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Respiratory system > Upper and lower respiratory tract infections > Flashcards

Upper and lower respiratory tract infections Flashcards

1
Q

What are the common viral infective agents?

A

Adenovirus, paraflu I and III, influenza A and B, rhinovirus

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2
Q

What are the common bacterial infective agents?

A

Streptococci, Haemophilus influenzae, Staphylococcus aureus, Moraxella catarrhalis , Mycoplasma

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3
Q

What are the common symptoms?

A

Sore throat, fever

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4
Q

What are the common symptoms?

A

lymphadenopathy, decreased appetite, dysphagia (trouble swallowing), redness and sings of inflammation

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5
Q

What investigations should be carried out?

A

Nose or throat swab, full blood count (raised white blood cells and C reactive protein)

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6
Q

What is the treatment?

A

If not serious just rest, fluids and paracetamol or aspirin, most of them are self-limiting

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7
Q

What are the infections of upper respiratory tract?

A

Rhinitis, otitis media, tonsillitis, epiglottitis, laryngitis, pharyngitis, laryngotracheal

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8
Q

What is rhinitis or coryza?

A

irritation and inflammation of the mucous membrane in the nose

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9
Q

What are the symptoms of rhinitis?

A

stuffy and runny nose, sneezing, post-nasal drip

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10
Q

What are other possible complications?

A

pneumonia, bronchiolitis, septicaemia

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11
Q

What is otitis media?

A

Inflammation of the middle ear, red and bulging drum

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12
Q

What are the common causes of otitis media?

A

Usually viral,secondary pneumococcal/ heamophilar infection

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13
Q

What are the possible complications of otitis media?

A

rupture of ear drum

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14
Q

What is the most important treatment in otitis media?

A

Analgesia

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15
Q

What is tonsillitis?

A

inflammation of tonsils

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16
Q

What is pharyngitis ?

A

Inflammation of pharynx

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17
Q

What are the common causes of tonsillitis and pharyngitis?

A

Can be both viral and bacterial, difficult to distinguish, need to do throat swab

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18
Q

What is the treatment for tonsillitis and pharyngitis?

A

Nothing or 10 days of penicillin

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19
Q

What is croup?

A

Laryngotracheocronchitis in children

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20
Q

What is the common cause of croup?

A

viruses especially paraflu I

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21
Q

What are the signs of croup?

A

Coryza, stridor, hoarse voice and barking cough

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22
Q

What is the treatment for croup?

A

Dexamethasone

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23
Q

What is epiglottitis?

A

inflammation of epiglottis

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24
Q

What is the common cause of epiglittitis?

A

Usually bacterial, H. influenza, possibly by haemolytic streptococci

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25
Q

What are the signs of epiglottis?

A

Stridor, very unwell patients, sat forward, drooling, difficulty swallowing

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26
Q

What is the treatment for epiglottitis?

A

intubation and antibiotics

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27
Q

What are the main lower respiratory tract infections?

A

bronchitis, bronchiolitis, pneumonia, acute exacerbation of COPD, empyema, lung abscess, bronchiectasis

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28
Q

What is acute bronchitis?

A

Inflammation of bronchi

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29
Q

What is pneumonia?

A

Inflammation of lungs (alveoli)

30
Q

What are the symptoms of pneumonia?

A

Malaise, fever, chest pain pleuritic on inspiration, purulent sputum that is rusty colour, headache, dyspnoea

31
Q

What are the signs of pneumonia?

A

Pyrexia, tachypnea, central cyanosis, bronchial breath sounds, dullness on percussion, inspiratory crackles, increased vocal resonance

32
Q

What investigations should be performed to diagnose pneumonia?

A

Full blood count and serum biochemistry, sputum cultures, throat swab, urinary legionella antigen test, chest X ray

33
Q

What does the chest X ray show?

A

white consolidation as alveoli are filled with inflammatory cells, fluid and bacteria

34
Q

What can be observed on CT?

A

Air bronchogram, the bronchi filled with air can be observed as the alveoli are opacified (filled with fluid)

35
Q

What are the common causes of pneumonia?

A

Most commonly streptococcus pneumonia, H. influenazae, Legionella, Staph aureus, Mycoplasma pneumoniae, Chlamydia psittaci, all viruses

36
Q

How can be the severity of pneumonia be assessed?

A

Using the CURB 65 score

37
Q

What is CURB 65 score?

A

C confusion, U blood urea >7, respiratory rate > 30, diastolic pressure < 60 age > 65, each has one point

38
Q

Where is pneumonia treated?

A

0 is community treatment, 1-2 hospital, 3-5 ITU and high risk of death

39
Q

How is pneumonia treated?

A

0-1 Amoxicillin or clarithomycin/ doxycicline
1-2 amoxicilin and clarithomycin or levofloxacin
3-5 co-amoxiclav and clarithomycin or levofloxacin

40
Q

What are the supportive treatments for pneumonia?

