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Respiratory 2 > URTI/LRTI in Adults > Flashcards

URTI/LRTI in Adults Flashcards

1
Q

What parasite is a risk when eating cooked or uncooked shellfish / crustaceans?

A

Paragonimiasis

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2
Q

Paragonimiasis

A

Paragonimiasis is a food-borne parasitic infection caused by the lung fluke, most commonly Paragonimus westermani. It infects an estimated 22 million people yearly worldwide. It is particularly common in East Asia.

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3
Q

An infection with Paragonimiasis can produce what symptoms?

A

Cough

Hemoptysis

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4
Q

Explain this chest X-ray.

A

Consolidation with a perihylar distribution with sparing of the apices and peripheries.

Caused by PCP.

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5
Q

PCP

A

Pneumocystis pneumonia

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6
Q

Pneumocystis pneumonia

A

Pneumocystis pneumonia causes pneumonia in people with a weakened immune system.

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7
Q

What is PCP (pneumocystis pneumonia) caused by?

A

It is caused by a yeast-like fungus called Pneumocystis jirovecii (PJP).

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8
Q

How do you diagnose pneumonia?

A
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9
Q

What are the risk factors for community acquired pneumonia?

A

Immune deficiency

Age

Malnutrition

Steroids

Liver / Renal failure

Diabetes

Prior viral infection

Inflammatory lung disease

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10
Q

What is the prevention available for pneumonia?

What are the two types of this prevention?

A

Pneumococcal vaccines:

Polysacharide vaccine

Conjugate vaccine

Note: Neither are very good at preventing pneumonia.

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11
Q

How can you tell if someone has been vacinated against TB?

A

Look on their right deltoid for the BCG scar.

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12
Q

How does pulmonary TB present?

A

Cough, sputum, fever, weight loss, night sweats, haemoptysis.

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13
Q

What is this a chest X-ray of, explain it.

A

The chest X-ray is suggestive of a TB infection.

The essential indicator is the cavitatory apical lung disease - seen in this X-ray in the top right lung.

Cavitatory apical lung disease is the classic sign of TB.

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14
Q

What is the diagnosis?

A

Miliary TB

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15
Q

Miliary TB

A

Miliary TB is a potentially fatal form of TB that results from massive lymphohematogenous dissemination of Mycobacterium tuberculosis bacilli.

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16
Q

Where is the greatest concentration of TB infection in the UK?

A

London - due to high immigrant populations.

High risk populations include: Indian, African

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17
Q

Mantoux test

A

The Mantoux test is a widely used test for latent TB. It involves injecting a small amount of a substance called PPD tuberculin into the skin of your forearm. It’s also called the tuberculin skin test (TST).

Measures the immune response - bigger immune response = prior exposure to TB and thus needs to be screened for the disease.

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18
Q

IGRA test

A

The IGRA test measures the release of a substance called gamma interferon by white blood cells in a sample of blood when the cells are exposed to specific TB antigens.

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19
Q

Clubbing can indicate what?

A

Lung cancer

Bronchiectasis

Lung abcess

Empyema

Cystic fibrosis

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20
Q

A history of repeated small haemoptysis, or blood-streaking of sputum, is highly suggestive of what?

A

Lung cancer

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21
Q

Haemoptysis, fever, night sweats and weight loss is suggestive of what?

A

TB

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22
Q

What is the most common URTI infection and what is it caused by?

A

Acute coryza caused by rhinovirus infection.

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23
Q

Bordetella pertussis causes what condition?

A

Whooping cough

24
Q

What are the symptoms of rhinosinusitis?

A

Rhinosinusitis typically causes a combination of nasal congestion, blockage or discharge and may be accompanied by facial pain/pressure or loss of smell. Examination usually confirms erythematous swollen nasal mucosa and pus may be evident.

25
Q

Mycoplasma pneumoniae is more common in which population?

A

Young people

26
Q

Haemophilus influenzae is more common in which population?

A

The elderly

27
Q

In pneumonia what sounds are heard on auscultation?

A

Crackles

28
Q

What are the most important aspects of managing pneumonia?

A

The most important aspects of management include oxygenation, fluid balance and antibiotic therapy. In severe or prolonged illness, nutritional support may be required.

29
Q

Hospital acquired pneumonia

A

Hospital-acquired pneumonia (HAP) or nosocomial pneumonia refers to a new episode of pneumonia occurring at least 2 days after admission to hospital.

30
Q

What are the symptoms of miliary TB?

A

Blood-borne dissemination gives rise to miliary TB, which may present acutely but more frequently is characterised by 2–3 weeks of fever, night sweats, anorexia, weight loss and a dry cough.

31
Q

Bloodborne disemination

A

A bloodborne disease is a disease that can be spread through contamination by blood and other body fluids.

32
Q

What is important to think about when considering TB?

A

The risk factors and predisposition of a person to have TB.

