lower respiratory tract infections

Question 1

What parts of the body are included in the lower respiratory tract?

Answer 1

trachea
bronchus
bronchioles
lungs

Question 2

What are the LRTI associated with the lungs?

Answer 2

Pneumonia

abscesses

Question 3

What are the two types of bronchitis?

Answer 3

Acute

chronic

Question 4

What are the 4 types of pneumonia?

Answer 4

hospital acquired
community acquired
ventilator acquired
aspiration

Question 5

What types of microorganisms cause LRTI?

Answer 5

bacteria
viruses
fungi - mainly only in immunocompromised

Question 6

What is acute bronchitis?

Answer 6

inflammation and oedema of the trachea and bronchi

Question 7

What are the symptoms of acute bronchitis?

Answer 7

dry cough - may be associated with retrosternal pain due to inflammation
dyspnoea - dificulty breathing
tachypnoea - fast breathing

Question 8

Which microorganisms are the main cause of acute bronchitis?

Answer 8

viruses e.g.
rhinovirus
coranovirus
adenovirus
influenza

Question 9

How do you diagnose acute bronchitis?

Answer 9

diagnostic tests not included in mild presentation
vaccination/previous exposures helps to rule out organisms
cultures of respiratory secretions

Question 10

What is the treatment for acute bronchitis?

Answer 10

supportive treatment
oxygen/respiratory support for severe disease/co-morbidites
bacterial = antibiotics

Question 11

What is chronic bronchitis?

Answer 11

sputum producing cough on most days for at least 3 months of two successive years
caused by exogenous irritants not microorganisms
have acute exacerbation via infective agents

Question 12

How would you treat a acute exacerbation in chronic bronchitis?

Answer 12

oxygen/ventilation

Question 13

What is bronchiolitis?

Answer 13

inflammation and oedema of the bronchioles

Question 14

What are the symptoms of bronchiolitis?

Answer 14

acute wheeze
cough
nasal discharge
respiratory distress

Question 15

What microorganism commonly causes bronchiolitis?

Answer 15

RSV (Respiratory syncytial virus)

Question 16

How is bronchiolitis diagnosed?

Answer 16

chest x ray
FBC
microbiological diagnosis of nasopharyngeal aspirate via PCR

Question 17

What is the treatment for bronchiolitis?

Answer 17

oxygen
feeding support
bacterial = antibiotics

Question 18

What is pneumonia?

Answer 18

infection affecting the most distal airways and alveoli forming inflammatory exudate

Question 19

What are the two anatomical patterns of pneumonia?

Answer 19

bronchopneumonia - patchy distribution from inflammed bronchioles and bronchi to alveoli
lobar pneumonia - large part or whole of lobe

Question 20

What microorganism is lobar pneumonia normally caused by?

Answer 20

streptococcus pneumoniae

Question 21

What 2 categories are the bacterial causes of pneumonia split into?

Answer 21

typical

atypical

Question 22

What is ‘atypical’ in reference to pneumonia and microorganisms?

Answer 22

fails to respond to penicillin

difficult to grow

Question 23

What are examples of typical organisms?

Answer 23

streptococcus pneumoniae
haemophilus influenza
moraxella catarrhalis
staph aureus
klebsiella pneumoniae

Question 24

What are examples of atypical organisms?

Answer 24

mycoplasma pneumoniae
legionella pneumophillia
chlamydophilia pneumoniae
chalmydophila psittaci
coxiella burnetii

Question 25

What are the symptoms of pneumonia?

Answer 25

``` rapid onset fever/chills productive cough (can have blood) sputum pleuritic chest pain malaise ```

Question 26

What are the signs of pneumonia?

Answer 26

``` tachypnoea - fast breathing tachycardia - fast heart rate hypotension dull to percuss reduced air entry, bronchial breathing - hollow blowing sounds, crackles ```

Question 27

What are the symptoms of primary viral pneumonia?

Answer 27

cough breathlessness cyanosis

Question 28

what are examples of microorganisms that cause secondary viral pneumonia?

Answer 28

s. pneumoniae h. influenzae s. aureus

Question 29

How is viral pneumonia diagnosed?

Answer 29

``` viral antigen detection using PCR routin observations bloods chest x ray nasal flush in children ```

Question 30

What is tool is used to assess the severity of pneumonia?

Answer 30

CURB65

Question 31

What acronym is used for the management of patients with community acquired pneumonia?

Answer 31

``` A = airway B = breathing C = circulation ```

Question 32

Why do you have to be careful when providing oxygen to a patient with COPD?

Answer 32

rely of hypoxic drive to breath