CPRS Case 8: Pulmonary infection Flashcards Preview

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Flashcards in CPRS Case 8: Pulmonary infection Deck (15)
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1

Anatomy of lung, pleura and surface anatomy

See lecture

2

Cardinal signs and symptoms of acute inflammation

See lecture

Red
Swelling
Pain
Heat

3

Pathophysiological bases of fever

Fever:
Macrophage release IL1, TNF —> PGE2 —> increase thermal set-point

4

Pathophysiological bases of cough

Cough: clean foreign material and excess secretion from central airway
Cough reflex: abdominal muscle contraction, closure of glottis

Causes:
- virus induced acute upper respiratory tract infection (dry cough)
- chronic respiratory disease (asthma)
- increased mucus production
- increased sensitivity of cough reflex

Receptors:
- Larynx
—> irritant receptor (myelinated)
—> C-fibre ending (non-myelinated)
- Lung
—> stretched receptor (myelinated)
—> Pulmonary + Bronchial C fibre endings (non-myelinated)

5

Pathophysiological bases of haemoptysis

Causes:
- Bronchitis (most common cause)
- lung cancer
- pulmonary infection —> Pneumonia, Tuberculosis

Superficial mucosal acute inflammation and oedema —> rupture of superficial vessels —> haemorrhage

Haemorrhage + cough —> Haemoptysis

6

Important pathogens in community-acquired pneumonia

Bacteria:
1. S. pneumoniae
2. S. aureus
3. Haemophilus influenzae

Virus: Respiratory syncytial virus, parainfluenza virus (children)

7

Aetiology, pathogenic mechanism, pathology, treatment and prevention of disease caused by influenza virus and S. pneumoniae

See lecture + senior notes

8

Influence of pneumonia on gas exchange function

1. Reduction in total available SA of respiratory membrane
2. VQ mismatch since ventilation is reduced while blood flow remains normal
—> hypoxaemia + hypercapnia

9

Common acute and long term complications to pneumonia

1. Fibrosis
2. Lung abscess

Spread of infection:
Adjacent organ: pleuritis, empyema thoracis, pericarditis
Distant organ: meningitis, arthritis

10

Lung function data of obstructive and restrictive lung diseases

Obstructive:
- Difficulty in exhaling air from lungs (exhalation problem)
- FEV1 ↓↓ while FVC ↓ —> FEV1 / FVC ↓ —> FEV1/FVC < 80%

Restrictive:
- FEV1 ↓, FVC ↓ —> ↓FVC > ↓FEV1 —> FEV1/FVC > 80%
- Pneumonia is in restrictive category

11

Signs and symptoms of pneumonia and sepsis

Pneumonia:
- Systemic:
—> fever and chills
- Respiratory symptoms:
—> stabbing chest pain
—> cough with sputum
—> SOB if severe

Signs:
- Palpation:
—> limited chest expansion
—> increased tactile fremitus
- Percussion:
—> dull / no resonance
- Auscultation:
—> bronchial breath sounds
—> coarse crepitation

Sepsis:
- Tachypnea
- Tachycardia
- Drowsiness

12

Key investigations and precautions for community acquired pneumonia

Key investigations
- Blood count
- Sputum culture
- Radiological exam
- Viral investigation
- Urine antigen detection assay

Precaution: Droplet precaution

13

Appropriate antibiotics for community acquired pneumonia

Beta-lactam +/- macrolide

14

Role of vaccination in prevention of infectious diseases

1. Induction of ACQUIRED immunity against pathogen
2. Protection of HERD immunity

15

Role of smoking in respiratory infection and respiratory disease

1. Irritation of trachea and larynx
2. Swelling and narrowing of airways + excess mucus —> reduced lung function + breathlessness
3. Impairment of lungs’ clearance system —> build up of poisonous substance —> lung irritation and damage —> risk of lung infection
4. Permanent damage to air sacs —> COPD