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PHAM02 - term 2 > Wk 26: Respiratory tract infections + pneumonia > Flashcards

Wk 26: Respiratory tract infections + pneumonia Flashcards

1
Q

What does the upper respiratory tract consist of?

A
  • Nasal passage
  • Pharynx
  • Larynx
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2
Q

What is sinusitis?

A

Inflammation of paranasal sinuses

  • Nasal discharge, facial pain, headache, anosmia
  • Referral: orbital + intracranial involvement
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3
Q

Which patients require referral for sinusitis?

A
  • > 10 days
  • Young + elder
  • Immunocompromised
  • Persisting fever
  • Chest pain
  • Neurological changes
  • Caution: diabetes + asthma
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4
Q

What antibiotics are given for sinusitis?

A
  • Phenoxymethylpenicillin: less resistance bc narrow spec - 500mg QDS 5 days
  • Severe: co-amox - 500mg TDS 5 days
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5
Q

What are the treatment for acute otitis media in patients not requiring admission?

A
  • Paracetamol/NSAIDs
  • W/o antibiotic: symptoms improve w/in 24hrs (60%)
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6
Q

What antibiotics are given for acute otitis media?

A
  • Amox 5-7 days
  • Worsening despite 2-3 days of abx: co-amox
  • Allergic: eryth/clarith 5-7 days
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7
Q

Define penumonia

A
  • Tissue inflammation in lungs
  • Alveoli filled w/ pus
  • Confirmed: new shadowing on x-ray
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8
Q

What is inflammation of the lung parenchyma in pneumonia?

A
  • Consolidation
  • Alveolar air spaces filled w/ exudate, inflammatory cells + fibrin
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9
Q

What are the classifications of pneumonia?

A
  • Community acquired
  • Hospital acquired
  • Healthcare associated
  • Aspiration
  • Ventilator associated
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10
Q

What are the features of community acquired pneumonia?

A
  • Cough
  • Sputum, wheeze, dyspnoea or pleuritic pain
  • Focal chest signs: dullness on percussion, crepitations + fremitus
  • Sweats, fever, myalgia + fever above 38
  • Chest xray abnormal
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11
Q

Which groups are at risk of pneumonia?

A
  • Smokers
  • Chronic lung disease
  • Immunocompromised
  • Elderly/frail
  • Diabetes
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12
Q

What are common causes of pneumonia?

A
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Mycoplasma pneumonia
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13
Q

What is streptococcus pneumoniae?

A
  • Most common cause CAP
  • Gram +ve diplococci
  • Affect virulence of organism
  • Affects hx viral infection
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14
Q

What is haemophilus influenzae?

A
  • Gram -ve rod
  • Affects: COPD
  • Antibiotic sensitive
  • Segmental, wide spread consolidation
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15
Q

What is mycoplasma pneumonia?

A
  • Lacks cell wall tf resistant to beta lactam antibiotics
  • Affects young
  • Don’t elevate WBC
  • Patchy opacities lower/middle lobes
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16
Q

How do you assess for severity?

A

CURB 65 + obs

17
Q

When would you treat according to CURB-65?

A
  • 0: home based care
  • 2/more: hospital
18
Q

When would you offer microbiology tests for CAP?

A

Mod/severe:

  • Blood + sputum cultures AND
  • pneumococcal + legionella urinary antigen tests
19
Q

What is the management for low severity community acquired pneumonia?

A

5 days treatment:

  • Amox 500mg TDS

Allergic:

  • Clarith 500mg BD
  • Doxy 200mg 1st day + 100mg OD 4 days

No improvement in 3 days: GP

20
Q

What is the management for mod/severe severity community acquired pneumonia?

A
  • 7-10 days treatment
  • Mod: amox + macrolide
  • Severe: beta lactamase stable + macrolide (IV)
21
Q

What happens if a patient is admitted to hospital after CAP?

A
  • Chest x-ray + blood test
  • Admin Ax w/in 4 hrs
  • CRP conc on admission + repeat after 48-72 hrs
22
Q

What would you need to consider before switching from IV to oral?

A
  • Resolution of fever >24hrs
  • <100bpm
  • Resolution of tachypnoea
  • Hydrated + fluids
  • Absence of hypoxia
  • Improving WBC
  • Non-bacteremic infection
23
Q

What are other treatments available for CAP after hospital admission?

A
  • Oxygen
  • Bronchodilators
  • Steroids
  • Asses risk of VTE
  • Pain management
24
Q

When would a patient not be ready for discharge?

A

Past 24 hrs: 2/more:

  • Temp >37.5
  • RR: 24
  • HR: >100
  • Systolic: <90
  • O2: <90
  • Abnormal mental status
  • Inability to eat w/o assistance
25
Q

Outline the recovery of someone w/ CAP

A
  • Wk 1: fever resolved
  • Wk 4: chest pain + sputum prod red
  • Wk 6L cough + breathlessness red
  • 3 months: most symptoms resolved but fatigue present
  • 6 months: normal
26
Q

What is the common cause of URTI infection?

A

Rhinovirus

27
Q

What are pharmacy red flags of urti?

A
  • Cough >3wks
  • Chest pain
  • Unexplained weight loss
  • Dyspnoea

PHAM02 - term 2 (21 decks)

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