Session 8- Lower Respiratory Tract Infection and Pneumonia

Question 1

what is acute bronchitis

Answer 1

inflammation of the large airwats of the lung- bronchi

Question 2

what is bronchectasis

Answer 2

permanent dilation and thickening of the airways associated with chronic cough, sputum production, bacterial colonisation and recurrent infection

Question 3

what is broncholitis

Answer 3

a viral infection of the bronchiole, the smallest air passages in the lungs. Most commonly caused by resp syncytial virus and most commonly occurs in children

Question 4

what is empyema

Answer 4

collection of pus in the pleural cavity associayed with pneumonia but may also develop after thoracic surgery or trauma

Question 5

what is a lung abcess

Answer 5

localised collection of pus within the lung that leads to cavity formation usually with a thich wall, radiological imaging typically demonstrates the presence of air-fluid levels in the cavity

Question 6

when to abcesses most commonly occur

Answer 6

when microbial infection causes necrosis of the lung parenchyma, if they communicate with an airway they may lead to a purulent cough

Question 7

what is an air fluid level

Answer 7

when air rises above a fluid in a contained space and there is a flat surface at the ‘air-fluid’ interface

Question 8

what is pneumonia

Answer 8

inflammation of the lung parenchyma due to infection

Question 9

what is a common feature of pneumonia

Answer 9

cellular exudate in alveolar spaces

Question 10

what 2 ways pneumonia present

Answer 10

lobar

bronchopneumonia

Question 11

what is the most common causative ogranism in CAP

Answer 11

streptococcus pneumonia- gram positive coccus in chains

Question 12

what is CAP less commonly caused by

Answer 12

haemophilus influenzae
moraxela catarrhalis
group A streptococci
staph aureus

Question 13

what atypical mictorganisms cause CAP

Answer 13

mycoplasma pneumoniae
chlamydia pneumonae
legionella pneumophilia

Question 14

what is a nosocomial or hospital acquired pneumonia defined as

Answer 14

infection of the lower resp tract in hospitalised patients occuring >48 hours after admission

Question 15

what are important causative organisms of hospital acquired pneumonia

Answer 15

Pseudomonas aueroginosa 
Escherichia coli
klebisella pneumoniae
acinetobacter species
staph aureus

Question 16

when is aspiration pnemonia more likely

Answer 16

individuals whose level of consciousness is altered due to anaesthesia, alcohol, drug abuse or have swallowing-related problems

Question 17

causative agesnt fo aspiration oneumonia

Answer 17

oral flora
anaerobes
pseudomonas aeruginosa

Question 18

what organisms are individuals with a poor immune system susceptible to

Answer 18

pneumocystis jiroveci
aspergillus spp
cytomegalovirus

Question 19

clinical features pneumonia

Answer 19

malasie
fever
cough productive of sputum which may be purulent or rusty coloured

Question 20

what is a dry cough that doesnt resolve with time be indicatie of

Answer 20

atypical pneumonia caused by mycoplasma pneumoniae or chlamydia pneumoniae

Question 21

what are yhe new focal chest signs in CAP

Answer 21

crackles
decreased breath sounds
dullness to percussion
wheeze 
increased vocal resonance over area consolidation

Question 22

what is the CURB 65 score

Answer 22

assessed severity of pneumonia

C- new mental confusion
U- urea
R-resp rate
B- blood pressure

used to decide whether to hospitilisse or not

Question 23

what antibitiocs are used in hospital acquired pneumonia and why

Answer 23

Iv co-amoxiclav a yjis will cover gram negative organisms which are the most likely causative agent

Question 24

what does the URT consist of

Answer 24

nasal cavity
pharynx
larynx

Question 25

what does the lower resp tract consist of

Answer 25

trachea
bronchi
terminal bronchioles

Question 26

what does the resp zone consist of

Answer 26

resp bronchioles

alveolar ducts and alveoli

Question 27

how might a patient with pulmonary TB also develop TB in the gut

Answer 27

patients may deve;op TB if they have active TB and cough uo some MTB which is then swallowed but MTB is resistant to stomach acid

Haematogenous spread to gut

via lymphatic system