Resp 7 - Lower RTI's + Pneumonia Flashcards Preview

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Flashcards in Resp 7 - Lower RTI's + Pneumonia Deck (26):
1

List the natural defences against infection in the respiratory tract:

- Nasal hairs
- Muco-cilliary clearance
- Cough/sneezing reflex
- Lymphoid follicles in pharynx and tonsils
- Alveolar macrophages
- Local IgA and IgG secretions

2

List some organisms which make up the normal flora of the upper respiratory tract:

Anaerobes (ie Bacteroides, Clostridium, Lactobacillus)
Viridans streptococci
Neisseria spp.
Candida sp.
Strep. pneumonia
Strep. pyogenes
Haem. influenzae
Pseudosmonas spp
E coli

3

List some bacteria which make up the normal flora of the lower respiratory tract:

Normally bacteria free

4

List the most common infections in the upper respiratory tract:

Rhinitis
Pharyngitis
Laryngitis
Epiglottitis
Tracheitis
Sinusitis
Otitis media

5

What type of organisms most commonly cause upper respiratory tract infections?

Viruses

6

List the most common infections in the lower respiratory tract:

Bronchitis
Bronchiolitis
Pneumonia

7

Define bronchiectasis:

Chronic widening of airways leading to mucous build-up = more vulnerable to infection

8

Define acute bronchitis:

Inflammation of medium-sized airways (mainly in smokers)

9

What are the symptoms of acute bronchitis?

Cough
Fever
Increased sputum
(worsened) Shortness of Breath

10

What organisms are associated with acute bronchitis?

- Viruses
- Strep. pneumonia
- Haem. influenzae
- Moraxella catarrhalis

11

What is the treatment for acute bronchitis?

- Physiotherapty
- Bronchodilation
+/- Antibiotics

12

Define pneumonia:

Inflammation of the respiratory portion of the lung, usually due to infection
= Cellular exudate in alveolar spaces

13

What is the normal presentation of pneumonia?

- Malaise
- Fever
- Productive cough (sputum may be purulent/rusty/bloody)
- Pleuritic chest pain
- Shortness of breath
- Nausea/vomiting

14

Define lobar pneumonia:

Inflammation of a particular lobe of the lung

15

Define bronchopneumonia:

Inflammation arising from the bronchi/bronchioles, often diffuse and patchy

16

How does interstitial pneumonia present?

- Sudden onset dyspnoea
- Rapid respiratory failure

IDIOPATHIC

17

Who is most at risk of developing aspiration pneumonia?

- Stroke patients
- Epileptics
- Alcoholics/drug users

18

What are the 4 main types of pneumonia?

1) Hospital-acquired
2) Community-acquired
3) Aspiration
4) Immuno-compromised patient

19

What organisms most commonly cause community-acquired pneumonia (85% cases)?

- S. pneumoniae
- H. influenzae
- K. pneumonia
- S. aureus

20

Define hospital-acquired pneumonia:

Infection of the lower respiratory tract, which was not incubating at time of admission.
Usually occurs ~ 2-3 days after admission, usually associated with impaired defenced.

21

What organism most commonly causes hospital-acquired pneumonia?

S. pneumoniae

22

What is often seen in examination of a patient with pneumonia?

- Pyrexia
- Tachycardia
- Tachypnoea
- Cyanosis
- Crackles
- Dullness-to-percussion
- Tactile-vocal-fremites
- Bronchial breathing

23

What scoring system would you use to assess the severity of pneumonia in a patient? Explain it:

CURB 65 score:

C = new mental confusion
U = urea > 7mmol/L
R = respiratory rate > 30/min
B = systolic blood pressure < 90 mmHg
65+ = age over 65

If score = 2+ : Indicates need for hospital treatment
If score = 3+ : May need ICU treatment

24

Name 5 different ways to collect specimens for diagnosis of pneumonias:

1) Sputum
2) Broncholavage fluid
3) Blood
4) Urine
5) Nose/Throat swabs

25

Give the 3 opportunistic pathogens which often cause pneumonia in immunocompromised patients:

1) Pneumocystitis jiroveci
2) Aspergillus spp.
3) CMV (cytomegalovirus)

26

What is the management of pneumonia?

- Good fluid intake (IV if required)
- Anti-pyretics
- Analgesics for pleural pain
- O2 (if cyanotic with good respiratory drive)
Antibiotic:
- Amoxicillin if community-acquired (Tetracyclin if allergic)
- Co-Amoxiclav + Clarithromycin if hospital-acquired