included under upper respiratory infections?

A

Coryza (common cold)
Pharyngitis (sore throat)Sinusitis
Epiglottitis

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2
Q

What is included under lower respiratory infections?

A

Acute bronchitis
Acute exacerbations of chronic bronchitis
Pneumonia
Influenza

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3
Q

What is coryza?

A

Acute inflammation of the nasal passages

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4
Q

What are the symptoms of coryza?

A 
Sore throat (often)
Mild fever (37.5 (sometimes)
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5
Q

What are the possible complications of coryza?

A

Sinusitis

Acute bronchitis

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6
Q

What is the recommended treatment for coryza?

A

Rest and paracetamol

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7
Q

How does coryza spread?

A

Droplets

Fomites

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8
Q

What causes coryza?

A

Adenovirus
Rhinovirus
Respiratory syncytial virus

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9
Q

Which virus causes respiratory disease in children?

A

Respiratory syncytial virus

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10
Q

What precedes acute sinusitis?

A

Common cold

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11
Q

What symptom indicates acute sinusitis?

A

Purulent nasal discharge

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12
Q

Where can acute sinusitis in the ethmoid sinuses spread?

A

Eyes and brain

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13
Q

What is the danger in acute sinusitis of the cavernous sinuses?

A

Cain fact/block the carotid artery and CN III - can be fatal

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14
Q

What are the symptoms of acute tonsillitis and quinsy?

A

Painful to eat & hard to breathe

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15
Q

Why should you NEVER blindly cut open the quinsy to drawn pus?

A

Because the carotid artery runs down the quinsy

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16
Q

Why is diphtheria life-threatening?

A

Toxin production

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17
Q

What is characteristic of diphtheria?

A

Pseudomembrane

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18
Q

Why is acute epiglottis life-threatening in children?

A

Obstruction - swelling of the epiglottis blocks the larynx

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19
Q

What symptom indicates acute epiglottis in children?

A

Hot runny nose (because can’t swallow own saliva)

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20
Q

How do you treat acute epiglottis in children?

A

One attempt at intubation; if fails - emergency tracheostomy

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21
Q

What should you NOT do if suspect acute epiglottis in a child? Why?

A

Ask them to open their mouth - will cough & obstruct the airway and die

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22
Q

What priced acute bronchitis?

A

Common cold

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23
Q

How does chronic bronchitis present clinically?

A

Productive cough (possibly sputum)
Minority have fever
Normal chest exam & X-ray
May have transient wheeze

24
Q

How is acute bronchitis treated?

A

Usually self-limiting
No antibiotics (usually)
Significant morbidity in patients with chronic lung disease

25
Q

What is the incubation time of the rhinovirus?

A

1-5 days

26
Q

What is the incubation time of group A streptococci?

A

1-5 days

27
Q

What is the incubation time of influenza & para-influenza virus?

A

1-4 days

28
Q

What is the incubation time of RSV?

A

7 days

29
Q

What is the incubation time of pertussis?

A

7-21 days

30
Q

What is the incubation time of diphtheria?

A

1-10 days

31
Q

What is the incubation time of the Epstein-Barr virus?

A

4-6 weeks

32
Q

What are the clinical features of acute exacerbations of COPD?

A

Usually preceded by URTI
Increase sputum production and purulence
More wheezy
Breathless

33
Q

What would be expected upon examination of a patient with acute exacerbations of COPD?

A 
Respiratory distress
Wheeze
Coarse crackles
May be cyanosed 
Ankle oedema in advanced disease
34
Q

How are acute exacerbations of COPD treated in primary care?

A

Antibiotic (doxycycline/amoxicillin)
Bronchodilator inhaler
Sometimes short steroid course

35
Q

When should a patient with acute exacerbation of COPD referred to hospital?

A

Evidence of respiratory failure

ot coping at home

36
Q

How would acute exacerbation of COPD be managed in hospital?

A

Same as in primary care AND …
Measure ABGs
CXR to look for other disease
Give O2 if in respiratory failure

37
Q

The presence of what (3) in the alveoli would indicate pneumonia?

A

Neutrophils
Lymphocytes
Macrophages

38
Q

What are the symptoms of pneumonia? (15)

A 
Malaise
Anorexia
Sweats
Rigors (Shaking/shivering)
Myalgia
Arthralgia 
Headache
Confusion
Cough (due to pus in chest)
Pleurisy
Haemoptysis (RBCs enter alveolar spaces)
Dyspnoea
Preceding URTI
Abdominal pain (if infect in base of lung)
Diarrhoea (if swallow sputum)
39
Q

What are the signs of pneumonia?

A 
Fever
Riggers
Herpes labialise
Tachypnoea
Crackles
Pleural rub
Cyanosis
Hypotension
40
Q

How do you investigate pneumonia?

A 
Blood culture
Serology
ABGs
Full blood count
Urea
Liver function
Chest x-ray
41
Q

How is the CURB65 severity score calculated

A 
1 point for each of
C - new onset of Confusion
U - Urea >7 
R - Respiratory rate > 30
B - Blood pressure systolic <90 or diastolic >61
65 - age 65 or older
42
Q

What severity markers are there for pneumonia?

A

CURB65 score
Temperature <35 or >40
Cyanosis - PaO2 < 8 kPA
WBC <4 or >30Multi-lobar involvement

43
Q

Which pathogens cause pneumonia?

A 
S. pneumonia (most)
H. influenza
Legionella sp. 
Staph. Aureus
M. pneumonia
C. pneumonia
Gram neg enterobacteria
Viruses
Influenza A &amp; B 
(Possible that none is found)
44
Q

Pneumonia and other infectious disease is particularly linked to which animal?

A

Birds

45
Q

Mycoplasma pneumonia shows prevalence peaks every _ years

A

4

46
Q

Chicken pox pneumonia can be ____ in adult smokers

A

fatal

47
Q

Younger people tend to get which pathogen for pneumonia?

A

M. pneumonia

48
Q

Older people tend to get which pathogen for pneumonia?

A

Strep. pneumonia

49
Q

How is community-acquired pneumonia treated?

A 
Antibiotics (amoxicillin / doxycycline)
Oxygen - maintain SaO2 at 94-98% or 88-92%
Fluids
Bed Rest 
No smoking
50
Q

What are the possible complications of pneumonia?

A

Respiratory failure
Pleural effusion
Empyema
Death

51
Q

How is empyema treated?

A

Drained using ultrasound to guide the needle

52
Q

What does hospital acquired pneumonia require?

A

Extended gram neg cover

53
Q

What does aspiration pneumonia require?

A

Anaerobic cover

54
Q

How does Legionella present?

A

Chest symptoms may be minimal

GI disturbances are common as well as confusion

55
Q

How can pneumonia be prevented?

A 
Influenza &amp; parainfluenza vaccine (>65 yrs / chronic cardiac disease / immunocompromised)
Influenza vaccine (Health care workers)

Respiratory Anatomy & Disease Mechanisms (13 decks)

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