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Monica Respiratory > Resp tract infection > Flashcards

Resp tract infection Flashcards

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1
Q

conditions affecting upper resp tract

A

common cold - coryza
sore throat - pharyngitis
sinusitis
epiglottis

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2
Q

conditions affecting lower resp tract

A

acute bronchitis
acute exacerbations of chronic bronchitis
pneumonia
influenza

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3
Q

coryza

A

common cold

acute viral infection of nasal passages

symptoms can include
sore throat
mild fever

spread
droplets + fomites

complications
sinusitis
acute bronchitis

self limiting

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4
Q

acute sinusitis

A

after common cold

purulent nasal discharge

treatment
viral aetiology
self limited
10 days = better

some
antibiotics

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5
Q

diptheria

A

life threatening
toxin production
characteristic pseudo-membrane
not UK = vaccination

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6
Q

acute epiglottitis in children

A

life threatening due to obstruction

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7
Q

acute bronchitis

A

cold then to chest

clinical features
productive cough
fever
normal chest exam
normal chest X ray
transient wheeze
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8
Q

acute bronchitis treatment

A

self limiting = normally
antibiotics = not indicated
sign morbidity = patients with chronic lung disease

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9
Q

URTI incubation times

A 
rhiovirus 1-5 days
group A streptococci 1-5 days
influenza + parainfluenza viruses 1-4 days
RSV 7 days
Pertussi 7-21 days
Diptheroa 1-10 days
Eptsein Barr virus 4-6 days
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10
Q

acute COPD exacerbation

A

chronic sputum production
bronchoconstriction
airway inflammation

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11
Q

acute COPD clinical features

A 
preceded by upper resp tract infection
increased sputum production
increased sputum purulence
more wheezy
breathless
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12
Q

acute COPD on examinations

A 
resp distress
wheeze
coarse crackles
may be cyanosed
advanced disease = ankle oedema
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13
Q

acute COPD exacerbations primary care managemnent

A

antibiotic e.g. doxycylcline/ amoxicillin

bronchodilator inhalers

short course of steroids

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14
Q

acute COPD exacerbations refer to hospital

A

resp failure evidence

acopia

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15
Q

acute COPD exacerbations hospital management

A

arterial blood gases
CXR - find other diseases
O2 - resp failure

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16
Q

pneumonia symptoms

A 
malaise
anorexia
sweats
rigors
myalgia
arthralgia
headache
confusion
cough
pleurisy
haemoptysis
dyspnoea
preceding URTI
abdominal pain
diarrhoea
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17
Q

pneumonia signs

A 
rigors
fever
herpes labialis
tachypnoea
crackles
rub
cyanosis
hypitension
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18
Q

pneumonia investigation

A 
blood culture
serology
arterial gases
full blood count
urea
liver function
chest X ray
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19
Q

what is CURB65

A

severity score for community acquired pneumonia

1 point given for each

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20
Q

what does CURB65 stand for

A 
C new onset confusion
U urea>7
R resp rate >30/min
B B.P. systolic <90 Diastolic <61
65 age 65 years or older
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21
Q

