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Medicine year 1 > Respiratory infection > Flashcards

Respiratory infection Flashcards

(115 cards)

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1
Q

Describe pneumonia

A

an infection of the lung parenchyma involving fluid filled distal airspaces

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2
Q

What types of organisms can cause pneumonia (3)

A

Viruses
Bacteria
Fungi

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3
Q

Describe the development of pneumonia (4)

A

Alveoli are filled with neutrophils
Exudate in the alveoli consists of neutrophils, macrophages, and fibrin
Exudate begins to organise
The exudate can be resolved or scar

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4
Q

in what way does the exudate begin to organise in progression of pneumonia

A

it becomes a more formed mass of macrophages and fibroblasts

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5
Q

What can happen in resolution of pneumonia exudate (2)

A

it can be broken down be enzymes then resorbed Or phagocytosed

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6
Q

How does scaring occur (pneumonia)

A

further fibrosis occurs

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7
Q

What are the complications of pneumonia (4)

A

fibrous scarring
Abscess formation
Empyema
Bronchiectasis

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8
Q

Describe abscess formation in the context of pneumonia (2)

A

localised collection of pus
Which results in necrosis of the lung parenchyma

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9
Q

What are the symptoms of abscess formation due to pneumonia (2)

A

chronic malaise
Fever

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10
Q

Describe empyema in the context of pneumonia (3)

A

collection of pus in the pleural cavity
Which can organise
Leading to fibrous adhesions in the pleural cavity

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11
Q

What is bronchiectasis

A

abnormal and fixed dilation of bronchi and bronchioles

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12
Q

What can accumulate in dilated airways due to bronchiectasis

A

Purulent secretions

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13
Q

describe lobar pneumonia

A

confluent consolidation of most of the lung lobe

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14
Q

What is the most common causative organism of lobar pneumonia

A

streptococcus pneumonia

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15
Q

What is bronchopneumonia (3)

A

patchy, widespread consolidation of the lungs
beginning in the terminal airways then spreading to adjacent alveolar lung
Often bilateral and basal

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16
Q

What are common causative organisms of bronchopneumonia (5)

A

strep, pneumoniae
Haemophilia influenza
Staphylococcus
Anaerobes
Coliforms

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17
Q

Describe tuberculosis (3)

A

Primary infection begins in lung
Chronic infection can be at many body sites
A mycobacterial infection

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18
Q

How does pathogenicity of mycobacterium occur

A

They are able to avoid phagocytosis and stimulate a host T-cell response

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19
Q

What type of hypersensitivity is associated with tuberculosis

A

Type 4 (delayed)

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20
Q

Describe miliary TB (2)

A

results from haematogenous dissemination
Multiple tiny foci are spread throughout the lungs and other organs

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21
Q

What are the types of TB (2)

A

primary
Secondary

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22
Q

Describe primary TB (4)

A

Occurs due to first exposure/up to 5 years after
Inhaled organism undergoes phagocytosis then is carried to hilar lymph nodes
Immune activation occurs
Granulomatous response occurs in nodes and lungs

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23
Q

What is Ghon focus (2)

A

small focus of consolidation in lung
Near pleura/lower part of upper lobe/upper part of lower lobe

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24
Q

Describe secondary tuberculosis (4)

A

reinfection or reactivation of disease
Initially remains localised
Spreads via airways and/or blood stream
Causes fibrosis and cavitating apical lesions

