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Hugh's MD1 Respiratory > Upper and Lower Respiratory Tract Infections > Flashcards

Upper and Lower Respiratory Tract Infections Flashcards

1
Q

Has is pain causes in ottis media?

A

Fluid build up causes pressure on the tympanic membrane

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1
Q

T/F When the tympanic membrane bursts in response to infection the resolution is better if antibiotics haven’t been used.

A

True

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1
Q

Which bacteria doesn’t have a cell wall and is the most common cause of atypical pneumonia?

A

Mycoplasma

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2
Q

What is the main cause of bronchiolitis?

A

RSV

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2
Q

What are some common causes of Empyema?

A

Staph. aureus secondary to pneumonia

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2
Q

How does legionella survive within in air conditioning units?

A

It is eaten by amoebae that are unable to kill them, legionella can also survive in our macrophages.

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3
Q

Is which areas of the URT are there more anaerobes?

A

Nasal washings

Saliva

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3
Q

What are the most common bacteria present in the URT microbiota?

A

Viridans streptococci (multiple species),

Neisseria spp. (low grade),

Corynebacterium spp,

Gram -ve anaerobes,

H. influenzae (not type B),

C. albicans

Strep. pneumoniae

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3
Q

What are the common causes of Croup

A

Parainfluenza virus, influenza A and RSV

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3
Q

What is the cause of Q fever?

A

Coxiella burnetti for cattle.

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4
Q

What are some common causes of pharyngitis (without nasal involvement)?

A

Adrenovirus, enterovirus, influenza, reovirus, Strep pyogenes, Strep grp C and G

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5
Q

Which disease is associated with homelessness?

A

TB

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7
Q

What are the 6 syndromes of the upper respiratory tract?

A

Pharyngitis/Tonsillitis

Common cold

Ottis Media

Sinusitis

Epiglottitis

Croup

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8
Q

Which disease is spread by birds?

A

Chlamydophila psittaci

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9
Q

What are some common causes of acute exascerbation of chronic bronchitis?

A

Pneumococci, H. influenzae

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10
Q

What are some common causes of ottis media?

A

Strep. pneumoniae, H. influenzae, Moraxella catarrhalis

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10
Q

What is the best guess antibiotics for community acquired pneumonia?

A

pen-G/amoxycillin + doxycycline/macrolide - usually don’t want to used a bactericidal + doxy however here these two will cover all the bacterial causes of pneumonia

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11
Q

What are some common causes of bronchitis?

A

Usually part of viral URTI

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12
Q

How can epiglottitis be diagnosed?

A

Blood sample or Xray. Do not attempt to take sample off the epiglottis!

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14
Q

What are some less common commensals of the URT?

A

Strept pyogenes, Neisseria meningititis

16
Q

What are some common causes of the common cold?

A

Rhinovirus

parainfluenza

RSV

enterovirus (during summer)

Coronavirus

Human metapneumonia virus

18
Q

Why are babies more susceptible to ottis media?

A

The eustachian tube is wider - allows bacteria to travel up it from the pharynx (against the action of the cilia membrane)

19
Q

Which pneumococcal vaccine do you use in adults?

A

23 valent polysaccaride

21
Q

What are some common causes of epiglottitis?

A

H. influenzae type b - Rarely seen now due to the vaccine

22
Q

Which pathogen is picked up from soil?

A

Legionella longbeachae - common in Australia

24
Q

What percentage of cases of pharyngitis (without nasal involvement) are caused by bacteria? What are the bacteria?

A

20%, Grp A, C and G strep

26
Q

In which URT syndrome is treatment necessary?

A

Epiglottitis - essential

Pharyngitis - If bacterial

Sinusitis - If bacterial and severe

Ottis media - if under 2

(children over 2 will have side effects from the treatment than complications from the infection)

27
Q

For what species is serological testing helpful in diagnosing pneumonia?

A

Those which are slow to culture including

  • Legionella pneumophila
  • Mycoplasma pneumoniae
  • Chlamydophila and chlamydia
  • Coxiella burnetti
28
Q

After which anatomical structure is the respiratory tract divided?

A

The epiglottis

28
Q

Which disease is associated with alcoholism?

A

Klebsiella

29
Q

What are the main vaccines for prevent pneumonia?

A

Influenza vaccine and pneumococcal vaccine

29
Q

Why must you use a conjugate vaccine for pneumococcus in children?

A

The conjugate will stimulate a T cell response which will provide help to the B cell mediated antibody protection. This isn’t required in adults.

30
Q

What disease is caused by a pathogen that colonised air conditioning unit?

A

Legionnaires disease

31
Q

What are some common causes of typical pneumonia (inflammation in the alveolar/airways)

A

Pneumococci, H. influenzae, Staph, Klebsiella, Legionella, TB, Chlamydophila (C. pneumoniae and C. psttaci)

32
Q

In which URT syndromes is it important to make laboratory diagnosis?

A

Epiglottitis, Pharyngitis/tonsillitis

34
Q

What promoted Mr Gram to invent his famous stain?

A

To differentiate streptococcus and Klebsiella as causes of pneumonia.

35
Q

What are some common causes of atypical pneumonia (interstitial inflammation)?

A

Mycoplasma, Chlamydia, M. cattarhalis, Influenza, RSV, adenovirus

36
Q

What are some common causes of lung abscesses?

A

Mixed anaerobes, Staph, Klebsiella

37
Q

What are some common LRT syndromes

A

Acute bronchitis

Acute exascerbation of chronic bronchitis

Bronchiolitis

Pneumonia

Lung Abscess

Empyema

38
Q

After which anatomical structure is the respiratory tract supposed to be sterile?

A

The Larynx

38
Q

Is the common cold spread more by hands or coughing?

A

Hands

39
Q

What factors should be considered when making an aetiological diagnosis?

A

Community vs hospital acquired

Severity index

Existing illness in the host eg COPD, AIDS, CF

Risk factors like Occupation, travel, homelessness, soils, contact with animals

41
Q

What are some common causes of pharyngitis (with nasal involvement)?

A

Adenovirus, enterovirus, parainfluenza virus, influenza

43
Q

The absence of what indicates a properly collected sputum sample?

A

Squamous epithelial cells as they come from the URT.

44
Q

Why it is thought that bronchiolitis only occurs in children under 1 year old?

A

Maternal ab against RSV react to virus in the baby that causes a inflammatory response that narrows the bronchioles. This causes air trapping and wheeze.

45
Q

What types of samples are taken for the diagnosis of pneumonia?

A

Sputum

transtracheal aspirate - avoids passing the URT

Tracheostomy

Endotracheal tube - passes through the URT though

Pleural tap - for empyema

Lung biopsy - used when the patient doesn’t respond to the initial treatment. By needle (radiologist) or during open surgery.

47
Q

Which pneumococcal vaccine do you use in children?

A

13 Valent conjugate

48
Q

What are some must know causes of pneumonia

A

Influenza - for typing

Legionella - for outbreaks

Community acquired MRSA

Bioterrism agents eg anthrax

SARS, MERS

Should know

Penicillin resistant S. pneumoniae

Gram -ves like P. aeruginosa

49
Q

What are some common causes of sinusitis?

A

Primary infection: viral, part of common cold syndrome

Secondary: Haemophila influenzae, Streptococcus pneumoniae

Hugh's MD1 Respiratory (15 decks)

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