Lower Respiratory Tract Infections

Question 1

4 common LRTIs

Answer 1

Bronchitis
Bronchiolitis
Pneumonia
Influenza

Question 2

What causes 99% of cases of bronchitis

Answer 2

Viruses

Question 3

Does bronchitis need treatment to resolve

Answer 3

No - self limiting

Question 4

Self limiting

Answer 4

Disease that tends to go away on its own without treatment

Question 5

What viruses and bacteria can cause bronchitis

Answer 5

Virus - adenovirus coronavirus parainfluenza influenza rhinovirus RSV
Bacteria - bordetella pertussis, mycoplasma pneumonia

Question 6

How long is acute bronchitis symptomatic for

Answer 6

Up to 2 wks

Question 7

Acute bronchitis symptoms

Answer 7

Sore throat
Fatigue
Stuffy/runny nose
Fever
Body aches
Vomiting
Diarrhea

Question 8

Bronchitis pathophysiolgy

Answer 8

Inflammation of bronchi

Question 9

How is acute bronchitis prevented

Answer 9

Decrease infection risk - hygiene, PPE, etc

Question 10

What medications are recommended for bronchitis symptoms relief

Answer 10

Antipyretics
Analgesics
Antitussives

Question 11

How does a CXR appear in a bronchitis patient

Answer 11

Usually clear

Question 12

Bronchiolitis

Answer 12

Inflammation of bronchioles usually in children under 2yrs

Question 13

What signs could suggest a suspected bronchitis case is actually another pathology

Answer 13

Signs of consolidation
Airway obstruction
Fever
Incr RR
incr HR

Question 14

Hospital acquired pneumonia

Answer 14

Pneumonia that occurs >48hrs after hospital admission and no incubation at time of admission

Question 15

2 types of pneumonia acquisition

Answer 15

Community acquired
Hospital acquired

Question 16

Pneumonia

Answer 16

Inflammation of the alveoli in either or both lungs

Question 17

What happens to alveoli during pneumonia infection

Answer 17

Become inflamed and fill with fluid
Lose barrier function

Question 18

Which groups are at greatest risk for pneumonia

Answer 18

Elderly
Very young

Question 19

What is the most frequent pathogen to cause pneumonia

Answer 19

Streptococcus pneumoniae

Question 20

How long do pneumonia symptoms usually last

Answer 20

3-4 wks

Question 21

How does pneumonia as a direct injury cause alveolar dysfunction

Answer 21

Inflammation and innate immune response

Question 22

How can pneumonia be caused by pathogenic microorganisms in the lung parenchyma

Answer 22

Microorganism overgrowth causes intra alveolar exudates

Question 23

How can pneumonia be diagnosed

Answer 23

Physical exam
Complete blood count
Sputum culture
Urine test
PCR
CT scan

Question 24

How does a CXR appear in a pneumonia patient

Answer 24

Consolidation

Question 25

What is needed for a pneumonia diagnosis in secondary care

Answer 25

Clinical signs and symptoms Consolidation on CXR

Question 26

What is needed for a pneumonia diagnosis in primary care

Answer 26

Signs and symptoms New focal chest signs 1+ systemic feature

Question 27

What features are involved in CURB65 score

Answer 27

Confusion Blood urea Resp rate 30+/min Blood pressure SBO<99/DBP<60

Question 28

How is pneumonia severity assessed

Answer 28

CRB65 score - community CURB65 score - hospital

Question 29

How is pneumonia with a CRB65 score of 3/4 treated

Answer 29

Urgent hospital admission Empirical antibiotics

Question 30

How long should a pneumonia patient be given antibiotics

Answer 30

5 days

Question 31

Which antibiotic is the first choice for pneumonia treatment

Answer 31

Doxycycline

Question 32

4 Oxygen delivery systems

Answer 32

Nasal cannula Simple face mask Non rebreather mask Venturi mask

Question 33

When should oxygen be given

Answer 33

Hb O2 saturation <94%

Question 34

Which type of oxygen delivery is most suitable for emergency and trauma use

Answer 34

Non rebreather mask

Question 35

Which oxygen delivery system gives the most accurate O2 concentration

Answer 35

Venturi mask

Question 36

Does a nasal cannula give a low medium or high o2 concentration

Answer 36

Low to medium

Question 37

Which oxygen delivery system gives an O2 concentration between ~24 - ~50%

Answer 37

Nasal cannula

Question 38

Which oxygen delivery systems give O2 concentrations between 60 and 90%

Answer 38

Simple face mask Non rebreather face mask

Question 39

Is a CRB65 or CURB65 score given in the community

Answer 39

CRB65