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Y1 RESPIRATORY > MicroBio and Respiratory Tract Infections > Flashcards

MicroBio and Respiratory Tract Infections Flashcards

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1
Q

How can direct virus detection be done for PCR?

A

Nasopharyngeal swabs

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2
Q

Where does H. influenzae tend to colonise in the body?

A

Upper respiratory tract

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3
Q

H. influenza is a Gram positive bacillus. True/False?

A

False

Gram negative bacillus

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4
Q

Which organisms are most commonly associated with exacerbations of COPD?

A

H. influenzae
Strep pneumoniae
Moraxella catarrhalis

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5
Q

Which organism causes whooping cough? How is it treated?

A

Bordetella pertussis

Macrolides

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6
Q

Strep pneumoniae is a B-haemolitic cocci in clusters. True/False?

A

False

A-haemolytic cocci in chains

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7
Q

The majority of organisms that cause HAP are Gram what?

A

Negative

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8
Q

If CURB56 score 0-2, which antibiotics are given?

A

Amoxicillin (Doxycycline if penicillin allergic)

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9
Q

If CURB65 score 3-5, which antibiotics are given?

A

Co-amoxiclav + IV clarithromycin/PO doxycyline (IV levofloxacin if penicillin allergic)

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10
Q

In severe HAP, which antibiotics are given?

A

Amoxicillin (Co-trimoxazole if penicillin allergic), Metronidazole, Gentamicin

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11
Q

Which antibiotics are used for Legionnaire’s disease?

A

Erythromycin/Clarithromycin

Levofloxacin if penicillin allergic

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12
Q

Which organism particularly causes pneumonia in AIDS patients?

A

Pneumocystis jiroveci

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13
Q

Which organisms are most common in CAP?

A

Strep pneumoniae
HI
Mycoplasma pneumoniae

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14
Q

Which organisms are most common in viral pneumonia?

A 
Influenza
Parainfluenza
Measles
Varicella zoster
RSV
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15
Q

Give the two main classifications of pneumonia

A

Bronchopneumonia

Lobar pneumonia

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16
Q

List the main complications of pneumonia

A

Pleurisy
Empyema
Abscess
Bronchiectasis

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17
Q

List the main reasons for reactivation of TB

A

More virulent organism

Reduced T cell function - age, HIV, immunosuppression

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18
Q

What is the most likely source of infection in an immunocomprimised host? How is it typically treated?

A

Opportunistic pathogen e.g. aspergillus, candidas

Variconazole, amphotericin B

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19
Q

Give two methods for diagnosing lung infection

A

Broncho-alveolar lavage (bronchoscope passed through mouth and fluid squirted into lung and collected)
Biopsy with stains

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20
Q

What is coryza?

A

Common cold - acute inflammation of nasal passages

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21
Q

How does diphtheria present?

A

Sore throat, low fever and pseudomembrane on tonsils/pharynx/nasal cavity

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22
Q

Describe acute epiglottitis and give its classic symptom

A

Inflammation and swelling of the epiglottis obstructs the vocal folds/trachea: life-threatening in children
CONSTANT DROOLING, sore throat, stridor

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23
Q

What are some symptoms of acute bronchitis? How does it arise?

A

Productive cough (with fever in minority)
Transient wheeze
Cold which goes to the chest

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24
Q

CXR and chest examinations are usually normal in acute bronchitis. True/False?

