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Respiratory > Week 6 - RTIs and Pneumonias > Flashcards

Week 6 - RTIs and Pneumonias Flashcards

1
Q

Name the most common URTI and its infectious agent

A
  • Rhinitis

- Rhinovirus

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2
Q

What are the most common viral causes of pharyngitis, laryngitis, sinusitis and otitis media?

A
  • Coronavirus
  • Influenzae
  • Respiratory Syncytial virus
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3
Q

List the defences of the resp tract

A
  • Mucociliary escalator -> Ciliated columnar epithelia and Goblet cells
  • Nasal hairs
  • Cough and sneeze reflex
  • Mucosal associated lymphatic tissue such as lymphoid follicles of pharnxy, tonsils
  • Alveolar macrophages
  • Secretory IgA/IgG
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4
Q

What is pneumonia?

A

-A lower respiratory tract bacterial infection causing inflammation of the lung alveoli and terminal airways

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5
Q

How does pneumonia usually present?

A

-Patients are acutely unwell with non-productive cough, fever, SoB, pleuritic chest pain, maliase, tachycardia, tachypnoea, dull percussion and tactile vocal fremitus

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6
Q

What would an CXR of pneumonia often show?

A

-Consolidation

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7
Q

What is pneumonia often associated with in the history?

A
  • Immunocomprimised
  • Travel
  • Underlying lung disease
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8
Q

What is acute bronchitis?

A

-Inflammation of the medium airways

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9
Q

What group of people are at risk of acute bronchitis?

A

-Smokers

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10
Q

how does acute bronchitis usually present?

A

-Fever, productive cough, SoB

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11
Q

What will the CXR show in chronic bronchitis?

A

-Normal

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12
Q

What are the common causative organisms of acute bronchitis?

A
  • S.pneumoniae
  • H.influenzae
  • Viruses
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13
Q

How is acute bronchitis treated?

A
  • Bronchodilators
  • Analgesics and antipyretics
  • Antibiotics if necessary
  • Physiotherapy to remove secretions
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14
Q

What is a major difference between acute and chronic bronchitis?

A

-Chronic not primarily infective

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15
Q

What are the common causes of Community Acquired Pneumonia?

A
  • Strep. pneumoniae
  • Haemophilus Influenzae
  • Moraxella catarrhalis
  • Staph. aureus
  • Klebsiella Pneumoniae
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16
Q

What are the common atypical causes of CAP?

A
  • Legionella

- Mycoplasma

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17
Q

What investigations would you order if you suspected CAP?

A
  • FBCs, U+Es, blood/sputum culture, CXR, CRP

- Assess with CURB 65

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18
Q

List some of the common respiratory tract flora

A
  • Viridans Streptococci
  • Neisseria spp
  • Strep pyogenes
  • Strep agalactiae
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19
Q

How would you treat CAP?

A
  • Mild to moderate -> Amoxicillin

- Moderate to severe -> Co-amoxiclav +/- doxycycline

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20
Q

What is lobar pneumonia? What is the most common cause? What is a characteristic of it?

A
  • Pneumonia which only affects an entire lobe of a lung
  • Strep pneumoniae
  • Hepatisation of lobe
21
Q

What is bronchopneumonia? Which type of pneumonia is it associated with?

A
  • Acute inflammation occurs in the walls of the bronchioles with multiple foci of isolated consolidation affecting one or more lobes
  • Hosptical acquired pneumonia
22
Q

What is interstitial pneumonia? What is the common cause?

A
  • Progressive scarring of both lungs involving the interstitium
  • Often idiopathic
23
Q

What is aspiration pneumonia? What is the common cause? Who is at risk of this?

A
  • Bronchopneumonia which develops due to aspiration of foreign materials into bronchial tree
  • Viridans strep
  • Epilepsy, alcoholics, drowning, dysphagia
24
Q

What is hospital acquired pneumonia?

A

-Pneumonia which has been acquired more than 48 hours after admission

25
Q

Which patients are most likely to get hap?

A

-Those on antibiotics, ventilators or immunocomprimised

26
Q

What are the most common causes of hap?

A
  • Staph aureus
  • Enterobacteriaciae
  • Psuedomonas spp.
27
Q

What is the treatment and mamagement of HAP?

A
  • Sputum culture and gram stain
  • Co-amoxiclav 1st line
  • Meropenem 2nd line
  • Assess with CURB 65
  • Analgesics and antipyretics, fluids
28
Q

Which RTIs are most common in HIV patients?

A
  • Pneumocystis jivarecii Pneumonia

- TB

29
Q

Which RTI is most common in patients with neutropenias?

A

-Aspergillus/fungus

30
Q

Which RTI is most common in bone marrow transplant patients?

A

-Cytomegalovirus

31
Q

What are the common causes of viral pneumonia?

A
  • Influenzae

- Adenovirus

32
Q

What are the possible outcomes of pneumonia?

A
  • Resolution with organisation of scar tissue

- Complications such as lung abscess, empyema, bronchiectasis

33
Q

What is characteristic of pneumonia caused by strep pneumoniae?

A

-Rust-coloured sputum

34
Q

What is characteristic of pneumonia caused by heaemophilus influenzae/pseudomonas?

A

-Green coloured sputum

35
Q

What are the criteria in CURB 65?

A
  • Confusion?
  • Urea above 7mmol/L?
  • Resp rate above 30?
  • BP below 90/60
  • Age over 65?
36
Q

How is pneumonia differentiated from acute bronchitis?

A

-CXR will be normal in bronchitis

37
Q

What is characteristic by pneumonia caused by klebsiella?

A

-Red jelly sputum

38
Q

When would you do a urine sample in a RTI?

A

-If legionella/pneumococcus was suspected

39
Q

When is a bronchoalveolar lavage indicated?

A

-In non-productive infection which is not responding to treatment

40
Q

When would you do a nose/throat swab when investigating pneumonia?

A

-If you thought it was viral pneumonia

41
Q

What CURB 65 scores do you manage as severe?

A

-2-5

42
Q

What is bronchiectasis?

A

-Repeated episodes of inflammation causes loss of elastic tissue and increased damage which leads to more susceptibility to infection which leads to inflammation and so on

43
Q

What is empyema?

A

-Pus in pleural cavity

44
Q

Why may a patient failure to improve on treatment of pneumonia?

A
  • Resistant pathogen
  • Empyema/abscess
  • Adherence
  • Immunosupression
  • Other diagnosis?
45
Q

What is the gram status of S.pneumoniae?

A

-Gram positive diplococcus

46
Q

Which type of pneumonia shows ground glass opacity on CXR?

A

-Viral pneumonia

47
Q

Which type of organisms are asplenic patients susceptible to?

A

-Encapsulated eg s.pneumomnia, neiserriae

48
Q

How is pneumonia prevented?

A
  • Flu vaccine

- Chemoprophylaxis

Respiratory (17 decks)

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