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Respiratory system > Lower Respiratory Tract Infection > Flashcards

Lower Respiratory Tract Infection Flashcards

1
Q

name some symptoms of LRTI

A 
> malaise
> fever
> chest pain (pleuritic)
> cough
> purulent sputum
> dyspnoea
> headache
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2
Q

name some symptoms of LTRI

A 
> pyrexia
> tachpnoea
> central cyanosis
> dullness on percussion
> bronchial breath sounds
> inspiratory crepitations
> increased vocal reasonance
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3
Q

what investigations should be carried out if a LRTI is suspected?

A 
> serum biochemistry
> full blood count
> blood cultures
> throat swab
> sputum microscopy and cuture
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4
Q

what is the most common organism to cause pneumonia?

A

strep. pneumonia

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5
Q

what two species that cause pneumonia affect young people and are associated with no respiratory complications?

A

> mycoplasma

> chlamydia

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6
Q

what other organisms cause pneumonia?

A

> h. influenza
legionella
staph aureus

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7
Q

explain the CURB 65 severity scoring

A 
Confusion
U blood urea >7
Respiratory rate >30
B diastolic blood pressure <60
65, if the are older than 65
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8
Q

how would you treat a patient with a CURB score of 0/1?

A

amoxicillin or clarithromycin/doxycyciline

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9
Q

how would you treat a patient with a curb score of 2?

A

amoxicillin and clarithromycin or levofloxacin

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10
Q

how would you treat a patient with a curb score of 3/4/5?

A

co-amoxiclav and clarithromycin or levofloxacin

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11
Q

what supportive treatment could you give to someone with pneumonia?

A

> oxygen if they are hypoxic
i.v. fluids if they are shocked
continuous positive airway pressure
intubation and ventilation

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12
Q

what complications can arise from pneumonia?

A 
> septicaemia 
> acute kidney injury
> empyema (infection in the pleural space)
> lung abscess
> haemolytic anaemia
> ARDS
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13
Q

what is the differential diagnosis for pneumonia?

A 
> tuberculosis
> lung cancer
> pulmonary embolism
> cardiac failure
> pulmonary vasculitis
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14
Q

what is an empyema?

A

this is an infection of the pleural space that can often follow pneumonia. there is diffuse ossification of the thorax and along the pleura causing it to thicken.

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15
Q

what are the signs and symptoms of empyema?

A

> chest pain

> high swinging fever

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16
Q

what in investigations are carried out in an empyema?

A

chest CT scan and a pleural ultrasound

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17
Q

how is an empyema treated?

A

with a chest drain and intravenous antibiotics that may be prolonged to 6 weeks

18
Q

what organisms are more likely to result in a cavitating pneumonia?

A

staph. aureus
pseudomonas
anaerobes

19
Q

what is bronchiectasis?

A

this is a chronic condition where airways become full of mucous and dilate

20
Q

name some causes of bronchiectasis?

A

> idiopathic
immotile cilia syndrome (cilia don’t work properly)
cystic fibrosis
childhood infections such as measles
hypogammaglobulinaemia (immunoglobulin G isn’t produced so infection cannot be fought as well)
allergic bronchopulmonary aspergillosis

21
Q

what are the symptoms of bronchiectasis?

A

> chronic cough

> daily sputum production

22
Q

what are the signs of bronchiectasis?

A

> finger clubbing

> course inspiratory crepitations

23
Q

what investigations should be carried out in bronchiectasis?

A 
> CT of the thorax
> sputum culture
> serum immunoglobulins
> total IgE and aspergillus precipitins
> CF genotyping
24
Q

what is the treatment for bronchiectasis?

A

> chest physiotherapy
treatment of infection with antibiotics
maybe inhaled therapy with beta 2 agonists and inhaled corticosteriods

25
Q

what are some viral infectious agents that cause LTRI in children?

A

> RSV
parainfluenza 3
influenza A and B
adenovirus

26
Q

what is tracheitis?

A

this is croup (barking cough and stridor) that does not get better. the tracheal wall is swollen and there are luminal debris which cause the narrowing of the tracheal debris. the child is very sick and feverish. It is caused by staph and strep.

27
Q

what are the symptoms of bronchitis?

A

> loose rattily cough
post-tussive vomit
child well (parents worried)

28
Q

what is bacterial bronchitis caused by?

A

the disturbed mucociliary clearance by minor airway malacia or RSV/adenovirus.

29
Q

what would you expect to hear in a child with bronchitis in auscultation?

A

no wheeze or creps

30
Q

describe the natural history of bronchitis

A

it is usually following an URTI and lasts around 4 weeks. the first week is the worst then each winter it gets less severe.

31
Q

what is the criteria for persistent bacterial bronchitis?

A

> wet cough
more than 1 month
remission with antibiotics

32
Q

what species is the cause of bronchiolitis?

A

RSV, para flu 3 and HMPV

33
Q

what are the signs and symptoms of bronchiolitis?

A

> nasal stuffiness
tachypnoea
poor feeding
crackles

34
Q

bronchiolitis is caused by a respiratory sinsitium virus. what does this virus do to cells?

A

it creates multinucleated cells by breaking down the walls between the cells until the huge cell breaks off.

35
Q

how would you manage bronchiolitis?

A

maximum observation and minimal intervention

36
Q

what investigations would you carry out for bronchiolitis?

A

> NPA cohorting

> oxygen saturation (severity)

37
Q

describe the signs in childhood pneumonia?

A

> focal signs
presence of creps
fever

38
Q

what is the management for childhood pneumonia?

A

> nothing if it is mild
first line oral amoxicillin
oral macrolide (second choice)
only iv antibiotics if they are vomiting

39
Q

what are the signs and symptoms of pertussis?

A

> coughing fits (more than 2 weeks)
vomiting
colour change

40
Q

how is empyema in children managed?

A

intravenous antibiotics

Respiratory system (19 decks)

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