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Respiratory BJ > Lower Respiratory Tract Infections > Flashcards

Lower Respiratory Tract Infections Flashcards

1
Q

When in the year are LRTIs most common?

A

Winter

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2
Q

How does incidence of LRTI vary with age?

A

Very common in small kids
Drops off in kids>5
Then Increases with age

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3
Q

What is happening in Acute bronchitis?

A

The bronchi are temporarily inflamed

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4
Q

What are the symptoms of Acute acute bronchitis?

A 
Cough
Infected Sputum (green/yellow)
Wheeze
Fever
Shortness of Breath
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5
Q

What causes Acute Bronchitis?

A

An infection of the lungs, 90% of cases its viral

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6
Q

What bacteria are known to cause Acute Bronchitis?

A

Strep. Pneumoniae
Haemophilus Influenzae
Moraxella Catarrhalis

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7
Q

What part of the lung is affected by Pnuemonia?

A

The parenchyma, i,e, alveoli

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8
Q

What symptoms come with pneumonia?

A 
Breathlessness
Pleuritic chest pain/pluerisy
Cough often with infected sputum
Fever
Sweating/Shivering
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9
Q

How does a CXR look for someone with lobar pneumonia?

A

Large isolated sections of consolidation

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10
Q

How does a CXR look for someone with bronchopneumonia?

A

Patchy consolidation all over the lungs

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11
Q

How serious a killer is pneumonia?

A

The uks 2nd highest killer with a hospital mortality of 6-15%

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12
Q

What is bronchiectasis?

A

Permanent Abnormal dilatation of the bronchi which allows mucous to build up leading to chronic sepsis

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13
Q

What are some common causes for bronchiectasis?

A
  • Immunoglobulin deficiencies
  • Cystic fibrosis
  • Following severe infectious episodes like pneumonia and TB
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14
Q

What can bronchiectasis increase susceptibility to?

A

Frequent lung infections, including recurrent pneumonia

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15
Q

What are the common symptoms of bronchiectasis??

A 
Cough
Large scale sputum production
Copious pus formed
Occasional haemoptysis (couhing blood)
Frequent Chest infections
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16
Q

What other signs are there of bronchiectasis?

A

Clubbing

Lung crackles on both inspirtaiton and expiration

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17
Q

What kind of investigations can be used for bronchiectasis?

A
  • A sputum culture to show up resistant organisms like psuedomonas and klebsiella
  • Spirometry to show the level of airflow obstruction caused by the mucous/sepsis
  • CXR or CT
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18
Q

What would a CXR of bronchiectasis show?

A

Possibly nothing

In extreme cases cystic “tramlines” of the enlarged bronchi are visible

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19
Q

What would a CT of bronchiectasis show?

A

Outlines of dilated bronchi

20
Q

What is the main diagnostic test for bronchiectasis?

A

A high resolution CT

21
Q

How does an empyema form?

A
  • Fluid collects between pleura during pneumonia

- Microorganisms can inefct this fluid leading to pus formation and empyema

22
Q

How do we distinguish between pleural effusion and empyema?

A

The fluid is collected with a needle and examined

23
Q

How are pleural effusion and empyema treated?

A

An empyema must be drained completely, sometimes surgically, otherwise the infection persists.
A pleural effusion need only be drained if theres symptoms or it wont resolve.

24
Q

Why catn antibiotics treat an empyema?

A

They dont penetrate the pleural cavity well

25
Q

How does a lung abscess form?

A

During pneumonia pulmonary tissue necrosis occurs a pocket of infected fluid/debris forms

26
Q

How do we confirm a lung abscess diagnosis?

A

Chest CT.

A CXR can see them but not sufficiently for diagnosis.

27
Q

When does a lung abscess tend to occur?

A

In aspiration pneumonia. Alcoholism is the most common predisposing condition to lung abscesses

28
Q

How is a lung abscess treated?

A

With long-term antibiotics or sometimes drainage

29
Q

What are the 3 “levels” of microorgansism pathogenicity?

A
  • Primary
  • Facultative
  • Opportunistic
30
Q

What 3 factors feed into a lung infection?

A
  • Microorganism pathogenicity
  • Capacity to resist infection (host defences and age)
  • Exposure to infection
31
Q

What are the 5 categories of host defence to lung infection?

A
  • Mucocilliary escalator
  • Alveolar macrophages
  • Respiratory tract secretion
  • General immune system
  • Upper respiratory tract defences
32
Q

What do alveolar macrophages do to defend the lungs?

A

They phagocytose and digest any little foreign particle fucker that gets into the alveoli

33
Q

How does the mucocilliary escalator work?

A

macrophage ingests something undigestible
Hops onto mucous
Swept up by cilia (along with any foreign particles stuck in the mucous)
Swallowed (clearing throat) or coughed up

34
Q

How is the escalator damaged?

A

A viral infection can damage the ciliary epithelium preventing it from working and allowing infection ot take root.

35
Q

What do respiratory tract secretions do?

A

Help the mucocilliary escalator work

Contain important anti-bacterial compounds

36
Q

How does the upper respiratory tract protect us?

A
  • The nose filters large particles
  • particles stick to mucous and are swept away by cilia
  • Warms and humidifies air which is imporattn to escalator function
37
Q

What are the 6 aetiological classes of pneumonia?

A
  • Community acquired (CAP)
  • Hospital acquired (Nosocomial)
  • Pneumonia in the Immunocompromised
  • Atypical
  • Aspiration pneumonia
  • Recurrent pneumonia
38
Q

What causes consolidation on a pneumonia CXR?

A

Inflamed bronchioles and alveoli fill with suppurative exudate

39
Q

What are hte possible end points for pneumonia?

A
  • Most resolve
  • PLeursy/pleural effusion/empyema
  • Organistion & Scarring
  • Lung abscess
  • Bronchiecstasis
40
Q

What types of organistion can occur after pneumonia?

A

A mass lesion
Constrictive bronchiolitis
Cryptogenic organising pneumonia (COP)

41
Q

Name some microorganisms commonly causing LRTIs:

A 
Strep Pneumoniae
Haemophilus Influenzae
Klebsiella
Pseuodomonas
Staph Aureus
42
Q

What causes recurrent pneumonia?

A

Failure of the bodies defences due to:

  • Local bronchial obstruction (tumour,forien body etc)
  • Local pulmonary damage (e.g. bronchiecstasis)
  • Generalised lung disease (Cystic fibrosis, COPD)
  • Non-resp. disease (Aspiration, immunocompromised etc)
43
Q

What are the biggest causative organisms for community acquired pneumonia?

A

Strep Pneumoniae

Staph Aureus

44
Q

What are the bigest causative organisms for noscomial pneumonia?

A

Gram -ves

Staph Aureus

45
Q

Name some ways aspirating fluid is caused?

A
  • Vomiting
  • Oesophageal lesion
  • Obstetric anaesthesia
  • Neuromuscular disorders
  • Sedation
46
Q

What is hypostatic pneumonia?

A

Pneumonia caused by a build up of fluid in the lungs dorsal region. particularly in people bedridden.

Respiratory BJ (31 decks)

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