A

True

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25
Are antibiotics indicated in acute bronchitis?
No, unless there is underlying (chronic) lung disease (amoxicillin 1st line, doxycycline 2nd line)
26
Abdominal pain is not a symptom of pneumonia. True/False?
False | It could well be
27
What does CURB65 stand for? When is it used?
``` Confusion Urea more than 7 Resp rate more than 30 BP less than 90/61 65 yrs old Used to assess community-acquired pneumonia ```
28
What is the commonest pathogenic cause of pneumonia?
Streptococcus pneumoniae
29
What is special about legionella-acquired pneumonia? Detected via...
Chest symptoms may be absent - usually more GI disturbance | Urine antigen testing
30
How does influenza present?
High fever of abrupt onset Malaise and myalgia Headache Cough (initially dry and painful)
31
Haemophilus influenzae is the primary cause of flu. True/False?
False | May be secondary invader
32
Which influenza virus is present in pandemics?
Influenza A
33
When are antivirals given for flu?
When patient is at risk of complications (such as pneumonia)
34
Give examples of 2 antivirals
Oseltamavir | Zanamivi
35
Which disease(s) arises due to Coxiella burnetti? (3)
Pneumonia Q fever Endocarditis
36
What is bronchiolitis? Who is mainly affected? What is the common sign?
LRTI common in babies and young children Similar symptoms to a cold - cough, wheeze, fever STERNAL INDRAWING
37
Which virus is responsible for 90% of bronchiolitis?
RSV
38
What is an abscess? What name is given for an abscess in the tonsils?
Local collection of pus | Quinsy
39
Which 3 main types of virus cause coryza?
Rhinoviruses, RSV, adenoviruses
40
How does sinusitis present?
Frontal headache, facial pain Purulent rhinorrhoea Fever
41
What does xylometazoline do?
Nasal decongestant
42
Which group of viruses most commonly cause pharyngitis?
Adenoviruses
43
What is laryngotracheobronchitis? Who is it most severe in? What is its classical sign? How is it treated?
Inflammatory oedema that can affect vocal cords, usually following parainfluenza infection (CROUP) Most severe in kids under 3yrs BARKING COUGH Oral steroid
44
What common organism causes epiglottis? How would acute epiglottitis be treated?
Haemophillus influenza type B Urgent endotracheal intubation IV antibiotics - CEFTRIAZONE
45
How quickly can influenza viruses incubate?
3 days
46
Which patients are at risk of acute bronchitis?
Bacterially infected | COPD
47
Antibiotics would immediately be given to acute bronchitis patients. True/False?
False | Only given if underlying lung disease present
48
Describe chest pain in pneumonia
Usually pleuritic
49
Describe treatment for mild/moderate CAP
Amoxicillin IV for 7 days | Doxycycline if pen-allergic
50
Describe treatment for severe CAP
Co-amoxiclav IV + Clarythromicin IV (Levofloxacin if pen-allergic) Step down to Doxycycline Total duration = 10 days
51
Describe treatment for non-severe HAP
moxicillin + Metronidazole for 7 days
52
Describe treatment for severe HAP
Amoxicillin + Metronidazole + Gentamicin for 10 days
53
What is bronchiectasis?
Abnormal fixed dilation of bronchi, resulting in inflammation and build-up of mucus
54
What is the most common cause of bronchiectasis?
Cystic fibrosis
55
What is halitosis?
Bad breath
56
What happens clinically in bronchiectasis?
Recurrent bacterial infections | Productive cough
57
Which antibiotic is given for mild bronchiectasis?
Cefaclor/Ciprofloxacin | Flucloxacillin if S. aureus
58
Which antibiotic is given for persistent bronchiectasis?
Ceftazidime
59
Erythema marginatum is present in sarcoidosis. True/False?
FalseErythema nodosum, not marginatum
60
What happens to calcium and ACE levels in sarcoidosis?
They are raised
61
What is cystic fibrosis?
Autosomal recessive disorder in which there is a defect in the CFTR gene of chromosome 7
62
List some symptoms of CF
``` Thick sputum Recurrent infections Malabsorption Steatorrhoea Abnormal teenage milestones ```
63
What are the clinical features of an acute exacerbation of COPD? How is it treated?
Increased sputum production and purulence Increased SOB/ wheeze Productive cough Coarse crackles Antibiotics if increased sputum purulence - amoxicillin 1st line, doxycycline 2nd line
64
What is pneumonia?
Complete filling of alveolar spaces with inflammatory cells leading to impaired gas exchange
65
List some signs of pneumonia
``` Hypotension Fever and rigors SOB Productive cough Haemoptysis Pleurisy ```
66
How is pneumonia investigated?
``` CXR ABG/ O2 sats Sputum culture Bronchoscopy Blood test - urea Viral PCR ```
67
When is Klebsiella usually identified in pneumonia?
In alcoholics, described as 'red jelly sputum'
68
What are the common complications of flu?
Pneumonia Pericarditis Bronchitis Otitis media
69
What is advised in the management of pneumonia?
``` Antibiotics Vaccination Fluids Bed rest No smoking ```
70
What is advised in the management of flu?
Vaccination Paracetamol Bed rest Fluids
71
When in the vaccination of flu is live attenuated vaccine preferred over the killed form?
In young children

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