33
Q

What is the vaccine for TB?

A

BCG vaccine

34
Q

Mycosis

A

‘Mycosis’ is the term applied to disease caused by fungal infection.

35
Q

Allergic bronchopulmonary aspergillosis

A

Allergic bronchopulmonary aspergillosis (ABPA) occurs as a result of a hypersensitivity reaction to germinating fungal spores in the airway wall.

ABPA is a hypersensitivity response to the fungus Aspergillus.

36
Q

Allergic bronchopulmonary aspergillus occurs most commonly in what patients?

A

It occurs most often in people with asthma or cystic fibrosis.

37
Q

Pneumocystis jirovecii is a fungus that causes what infection?

A

Pneumonia

38
Q

Empyema

A

This is a collection of pus in the pleural space.

39
Q

What causes empyema?

A

It is always secondary to infection in a neighbouring structure, usually the lung, most commonly due to the bacterial pneumonias and tuberculosis.

40
Q

When should empyema be suspected?

A

An empyema should be suspected in patients with pulmonary infection if there is severe pleuritic chest pain or persisting or recurrent pyrexia, despite appropriate antibiotic treatment.

41
Q

What is the condition shown on this X-ray and why?

A

Empyema

Chest X-ray showing a ‘D’-shaped shadow in the left mid-zone, consistent with an empyema.

In this case, an intercostal chest drain has been inserted but the loculated collection of pus remains.

42
Q

Bronchitis

A

Bronchitis is inflammation of the bronchi in the lungs that causes coughing.

43
Q

What are the symptoms of bronchitis?

A

Symptoms include coughing up sputum, wheezing, shortness of breath, and chest pain. Bronchitis can be acute or chronic.

44
Q

Lung abscess

A

A lung abscess is an infection of the lung parenchyma resulting in a necrotic cavity containing pus.

45
Q

Lung abscesses commonly exist with what other condition?

A

Empyema

46
Q

Lung abscess symptoms

A

Symptoms are generally insidious and prolonged, occurring for weeks to months:

  • Fever, chills, and sweats
  • Cough
  • Sputum production (purulent with foul odor)
  • Pleuritic chest pain
  • Hemoptysis
  • Dyspnea
  • Malaise, fatigue, and weakness
  • Tachycardia and tachypnea
  • Dullness to percussion, whispered pectoriloquy, and bronchophony
  • Amphoric breath sounds (low-pitched sound of air moving across a large open cavity).
47
Q

What causes lung abscesses to form?

A

Aspiration is the main cause.

48
Q

Identify the condition shown:

A

Lung abscess

On a chest radiograph, a lung abscess may look to be a solid rounded lesion (A), or, if it has a connection with the bronchus, there may be an air-fluid level in a thick-walled cavitary lesion. CT scanning (B) can be used to localize the lesion and to place a needle for drainage and aspiration of contents for culture.

49
Q

Infleunza

A

A highly contagious viral infection of the respiratory passages causing fever, severe aching, and catarrh, and often occurring in epidemics.

50
Q

Where does influenza effect and what is the result?

A

Influenza viruses infect the respiratory tract, are highly contagious, and classically produce prominent systemic symptoms early in the illness. Influenza infection causes various clinical syndromes in adults, including nonfebrile common colds, pharyngitis, tracheobronchitis, pneumonia, and a range of nonrespiratory complications.

51
Q

Causes of Hemoptysis

A

Most commonly due to infection

  • Cystic Fibrosis
  • Pneumonia
  • Haemorrhagic Telangiectasia
  • Osler Rendu Weber Disease
  • Pulmonary Arterio Venous Malformations
  • Congenital heart disease
  • Systemic lupus erythematosus
  • Goodpasture’s syndrome
  • Idiopathic Haemosiderosis
  • Carcinoid tumour
52
Q

What are the four species of bacteria that can cause tuberculosis?

A
  • Mycobacterium tuberculosis
  • Mycobacterium bovis
  • Mycobacterium africanum
  • Mycobacterium microti.
53
Q

What type of infection is TB and how is it spread?

A

TB is an airborne infection spread via respiratory droplets.

54
Q

What can cause reactivation of latent TB?

A
  • HIV co-infection
  • Immunosuppressant therapy (chemotherapy/monoclonal antibody treatment), including corticosteroids
  • Diabetes mellitus
  • End-stage chronic kidney disease
  • Malnutrition
  • Ageing
55
Q

Non-tuberculosis mycobacterial infection

A

Non-tuberculous mycobacterial (NTM) infections occur in soil and water and are not usually pathogenic due to their lack of virulence. However, where there is a breach of the normal host defence mechanisms, certain strains have the potential to become pathogenic

56
Q

How are hilar lymph nodes affected in pulmonary TB?

A

Pulmonary TB: hilar lymph nodes are usually asymmetrically enlarged.

Respiratory 2 (22 decks)

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