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Semester 2 > Lower Respiratory Tract Infections > Flashcards

Lower Respiratory Tract Infections Flashcards

1
Q

Acute Bronchitis

A

Short term inflammation of the bronchi

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2
Q

Exacerbation of COPD

A

An event in the natural course of COPD characterised by a change in the patients baseline dyspnea. cough and/or sputum that is beyond normal day to day variations, is acute in onset and may warrant a change in regular medication

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3
Q

Pneumonia

A

Lung inflammation caused by bacterial or viral infection in which the air sacs fill with pus and may become solid

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4
Q

Empyema

A

The collection of pus in a cavity in the body

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5
Q

Lung Abscess

A

A type of liquefactive necrosis of the lung tissue and formation of cavities containing necrotic debris or fluid caused by microbial infection.

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6
Q

Bronchiectasis

A

Abnormal widening of the bronchi or their branches causing risk of infection

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7
Q

What do the scores of CURB65 mean?

A
  • 0: low risk and could be treated in community
  • 1-2: hospital treatment usually required
  • 3-5: high risk of death and need for ITU
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8
Q

What is the treatment for a CURB score of 0-1?

A

Amoxycillin or clarithromycin/ doxycycline

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9
Q

What is the treatment for a CURB score of 2?

A

Amoxycillin and clarithromycin or levofloxacin

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10
Q

What is the treatment for a CURB score of 3-5?

A

Co-amoxiclav and clarithromycin or levofloxacin (if penicillin allergic)

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11
Q

What other treatment may be required for pneumonia?

A
  • Oxygen
  • IV fluids
  • CPAP
  • Intubation and ventilation
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12
Q

What complications may arise from pneumonia?

A
  • Septicaemia
  • Acute kidney injury
  • Empyema
  • Lung abscess
  • Haemolytic anaemia (mycoplasma)
  • ARDS
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13
Q

What is the differential diagnosis for pneumonia?

A
  • Tuberculosis
  • Lung cancer
  • Pulmonary embolism
  • Cardiac failure
  • Pulmonary vasculitis (Wegner’s granulomatosis)
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14
Q

What are the symptoms of empyema?

A
  • Chest pain is a prominent feature
  • Absence of cough
  • High swinging fever
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15
Q

What tests are used to investigate empyema?

A
  • CT thorax
  • Pleural ultrasound
  • Plural aspiration (pH<7.2)
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16
Q

How is empyema treated?

A
  • Chest drain
  • IV antibiotics (may be prolonged)
  • Intrapleural t-PA/DNase sometimes required
  • Surgery for patients who show no improvement
17
Q

What bacteria often cause empyema?

A
  • Streptococcus
  • Staph aureus
  • Anaerobes
18
Q

Which organisms are more likely to result in cavitating pneumonia?

A
  • Staph aureus
  • Pseudomonas
  • Anaerobes
19
Q

What are the symptoms of a lung abscess?

A

Symptoms may be non specific

  • Lethargy
  • Weight loss
  • High swinging fever
20
Q

What investigations are used in lung abscess?

A
  • CT thorax

- Sputum culture (including TB microscopy and culture)

21
Q

What is the treatment for lung abscess?

A
  • Prolonged antibiotics

- Drainage via bronchial tree but on occasion percutaneous drainage

22
Q

What are the causes of bronchiectasis?

A
  • Idiopathic
  • Immotile cilia syndrome
  • Cystic fibrosis
  • Childhood infections such as measles
  • Hypogammaglobulinaemia
  • Allergic Bronchopulmonary Aspergillosis (ABPA)
23
Q

What are the symptoms of bronchiectasis?

A

-Chronic cough
-Daily sputum production (often copious)
Sometimes
-Wheeze
-Dyspnoea
-Tiredness
-Flitting chest pains
-Haemoptysis

24
Q

What are the signs of bronchiectasis?

A
  • Finger clubbing

- Course inspiratory crepitations (auscultation)

25
Q

What investigations should be carried out with bronchiectasis?

A
  • HRCT thorax
  • Sputum culture
  • Serum immunoglobulins
  • Total IgE and Asperigillus precipitins
  • CF genotyping
26
Q

What is the typical microbiology of a bronchiectasis sputum culture?

A
  • Haemophilus influenzae
  • Staph aureus
  • Pseudomonas species
27
Q

What is the treatment for bronchiectasis?

A
  • Chest physiotherapy
  • Prompt treatment of infections with appropriate antibiotics
  • May require inhaled therapy including beta 2 agonist and inhaled corticosteroid

Semester 2 (150 decks)

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