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Respiratory > Lower Respiratory Tract Infections > Flashcards

Lower Respiratory Tract Infections Flashcards

1
Q

Which age group are typically affected by bronchiolitis?

A

Young children and infants - often below 18 months.

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2
Q

What factors may worsen bronchiolitis?

A

Younger age at onset
Smokers in home
Premature birth

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3
Q

What virus is responsible for bronchiolitis?

A

respiratory syncytial virus (RSV).

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4
Q

What are symptoms of bronchiolitis?

A

Tachypnoea
Irritating cough
Poor feeding
Apnoea (in smaller babies)

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5
Q

How is bronchiolitis diagnosed?

A

PCR
History/Examination

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6
Q

How is bronchiolitis treated?

A

Supportive only - keep child upright and plenty of fluids.

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7
Q

What is the most common aetiology of acute bronchitis?

A

Around 90% are viral in origin.

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8
Q

What is the pathology behind acute bronchitis?

A

Infection irritates and inflames the bronchi, resulting in increased mucus production - which leads to cough.

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9
Q

What are symptoms of acute bronchitis?

A

Productive cough
Fever (only in some cases)
Chest exam normal

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10
Q

How is acute bronchitis managed?

A

Supportive only.

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11
Q

Which strain of influenza results in pandemics?

A

Influenza A.

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12
Q

How is influenza treated?

A

Supportive management
Antivirals if necessary
Vaccination can be offered to at-risk groups

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13
Q

What scoring system is used to assess severity of influenza infection?

A

CRB65 score.

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14
Q

Is Haemophilus influenzae a bacteria or a virus?

A

A bacteria.

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15
Q

What organism causes whooping cough (pertussis)?

A

Bordetella pertussis.

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16
Q

How does whooping cough present?

A

The patient will have cold-like symptoms, followed by a paroxysmal cough. Vomiting is common.
May have residual cough for over a month.

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17
Q

How is whooping cough treated?

A

If cough, <3 weeks, then antibiotics.
Vaccines are available to prevent disease.

18
Q

What is pneumonia?

A

A common lower respiratory tract infection, characterised by inflammation of lung tissue.

19
Q

What is the most common causative organism of community-acquired pneumonia?

A

Streptococcus pneumoniae.

20
Q

Which organism is typically responsible for pneumonia in elderly/COPD patients?

A

Haemophilus influenzae.

21
Q

What is the commonest cause of pneumonia in PWIDs?

A

Staphylococcus aureus.

22
Q

Which atypical pneumonia, often presents in immunocompromised patients (e.g. AIDS)?

A

Pneumocystis jiroveci.

23
Q

What atypical pneumonia often presents in alcoholics?

A

Klebsiella pneumoniae.

24
Q

What atypical pneumonia is associated with inhalation of contaminated water droplets?

A

Legionella pneumophila.

25
Q

What are the two forms of pneumonia that may develop?

A

Lobar pneumonia
Bronchopneumonia

26
Q

What form of pneumonia is typically seen in young, healthy adults?

A

Lobar pneumonia.

27
Q

An elderly patient presents with dyspnoea, confusion, pleuritic chest pain, rigours and is tachypnoeic - what is the diagnosis?

A

Pneumonia.

28
Q

What is the CURB65 score used for?

A

Used in pneumonia to determine how likely it is that streptococcus is responsible?.

29
Q

What are the criteria of CURB65?

A

Confusion
Urea>7mmol
Respiratory rate >30
BP - systolic<90/diastolic<60
>65 years

30
Q

What organism produces rust-coloured sputum in cases of pneumonia?

A

Streptococcus pneumoniae.

31
Q

What organisms cause green sputum in cases of pneumonia?

A

Haemophilus influenzae, or pseudomonas aeruginosa.

32
Q

What organism is characterised by red-currant jelly sputum in pneumonia patients?

A

Klebsiella pneumoniae.

33
Q

What causes foul-smelling sputum in pneumonia patients?

A

Anaerobic organisms.

34
Q

How should a patient with a CURB65 score of 0-2 be treated?

A

Amoxicillin (if allergic, give doxycycline).

Remember this depends on the setting.

35
Q

How should a patient with a CURB65 score of 3-5 be treated?

A

Co-amoxiclav and doxycycline.

Remember this depends on the setting.

36
Q

What is the most common cause of hospital-acquired pneumonia?

A

Staphylococcus aureus

37
Q

Which patients are more susceptible to bronchopneumonia?

A

Those with a co-morbidity.

38
Q

Alongside antibiotic therapy, what other steps are involved in pneumonia treatment?

A

Give oxygen therapy (if hypoxic)
Fluids
Bed rest
Smoking cessation

39
Q

What is typically the cause of intrapulmonary abscess?

A

Usually a preceding illness (e.g. pneumonia).

40
Q

How does an intrapulmonary abscess present?

A

Patient will have pneumonia symptoms, however they will deteriorate despite treatment.

41
Q

How is a intrapulmonary abscess investigated?

A

CXR - shows a walled cavity
CT scan - will allow distinction between this and emphysema to be made

42
Q

How is an intrapulmonary abscess treated?

A

Broad spectrum antibiotics
Some may require drainage/resection

Respiratory (28 decks)

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