Other pneumonia severity markers - not CURB65

A

temp <35 or >40
cyanosis PaO2 <8 kPa
WBC < 4 or > 30
multi lobar involvement

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22
Q

Most common pneumonia

A

strep pneumonia

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23
Q

pets link to pneumonia

A

chlamydia psitacci

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24
Q

pneumonia that peaks every 4 years

A

mycoplasma

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25
adult smokers + chicken pox
death from chicken pox pneumonia | varicella pneumonia
26
community acquired pneumonia: management
antibiotics - amoxicillin - doxycycline oxygen -maintain SaO2 94-98% or 88-92% fluids bed rest no smoking
27
pneumonia complications
resp failure pleural effusion emphema death
28
pneumonia special cases
hospital acquired -need extended gram negative cover aspiration pneumonia -need anaerobic cover legionella - chest symptoms - may be minimal - GI disturbance = common - confusion = common
29
Pneumonia Prevention
influenza + pneumococcal vaccines - over 65 - chronic chest or cardiac disease - diabetes - immunocompromised e.g. splenectomy influenza vaccine -healthcare workers
30
influenza clinical presentation
``` fever - high, abrupt onset malaise myalgia headache cough prostration ```
31
flu aetiology classical flu
influenza A | influenza B
32
flu aetiology flu like illness
parainfluenza virus
33
haemophilus influenza
bacterium
34
haemophilus influenza not a primary cause of flu rather a
secondary invade
35
flu trasmission
droplets/ direct contact resp secretions of someone with infection
36
high risk flu transmission
``` intubation cardiopulmonary resuscitation bronchoscopy suregry + post mortem = high speed devices dental procedures non invasive ventilation high frequency oscillatory ventilation sputum induction ```
37
flu complication
primary influenzal pneumonia (young adults) secondary bacterial pneumonia (infants/elderly) bronchitis otitis media influenza during pregnancy = perinatal mortality, prematurity, smaller neonatal size, lower birth weight
38
fly therapy
symptomatic -bed rest, fluids, paracetamol antivirals - oesltamivir - xamivir NICE guidelines
39
flu epidemics
winter epidemics | minor mutation in surface proteins - antigenic drift
40
flu pandemics
``` rare unpredictable influenza A only -antigenic shift -segmented genome -animal reservoir/ mixing vessel ```
41
lab confirmation of influenza
direct detection of virus PCR - nasopharyngeal swabs in virus transport medium - throat swabs in virus transport medium
42
flu prevention
killed vaccine -adults, health care workers, 6 months - 2 yrs live attenuated vaccine -2yrs - 17 - intra nassally
43
anti virals after flu contact
rarely used
44
most prevalent flu in winter
influenza
45
most prevalent flu in summer
rhinovirus species A
46
community acquired pneumonia causes
microbiological causes - mycoplasma pneumoniae - coxiella burnetii - chlamydia
47
mycoplasma, coxiella + chlamydophilia psittaci cna be referred to as
atypical pneumonia
48
mycoplasma, coxiella + chlamydophilia psittaci therapy
tetracycline + macrolides
49
mycoplasma, coxiella + chlamydophilia psittaci mortality
normally lower than classical bacterial pneumonia
50
mycoplasma, coxiella + chlamydophilia psittaci lab confirmation
serology - acute + convalescent bodies to lab - gold top vacutainer virus detection - PCR on resp swabs/ secretions - gradually increasing - mycoplasma only in Tayside
51
mycoplasma pneumoniae
community acquired = commonly children + young adults person to person only uncommon pneumonia in UK
52
coxiella burnetti (Q fever)
pneumonia pyrexia of unknown origin uncommon, sporadic zoonosis sheep + goats complications - culture negative endocarditis
53
chlamydia + resp disease
chlamydia psittaci --> psittacosis uncommon, sporadic zoonosis usually presents as pneumonia
54
bronchiolitis clinical presentation
``` one or two yrs fever coryza cough wheeze ```
55
bronchiolitis clinical presentation severe cases
grunting low PaO2 intercostal/ sternal indrawing
56
bronchiolitis
swelling in the smallest airways in the lungs, known as Bronchioles, obstructing them and making it more difficult for breathing
57
bronchiolitis complications
resp + cardiac failure - prematurity - pre-exisiting resp or cardiac disease
58
bronchiolitis cause
resp syncytial virus
59
bronchiolitus lab confirmation
PCR on throat or pernsaal swabs
60
bronchiolitis therapy
supportive
61
bronchiolitis epidemiology
``` every winter very common no vaccine spread in hospitals -cohort nursing -handwashing, gowns, gloves passive immunisation -poor efficacy ```
62
metapneumovirus
respiratory virus that causes an upper respiratory infection
63
metapneumovirus epidemiology
``` antibody positive by 5 2001 discovered not new world-wide highest = winter ```
64
metapneumovirus lab confirmation
PCR
65
chlamydia trachomatis
STI which can cause infantile pneumonia
66
chlamydia trachomatis diagnosed by
PCR on mothers urine or pernasal | child throat swab
67
chlamydophila pneumoniae
person to person mid resp infection may be picked up by Psitacossis test

Monica Respiratory (21 decks)

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