A

O2, IV fluids, intubation or ventilation, continuous positive airways pressure

41
Q

What are the possible complications of pneumonia?

A

septicaemia, acute kidney failure, empyema, lung abscess, haemolytic anaemia, actor respiratory distress syndrome

42
Q

What is empyema?

A

Accumulation of pus in pleural space

43
Q

What are the common bacteria associated with empyema?

A

Anaerobic organisms, staph aureus, streptococci

44
Q

What are the signs of empyema?

A

Prominent chest pain, absence of cough, often high swinging fever

45
Q

How can empyema be diagnosed?

A

Chest X ray, CT thorax and pleural ultrasound, diagnosed by aspiration , pH < 7.2 and fluid looks cloudy

46
Q

What is the treatment for empyema?

A

Chest drain, IV antibiotics, prolonged treatment, Intrapleural t-PA / DNase might be required, if not improved surgery might be required

47
Q

What is lung abscess?

A

Thin wall, filled with pus cavity

48
Q

What are the organisms associated with the abscess?

A

anaerobes, Staph aureus, pseudomonas

49
Q

What are the signs of lung abscess ?

A

Non-specific, weight loss, swinging fever, lethargy

50
Q

What is the treatment for lung abscess?

A

Prolonged antibiotics, occasionally percutaneous drainage

51
Q

What is bronchiectasis?

A

Chronic thickened airways walls, dilated and filled with mucus

52
Q

What are the causes of bronchiectasis?

A

idiopathic, immotile cillia syndrome, cystic fibrosis, childhood infections, allergic bronchopulmoanry aspergillosis, hypogammaglobulinaemia

53
Q

What are the essential investigations for bronchiectasis?

A

high resolution CT, sputum culture, serum immunoglobulins, IgE levels, CF genotyping

54
Q

What is the treatment for bronchiectasis?

A

chest physiotherapy, treatment of any infection with higher dose and longer duration, may need beta 2 agonist and bronchodilators

55
Q

What are the types of pulmonary infections?

A

primary, facultative, opportunistic

56
Q

What is primary pulmonary infection?

A

Caused by very infective organisms, can infect healthy people

57
Q

What is facultative pulmonary infection?

A

Infection in patients with predisposing lung pathology, common in clinical practise

58
Q

What is opportunistic pulmonary infection?

A

Caused by normally non-pathogenic or low pathogenic organisms, in immuno-compormised patients

59
Q

What features of upper respiratory tract help to prevent infection?

A

Spacial shape of nose cavity that enables turbulent air flow, nasal hair act as filter, epithelium that is most and warms up the air, cilia that moves up mucus with the trapped pathogens

60
Q

Describe the air flow in respiratory tract

A

Turbulent in nose, laminar in trachea, turbulent again in acinus

61
Q

What are the mechanisms that prevent infection in lower respiratory tract?

A

Macrophages in alveoli, muco-ciliary escalator that moves the mucus, cough reflex

62
Q

What is the common pathology of pulmonary infections?

A

Viral infections that disturb the muco-ciliary escalator, secondary bacterial infection

63
Q

What are the different possible types of pneumonia?

A

anatomica, aetiological, microbiological

64
Q

What are the different classes of pneumonia based on the aetiology?

A

community acquired, hospital acquired, in immunocompromised patients, atypical, aspiration, recurrent,

65
Q

What are the possible causes in pneumonia in immunocompromised patients?

A

Cytomegalovirus, fungi or yeast such as pneumocystis jirovecii

66
Q

Describe aspiration pneumonia

A

In apical right segment, in unconscious, vomiting, sedation, oesophageal lesions, neuromuscular disorders,

67
Q

What are the types of pneumonia based on anatomy?

A

broncho (very diffuse), lobar or segmental

68
Q

What is hypostatic pneumonia?

A

Occurs in patients who are in supine position for very long time, bed bound patients, poor drainage of the lungs and accumulation of mucus in the dorsal regions of the lungs

69
Q

What is endogenous lipid pneumonia?

A

Inflammation that results when lipids enter bronchial tree (due to accumulation of cellular debris such as cholesterol)

70
Q

Describe bronchopneumonia

A

Patchy consolidation, usually hypostatic, common in patents with cardiac arrest and chronic bronchitis, filled with pus in terminal and respiratory bronchioles ( where the air sits and accumulates), usually confined, lower of the lungs due to gravity, commonly bilateral

71
Q

Describe lobar pneumonia

A

Affect the whole lobe of the lungs, more aggressive microorganisms, spread, the pathogens are washed around, reaches the pleura

72
Q

What are the possible complications of pneumonia?

A

Pleurisy, pleural effusion, empyema, lung abscesses, bronchiectasis

Respiratory system (22 decks)

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