Clinical Flashcards

(45 cards)

1
Q

Upper respiratory tract infections

A

Common cold
Pharyngitis
Sinusitis
Epiglottitis

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2
Q

Lower respiratory tract infections

A
Acute bronchitis
Acute exacerbation of chronic bronchitis/ COPD
Pneumonia
Influenza
Fungal infection
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3
Q

Coryza

A

Acute viral infection of the nasal passages
Often accompanied by sore throat
Sometimes mild fever
Spread by droplets and fomites

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4
Q

Viruses causing coryza

A

Adenovirus
Rhinovirus
Respiratory syncytial virus

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5
Q

Acute sinusitis

A
Preceded by common cold
Frontal headache, 
Retro-orbital pain, 
Maxillary sinus pain, 
Tooth ache, 
Discharge
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6
Q

Diphteria

A

Bacterial infection
Produces toxin
Life threatening

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7
Q

Acute bronchitis

A
Productive cough
Fever – minority of cases
Normal chest examination
Normal chest X-ray
May have a transient wheeze
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8
Q

Rhinovirus incubation time

A

1-5 days

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9
Q

Group A streptococci incubation time

A

1-5 days

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10
Q

Influenza and para influenza virus incubation time

A

1-4 days

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11
Q

RSV virus incubation time

A

7 days

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12
Q

Pertussis incubation time

A

7-21 days

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13
Q

Diphtheria incubation time

A

1-10 days

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14
Q

Epstein-Barr Virus incubation time

A

4-6 weeks

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15
Q

Pneumonia

A

Signs and symptoms of a lower respiratory tract infection, with a new infiltrate on a CXR

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16
Q

CURB 65 Severity Score

A
C new onset of Confusion
U Urea >7
R Respiratory rate >30/min
B Blood pressure Systolic <90,Diastolic <61
65 Aged 65 or older

Score 1 point for each above
Only applies to community acquired pneumonia

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17
Q

Other severity markers for pneumonia

A

Temperature <35 or >40
Cyanosis PaO2 <8kPa
WBC <4 or>30
Multi-lobar involvement

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18
Q

Complications of pneumonia

A

Respiratory failure
Pleural effusion
Empyema
Death

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19
Q

Cases of pneumonia (4)

A

Community acquired
Hospital acquired
Aspiration pneumonia
Legionella

20
Q

Aetiology of classical flu

A

Influenza A virus

Influenza B virus

21
Q

Aetiology of flu-like illnesses

A

Parainfluenza viruses

many others

22
Q

Aetiology of Haemophilus influenzae

23
Q

‘Flu complications

A
Primary influenzal pneumonia
Secondary bacterial pneumonia
Bronchitis
Otitis media
Pregnancy complications
24
Q

Causes of community acquired pneumonia (other than flu)

A

Microbiological causes:
Mycoplasma pneumoniae
Coxiella burnetii
Chlamydia

25
What are most cases of bronchiolitis caused by?
Respiratory syncytial virus
26
Empyema
Pus in the pleural space
27
Signs of complicated effusion
``` +ve gram stain pH <7.2 low glucose septations loculations ```
28
Stridor
Inspiratory wheeze due to large airway obstruction
29
Possible causes of stridor in the supraglottis/larynx
Laryngomalacia Supraglottic mass Glottic lesion Vocal cord paralysis
30
Main causes of stridor in children
Infection Foreign Body Anaphylaxis/ Angioneurotic oedema Other (eg burns)
31
Main causes of stridor in adults
``` Neoplasms Anaphylaxis Goitre Trauma (burns, strangulation, irritant gases) Bilateral vocal cord palsy Cricoarytenoid arthritis Tracheopathia ```
32
Infections causing stridor in children
``` Epiglottitis Croup/ Pseudomembranous croup Retropharyngeal abscess Diphtheria Infectious mononucleosis ```
33
Tracheomalacia
Inflammatory condition which causes destruction of cartilage
34
Investigation in stridor
``` Laryngoscopy (beware in acute epiglottitis) Bronchoscopy Flow volume loop Chest X ray Other imaging ```
35
Treatment of laryngeal obstruction
Treat underlying cause eg foreign body removal, Mask bag ventilation with high flow O2 Cricothyroidotomy Tracheostomy
36
Treatment of malignant airway obstruction
Tumour removal (laser; photodynamic therapy; cryotherapy; diathermy; surgical resection) Tumour compression Radiotherapy Chemotherapy
37
Acute anaphylaxis
``` Type 1 Hypersensitivity (IE) Flushing, pruritus, urticaria Angioneurotic oedema Abdominal pain, vomiting Hypotension Stridor, wheeze and respiratory failure ```
38
Treatment of anaphylaxis
``` IM Adrenaline IV antihistamine IV corticosteroid High flow O2 Nebulised bronchodilators Endotracheal intubation ```
39
Snoring
Relaxation of pharyngeal dilator muscles during sleep Upper airway narrowing Turbulent airflow Vibration of soft palate and tongue base
40
Obstructive sleep apnoea
Intermittent upper airway collapse in sleep Hypoxia Sleep fragmentation
41
Risk factors for sleep apnoea
``` Enlarged tonsils Obesity Retrognathia Acromegaly Oropharyngeal deformity Neurological Drugs/alcohol Post-operative period ```
42
Clinical presentation of sleep apnoea
Excessive daytime sleepiness Personality change Cognitive / functional impairment Major impact on daytime function
43
Consequences of sleep apnoea
``` Hypertension Activated sympathetic system Raised CRP Impaired endothelial function Impaired glucose tolerance Increased CDV risk ```
44
Diagnosis of sleep apnoea
``` Snoring & EDS (raised Epworth score) Overnight sleep study - oximetry - domicillary recording - full polysomnography ```
45
Treatment for obstructive sleep apnoea
Remove underlying cause Continuous Positive Airway Pressure (CPAP) Mandibular Advancement Device Surgery