18 LRTI's Flashcards

1
Q

Who gets acute bronchitis?
Symptoms? (3)
Treatment?

A

Winter, children
Dry cough, dyspnoea, tachypnoea.
Supportive.

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2
Q

Causes of acute bronchitis?

4 viral 3 bacterial

A

Rhinovirus, coronavirus, adenovirus, influenza.
Bacterial = less common
Haemophilus influenzae, Mycoplasma pneumoniae, Bordetella pertussis.

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3
Q

What is chronic bronchitis?

A

Productive cough on most days for 3 months of 2 successive years. Exogenous irritants.
Acute infective exacerbations (same organisms as acute bronchitis).

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4
Q

Symptoms of bronchiolitis? (4)
Epidemiology?
Cause?

A

Wheeze, cough, nasal discharge, respiratory distress.
Winter, 2-10months old.
RSV:75%. Also parainfluenza/ adenovirus/ influenza.

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5
Q

How is bronchiolitis diagnosed? (3)

Treatment?

A

CXR, FBC, nasal aspirate for viral PCR.

Supportive: O2, feeding assistance.

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6
Q

What are the typical patterns of acute bacterial pneumonia?

A

Bronchopneumonia - bronchioles with spread to alveoli.

Lobar pneumonia - most of lobe, 90% Strep pneumoniae.

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7
Q

What are the four types of pneumonia?

A

Community acquired.
Hospital acquired: >48hrs after admission.
Ventilator acquired: >48hrs after intubation/ventilation.
Aspiration.

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8
Q

What is the epidemiology of community acquired pneumonia (CAP)?
Causative organisms? (4)

A
50-70yo. Midwinter to spring.
Strep pneumoniae, Haem influenzae (person to person).
Legionella pneumophilia (environment).
Chlamydophilia psittaci (from animals).
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9
Q

Why are atypical pneumonias named as such?

A

Traditionally because cases fail to respond to penicillin or sulpha drugs/ no organism could be identified.
Now: different presentation + Rx.

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10
Q

What is the presentation of bacterial CAP? (11)

A

Rapid onset fever/chills, productive cough, pleuritic chest pain, fatigue, anorexia.
Tachypnoea, tachycardia, hypotension.
Dull to percuss, reduced air entry, bronchial breathing.

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11
Q

What is the presentation of pneumonia caused by mycoplasma pneumoniae?
Complications? (4)

A

Epidemics every 4-8yrs.
Children. Cough.
Dx: serology.
Complications: pericarditis, arthritis, Guillan-Barre, peripheral neuropathy.

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12
Q

What is the presentation of pneumonia caused by legionella pneumophilia?
6 symptoms, 2 signs

A

Colonises water piping.
High fever, rigors, dyspnoea, cough, D+V, confusion.
Deranged LFTs, low sodium.

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13
Q

What is the presentation of pneumonia caused by chlamoydophila psittaci?
6 features

A

Bird exposure.
Pneumonia and splenomegaly.
Rash, hepatitis, haemolytic anaemia, reactive arthritis.

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14
Q

How does viral influenza present?

2o organsims? (3)

A

Fever, headache, myalgia, dry cough + sore throat.
1o viral pneumonia if cardiac/lung problems.
2o bacterial pneumonia: S.pneumoniae, Haemophilus influenzae, Staphaureus.

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15
Q

What are the recommended microbiological investigations for moderate-severe CAP? (5)

A
Sputum + gram stain.
Blood culture.
Pneumococcal urinary antigen.
Legionella urinary antigen.
PCR/serolgy: viral, mycoplasma pneumoniae, chlamydophilia sp.
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16
Q

What is the CURB65 score and what is it used for.

A
CAP severity assessment. 2:mod. 3-5:high.
Confusion.
Urea >7mmol.
Resp rate >30.
BP sys less 90. dias less 60
Age >65.
17
Q

How are LRTIs prevented? (2)

A

Pneumococcal vaccination if heart/lung/kidney disease, splenectomy.
Influenza vacc f >65, chronic disease or multiple morbidities.

18
Q

Which organisms cause hospital acquired pneumonia? (2)

A

Enterobacteriacae

Pseudomonas