Lower respiratory tract infection Flashcards Preview

Clinical Pathology > Lower respiratory tract infection > Flashcards

Flashcards in Lower respiratory tract infection Deck (28):
1

What constitutes the lower respiratory tract?

Anything below the larynx!

2

What are the predisposing factors to LRTI?

- Loss/suppression of cough reflex
- Ciliary dysfunction e.g. primary ciliary dyskinesia
- Mucus dysfunction e.g. CF
- pulmonary oedema
Immunodeficiency
- Macrophage function inhibition e.g. smoking

3

What are the main fungi that cause LRTIs and who do they infect most?

Immunocomprised
- aspergillus spp
- candida spp
- pneumocytitis jiroveci

4

What is bronchitis?

Inflammation and oedema of bronchi and trachea

5

What are the main symptoms of bronchitis?

dry cough, dyspnoea, tachypnoea

6

What is the main cause of bronchitis?

Viruses e.g. rhinovirus, adenovirus, influenza

7

Are bacterial causes of acute bronchitis common?

NO - mainly viruses but can be by
-M pneumoniae
-B pertussis
-H influenza

8

What are the diagnoses and treatment of acute bronchitis?

usually, mild self limiting disease
-supportive treatment
-O2 for co- morbidities

9

What is the definition for chronic bronchitis?

Sputum producing cough on most days for 3 months of 2 consecutive years (which is not attributable to another cause)

10

What is the main cause of chronic bronchitis?

Smoking, pollution, allergen - exogenous irritants (not infection)

11

What is bronchiolitis?

Inflammation and oedema of the bronchioles

12

Who does bronchiolitis effect the most?

Paeds (2-10 months)

13

What is the main cause of bronchiolitis?

RSV

14

How is bronchiolitis diagnosed?

-Chest x-ray
-FBC
-Microbiological analysis (nasopharyngeal aspirate)

15

What is pneumonia?

Inflammation of the most distal airways (formation of inflammatory exudate i.e. pus)

16

Name the two anatomical patterns of pneumonia; what do they look like

- Bronchopneumonia - patchy
- Lobar pneumonia - large part or entire lobe

17

What is the most common cause for lobar pneumonia?

S Pneumoniae

18

Name the 4 types of pneumonia

-Community acquired pneumonia (CAP)*

-Hospital acquired pneumonia (HAP) (48hrs after admission - diff. organisms to CAP)

-Ventilator acquired pneumonia (48hrs after ventilation/ET intubation)

- Aspirate pneumonia abnormal entry of food/fluid/stomach acid into LRT

19

What are the main modes of pneumonia acquisition?

-Person-to-person
-Own commensal bacteria
-Environment
-Animals

20

What are the typical organisms for pneumonia?

S Pneumoniae
H Influenzae
S Areus
Moraxella catarrhalis
Klebsiella pneumoniae

21

What are the major symptoms of pneumonia?

Productive cough (bloody)
RAPID ONSET
(fevers, rigor, pleuretic chest pain etc)

22

What are the major SIGNS of pneumonia?

Tachycardia, hypotensive, consolidation

23

What are the atypical bacterial that cause pneumonia?

- Mycoplasma pneumoniae - associated with nephropathy (e.g. Guinean-Barre, peripheral neuropathy)

- legionella pneumonia - water works/AC/showers - fever, D&V, confusion

- Chlamoydophila pneumoniae

- Chlamoydophila psittaci - birds

24

What patients are affected by primary viral pneumonia?

Patients with pre-existing cardiac/lung disorders - primary = rare

25

What non-microbiological investigations would you perform for investigating pneumonia?

-Chest X-ray
-Bloods - FBC,U&E,CRP, LFTs
-Obs - BP, pulse, oximetry

26

What microbiological testing should we conduct?

- Sputum gram stain and culture

- Blood culture

- Legionella urinary antigen

- Pneumococcal urinary antigen

-PCR (e.g. influenza) and serology e.g. chlymydophila sp. mycoplasma pneu

27

How do we assess pneumonia?

CURB65 (1 point for each!)

C= confusion

U = urea above 7mmol

R= respiratory rate above 30

B= Blood pressure (low)

65 = above 65yrs

28

How do we prevent LRTIs

Pneumococcal vaccinations (S. pneumoninae)

Flu vaccines

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