Week 19 - Chest Infection Flashcards
how many microorganisms are inhaled per day
between 100,000 and 1,000,000
how many microorganisms are always present
around 700
respiratory tract host defences - surface level
nasal hairs and turbinates
pseudostratified columnar epithelium with cilia - mucociliary clearance and tight junctions
mucus
airway angulation and branching bronchioles
coughing and sneezing
bronchoconstriction
respiratory tract host defences - cellular level
nasopharynx and airway microbiome
lymphoid tissue in pharynx - tonsils and adenoids
bronchus associated lymphoid tissue
immunoglobulins (IgA in large airway and IgG in alveoli)
antimicrobial peptides
surfactant
alveolar macrophages and dendritic cells
neutrophils
common causes of respiratory viral infections
rhinovirus
parainfluenza
influenza
corona
resp syncytial virus
adenovirus
common bacterial causes of infection
streptococcus pneumoniae
haemophilus influenzae
moraxella catarrhalis
staphylococcus aureus
legionella pneumophila
mycoplasma pneumoniae
coxiella burnetti
chlamydia pneumoniae and psittaci
treatments for chest infection
oxygen
glucocorticoids
anti virals
IL-6 inhibitors
JAK inhibitors
what is curb65
Confusion
Urea > 7mmol/L
Respiratory rate > 30 breaths pm
BP < 90/60 mmHg
> 65 y/o
what is curb65 used for
to predict mortality secondary to community acquired pneumonia
curb65 scores
0-1 low risk
2 moderate risk
3-5 high risk
pneumocystis jirovecii
human specific fungus
airborne
many may have asymptomatic colonisation
common cause of pneumonia in HIV infected patients in 80s/90s
lung infection in immunosuppressed
PJ diagnosis
induced sputum - give hypertonic saline nebuliser, physiotherapist then obtains sample
bronchoscopy
microscopy - silver stain
PCR for microbial DNA
PJ treatment
high dose IV cotrimoxazole and corticosteroids
prophylaxis for those at risk with oral cotrimoxazole
