ACUTE RESPIRATORY INFECTION AND PNEUMONIA Flashcards

1
Q

what are some of the main defence mechanisms of the respiratory tract?

A
nasal hairs
nasal turbinates
cough reflex
mucociliary escalator
trachea and bronchial tree narrowing 
sneezing
innate and acquire immune responses
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2
Q

what is commensalism?

A

a relationship between 2 organisms where 1 benefits and the other is unaffected

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3
Q

what is an infection?

A

the presence of a microorganism causing damage to body tissues

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4
Q

what is an opportunistic infection?

A

an infection caused by a microorganism that normally does not cause disease but becomes pathogenic when the body’s defence is compromised

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5
Q

what are some upper respiratory tract infections?

A
tonsilitis
pharyngitis
laryngitis
sinusitis
common cold
otitis media
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6
Q

what are some common lower respiratory tract infections?

A
tracheitis
bronchitis
pneumonia
lung abscess
bronchiolitis
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7
Q

what is acute bronchitis?

A

inflammation of the tracheo-bronchial treae

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8
Q

when is peak incidence for acute bronchitis?

A

winter

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9
Q

what are symptoms of acute bronchitis?

A

cough
shortness of breath
wheezing
retrosternal burning chest pain

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10
Q

what does acute bronchitis look like on chest xray?

A

normal

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11
Q

what are the main aetiological agents of acute bronchitis?

A

mostly viruses - rhinovirs, coronavirus, adenovirus, parainfluenza, influenza A/B
bacteria - haemophilus influenza, streptococcus pneumonia, staph aureus and mycoplasma pneumoniae

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12
Q

what are exacerbations of COPD?

A

acute bronchitis on a pre-existing diagnosis of COPD so you present with a sustained increase in symptoms including SOB, cough and wheeze

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13
Q

what is pneumonia?

A

an infection in the lungs caused by microbes resulting in ifnlamamtion that brings water into the lung tissue, making it harder to breathe.

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14
Q

what are the causative organisms of community acquired pneumonia?

A

s. pneumonia
s. aureus
h. influenza
group A streptococci
influenza virus
respiratory syncytial virus
parainfluenza

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15
Q

what are risk factors for community-acquired pneumonia?

A

advanced age, lowered immunity, smoker, alcohol abuse, malnutrition, chronic lung disease

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16
Q

outline the stages of pneumonia?

A

congestion - day 1-2 as blood vessels and alvelo start filling with excess fluid
red hepatization - days 3-4 as exudate starts filling airspaces, solidifies them and lungs develop a liver-like appearance
grey hepatozation - days 5-7 as lungs remain firm but red blood cells in exudate break down we get a colour change
resolution - day 8 -3 weeks as exudate is digested by enzyme ingested by macrophages and coughed up

17
Q

what are complications of pneumonia?

A

meningitis, sepsis, pleural effusions

18
Q

what are symptoms and signs of pneumonia?

A
fever
cough
haemoptysis
pleuritis chest pain
tachypnea
tachycardia
dyspnea
muscle pain
fatigue
crepitation on palpation
dullness to percussion
19
Q

what would you see on an x-ray of someone with pneumonia?

A

interstitial infiltrates consolidation and pleural effusion sometimes

20
Q

what causes typical pneumonia?

A

streptococcus pneumoniae

21
Q

what microroganism causes atypical pneumonia?

A

mycoplasma chlamydia and legionella

22
Q

what is nosocomial pneumonia?

A

hospital acquired pneumonia - occurs >48 hours after admission or following discharge

23
Q

what microorganisms cause nosocomial pneumonia?

A

MRSA
klebsiella pneumoniae
pseudomonas aeuginosa
acinetobacter

24
Q

what are risk factors for nosoconial pneumonia?

A

intubation
poor staff hygeine
contaminated quipment

25
Q

which type of pneumonia is associated with community acquired and which with nosocomial?

A

lobar pneumonia is most commonly associated with community acquired and bronchopneumonia with hospital acquired

26
Q

what is lobar pneumonia?

A

pneumonia characterized by inflammatory exudate within the intra-alveolar space resulting in consolidation affecting a large and continuous area of the lobe of a lung

27
Q

what is bronchopneumonia?

A

acute inflmmation of the bronchi, accompanied with inflamed patches in nearby lobules of the lungs

28
Q

what is atypical pneumonia?

A

pneumonia not caused by one of the pathogens most commonly assocuated with the disease
more likely to present with generlizd symptoms such as fever, headache, sweating, myalgia and bronchopneumonia

29
Q

what are the 2 syndromes that legionella pneumophila can cause?

A

legionnaires disease and pontiac fever

30
Q

what is legionnaires disease?

A

a type of atypical pneumonia

31
Q

where does legionella reside?

A

in warm water

32
Q

how do we assess the severity of pneumonia?

A
CURB65 score 
confusion of new onset
urea >7
resp rate >30
SBP <90 or DBP <60
Age >65
33
Q

whats the treatment for pneumonia?

A

oral amoxicillin
if atypical pathogens suspected then amoxicillin with clarithromycin or erythromycin (pregnancy)
if they have a penicillin allergy then give clarithromycin or doxycycline

if high severity then give Co-amoxiclav with clarythromycin or oral erythromycin - can give IV

34
Q

what is co-amoxiclav?

A

amoxicillin with clavulanic acid to kill the bacteria that cause an infection.
clavulanic acid is a beta lactamase inhibitor which prevents the bacteria from rendering the amoxicillin inactive

35
Q

what is bronchiectasis?

A

a long-term condition where the airways of the lungs become widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection.
persistant cough and SOB are common symptoms

36
Q

what is bronchiolitis?

A

a common lower respiratory tract infection that affects babies and young children under 2 years old- symptoms similar to a common cold
affects the brionchioles