Lower respiratory tract infections Flashcards
(45 cards)
What is examples of lower respiratory tract infections
Acute bronchitis Exacerbation of COPD Pneumonia Empyema Lung Abscess Bronchiectasis
What is the symptoms of pneumonia
Malaise - tirdness Fever Chest pain (pleuritic) - painful when breath Cough Purulent sputum Dyspnoea - breathlessness Headache
What is the sputum produced in pneumonia caused by Streptococcus pneumoniae and Klebsiella pneumoniae called
rusty sputum
What is the signs of pneumonia
Pyrexia Tachpnoea - fast respiratory rate Central cyanosis (blue tongue) Dullness on percussion of affected lobe(s) Bronchial breath sounds - harsh Inspiratory crepitations (rattes) Increased vocal resonance
What does the sign of central cyanosis indicate on a patient with pneumonia
Patient has become hypoxic
What is the different investigations used for pneumonia
Serum biochemistry and full blood count Chest X-Ray (CxR) Blood cultures Throat swab (for atypical pathogens) Urinary legionella antigen Sputum microscopy and culture
Why does a chest X-ray look white for a patient with pneumonia
looks white as alveoli filled with bacterial cells and inflammatory substances
Why are blood tests and sputum culture important in investigation of pneumonia
used to confirm an infection and to try to identify the type of organism causing the infection
What is the purpose of the Urinary legionella antigen investigation
To test for Legionnaires’ disease which is a form of atypical pneumonia caused by any type of Legionella bacteria
What is the greatest causing pathogens of pneumonia
Strep Pneumoniae 36% H. Influenzae 10.2% Legionella 0.4% Staph aureus 0.8% Mycoplasma pneumoniae 1.3% Chlamydia psittaci 1.3%
What are the risk factos affect the scoring on your severity of pneumonia
The CURB 65 C confusion U blood urea>7 R respiratory rate>30 B diastolic blood pressure<60 65 age>65
If you have 0 of the CURB 65 risk factors what is your severity and antibiotic treatment
low risk and could be treated in community with Amoxycillin or clarithromycin / doxycycline
If you have 1-2 of the CURB 65 risk factors what is your severity
if you have CURB2 how many antibiotics must you take and what are there names
hospital treatment usually required
2 -Amoxycillin and clarithromycin
If you have 3-5 of the CURB 65 risk factors what is your severity and antibiotic treatment
high risk of death and need for ITU
Co-amoxiclav and clarithromycin
When would levofloxacin be given in the treatment of pneumonia
CURB2 and above if patient is allergic to penicillin
What is the non antibiotic treatment for pneumonia
Oxygen
i.v. fluids
CPAP - continued positive airway pressure
Intubation and ventilation - if severe
What is continued positive airway pressure
a form of positive airway pressure ventilator, which applies mild air pressure on a continuous basis to keep the airways continuously open in people who aren’t able to breathe spontaneously on their own
What is the complications of pneumonia
Septicaemia - infection in blood Acute Kidney Injury Empyema Lung Abscess Haemolytic anaemia (breakdown of RBC) Acute respiratory distress syndrome
What different diagnosis can be made instead of pneumonia
Tuberculosis Lung cancer Pulmonary embolism Cardiac failure Pulmonary vasculitis (Wegners granulomatosis)
If the symptoms carry on for a long time is it more likely to be pneumonia or TB
TB
What could be mistaken as pneumonia on an X-ray
pulmonary embolism
pulmonary vasculitis
What further condtions could follow pneumonia
Lung abscess
empyema
(bronchiectasis)
What pathogens are responsible for empyema
Streptococcus (52%),
Staph. Aureus (11%),
Anaerobes (20%)
What is empyema
collection of pus (infection) in the pleural cavity
