Respiratory Tract Infections & Pneumonia

Question 1

Respiratory infections are divided into 2 groups. What are they?

Answer 1

1. Lower respiratory tract infection

2. Upper respiratory tract infection

Question 2

In which part of the respiratory tract does pneumonia occur?

Answer 2

Lower.

Question 3

What are some examples of upper respiratory tract infections?

Answer 3

1. Common cold
2. Tonsilitis
3. Sinusitus

Question 4

When are antibiotics given for an upper respiratory tract infection?

Answer 4

If the infection is severe, persistent, or is in an immunosuppressed patient.

Question 5

What is the treatment for a upper respiratory tract infection?

Answer 5

1. Rest
2. Fluids
3. Cough medicine
4. Paracetamol for pain

Question 6

What is the centor criteria used for?

Answer 6

It gives an indication if antibiotics should be given (i.e. if its bacterial or not)

Question 7

What is tonsillar exudate?

Answer 7

White string like marks appearing on tonsils

Question 8

What is tender anterior cervical lymphadenopathy?

Answer 8

Sore lymph nodes

Question 9

What is quinsy?

Answer 9

It is abscess around the tonsils, which can compromise the airways.

Question 10

In which part of the lungs does pneumonia compromise?

Answer 10

The lung parenchyma

Question 11

What is CAP (community acquired pneumonia)?

Answer 11

It is pneumonia acquired outside of a hospital setting.

It can be localised (only one part of the lung affected), or diffused

Question 12

What are the risk factors of acquiring CAP?

Answer 12

1. Children/elderly
2. Co-morbidities, e.g. diabetes
3. Lifestyle, e.g. smoking, alcohol, weight, etc
4. Medications

Question 13

What is the CURB-65 score?

Answer 13

It is a scoring system used to tell us whether the pneumonia can be treated in or out of hospital.

Question 14

What does CURB-65 stand for?

Answer 14

C: Confusion
U: Urea
R: Respiratory rate 
B: Blood pressure 
65: >65yrs of age

1 point is awarded for each one.

Question 15

What should the CURB-65 score be to treat someone in hospital?

Answer 15

> 1

Question 16

What is door to needle time (DNT), and what should the timing be in patients with pneumonia?

Answer 16

Door to needle time (DNT): it is the time from presentation with symptoms to the start of treatment.
It should be <1h

Question 17

What is the most common organism which causes pneumonia?

Answer 17

Streptococcus pneumoniae.

Question 18

What is hospital acquired pneumonia (HAP)?

Answer 18

It is pneumonia acquired at least 48h of hospital admission (most likely due to ventilation)

Question 19

What is aspiration pneumonia?

Answer 19

It is pneumonia acquired from inhaled contents into the lower airways (e.g. food), causing lung injury & a bacterial infection.

Question 20

In which patients is aspiration pneumonia most common in?

Answer 20

People who have an impaired gag, or cant swallow.

Question 21

What are some major complications of pneumonia which can occur?

Answer 21

1. Respiratory failure

2. Sepsis - leading to multi-organ failure