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25
What can lead to reactivation of tuberculosis
Decreased T-cell function
26
Where does secondary TB initially remain
apices of lungs
27
Describe histology of secondary tuberculosis (2)
Granulomas Caseous necrosis
28
What stain can be used to highlight mycobacteria
Zielh Nielsen stain
29
How is tuberculosis diagnoses in immunocompromised patients (3)
high index of suspicion Bronchi-alveolar lavage Cytology biopsy
30
What conditions of the upper respiratory tract exist (4)
Coryza/common cold Pharyngitis/sore throat Sinusitis Epiglottitis
31
What conditions of the lower respiratory tract exist (6)
acute bronchitis Acute exacerbation of COPD Pneumonia Influenza COVID 19 Fungal infection
32
Describe symptoms of strep throat (5)
exudate Pus Sore throat Dysphagia Dysphonia
33
Describe symptoms of tonsillitis (4)
swollen throat Erythrematous Dysphagia Dysphonia
34
How is tonsillitis treated
Tonsillectomy
35
Describe a complication of tonsillitis (2)
Quinsy A peri-tonsillar abscess which can be drained
36
Describe coryza (2)
an acute viral infection of the nasal passages Spread by droplets and fomites
37
What are the symptoms of coryza (2)
Sore throat Mild fever
38
What are the symptoms of sinusitis (5)
frontal headache Retro-orbital pain Maxillary sinus pain Tooth ache Discharge
39
How is acute sinusitis treated (3)
nasal decongestants Nasal steroids Pseudo-ephedrine
40
What additional symptom is associated with acute sinusitis
Purulent nasal discharge
41
What are the symptoms of acute bronchitis (3)
fever Productive cough Transient wheeze
42
What are the symptoms/sings of acute exacerbation of COPD
Sputum increased Sputum purulence increased Wheeze Breathlessness Respiratory distress Coarse crackles Ankle oedema Cyanosis
43
How are acute exacerbations of COPD managed (outpatient) (3)
antibiotics (doxycycline, amoxicillin) Bronchodilator inhalers Steroids (short period)
44
What are the signs of pneumonia
Pyresis Rigours Herpes labialis Tachypnoea Crackles Rub Cyanosis Hypotension
45
What investigations are used for pneumonia
blood culture Serology Arterial blood gas FBC Urea Liver function CXR CURB 65 score
46
What are the severity markers for pneumonia (4)
temperature Cyanosis White blood cell count Involvement of multiple lung lobes
47
Describe mycoplasma pneumonia (2)
no cell wall - therefore resitant to beta-lactam antibiotics Protracted paroxysmal cough
48
What are the clinical indicators of lower respiratory tract infection (3)
elevated CRP Elevated pro-calcitonin Elevated or low white blood cell count
49
When would IV antibitoics be used to treat respiratory infection (4)
If oral route is unavailable Sensitivity Deep seated infections First dosage
50
Describe cystic fibrosis (4)
Genetic disease Abnormally viscous mucus Which blocks structures Resulting in repeated chest infections and chronic colonisation
51
What causes cystic fibrosis
an autosomal recessive mutation in the gene coding for the CFTR protein
52
Describe the classes of CFTR defects
five - functional protein, not enough Four - protein is right shape, can open, but not enough chlorine let through Three - protein is right shape, won’t open Two - protein made but wrong shape One - massive protein defect
53
What is the action of CFTR when it works (3)
Pumps chloride ions into secretions Chloride ions draw water into secretions Water thins the secretions
54
What are the respiratory symptoms of cystic fibrosis (6)
Recurrent respiratory infections Chronic cough with sputum Dyspnoea Nasal polyps Haemoptysis Filled sinuses
55
What are the GI symptoms of cystic fibrosis (4)
Low BMI Bowel obstruction Problems with pancreas (stool) Gallbladder and liver disease
56
What are the other symptoms of cystic fibrosis (2)
salty sweat Bilateral absence of vas deferens
57
What are the signs of cystic fibrosis (4)
Cyanosis Clubbing Hyperinflation of chest Bilateral coarse crackles
58
What investigations are used for cystic fibrosis (2)
sweat test Genetic testing for CFTR mutations
59
How are the respiratory symptoms of cystic fibrosis managed (4)
chest physiotherapy Sputum samples Prophylactic antibiotics CFTR modulators
60
How are the pancreatic symptoms of cystic fibrosis managed (2)
CREON Diabetes monitoring
61
How are the bowel symptoms of cystic fibrosis managed (2)
laxatives fluids
62
How are the liver symptoms of cystic fibrosis managed
TIPSS is used for portal hypertension
63
How are exacerbations of cystic fibrosis managed (4)
Chest physiotherapy Antibitoics Increased dietary input Hydration
64
What are the special cases of pneumonia (4)
mycoplasma a Hospital acquired Aspiration Legionella
65
How is hospital acquired pneumonia treated (2)
amoxicillin Gentamicin
66
How is aspiration pneumonia treated (3)
anaerobic cover required Amoxicillin Metronidazole
67
How is legionella pneumonia treated
Levofloxacin
68
What pneumonia symptoms are associated with older patients (3)
Confusion Diarrhoea Reduced mobility
69
what symptoms of pneumonia are associated with younger patients (4)
cough Sputum Fever Pain
70
What is an Intrapulmonary abscess
liquefactive necrosis with confined cavitation resulting from a pulmonary infection
71
What do multiple Intrapulmonary abscesses indicate
bacteraemia
72
What are the risk factors for Intrapulmonary abscesses (4)
Immunosuppression Immunodeficiency Abnormal innate immunity Repeated insult
73
Describe the symptoms of Intrapulmonary abscesses (3)
lethargy/tiredness/weakness Cough ± sputum Vomiting
74
describe the signs of intrapulmonary abscesses (3)
indolent Weight loss Pneumonia that worsens despite treatment
75
What investigations can be used to identify intrapulmonary abscesses (3)
Ultrasound CT CXR
76
How are intrapulmonary abscesses managed (2)
broad spectrum antibiotics Surgical drainage
77
What is the hallmark of septic emboli
Multiple fluid filled cavities at the right base of the lungs
78
What is empyema
pus in the pleural space
79
Which stages of progression of effusion to empyema require chest tube drainage (2)
complicated parapneumonic effusion Empyema
80
Describe bronchiectasis and its effects (3)
localised an irreversible dilation of the bronchial tree Makes bronchi dilated, inflamed, and easily collapsible Causes airflow obstruction Causes impaired clearance of secretions
81
What conditions is bronchiectasis associated with (4)
Cystic fibrosis Lung infection Kartagener’s syndrome Immunodeficiencies
82
Describe the Pathophysiology of bronchiectasis (3)
excessive inflammatory response occurs, causing fibrosis The airways dilate as surrounding scar tissue contracts Dilation leads to mucus stasis
83
What bacteria are associated with bronchiectasis (2)
Haemophilus influenza Pseudomonas aeruginosa
84
What are the symptoms of bronchiectasis (4)
Chronic productive cough Fever Malaise Haemoptysis
85
What are the signs of bronchiectasis (5)
clubbing Recurrent infections Coarse crackles Reduced/absent breath sounds No/reduced response to antibiotics
86
Describe chronic bronchial sepsis
Condition with all hallmarks of bronchiectasis showing no bronchiectasis on a CT scan
87
What investigations are used to diagnose bronchiectasis (4)
CT FBC, urea, lft IgG/IgM/IgA (IgE) Standard/mycobacterial cultures
88
How does bronchiectasis present on a CT scan (2)
Airways are thickened and dilated Tram line shadowing
89
How is bronchiectasis managed (4)
smoking cessation Flu + pneumococcal carvings Antibiotics Physiotherapy
90
Describe antibiotic treatment of bronchiectasis (2)
antibiotic choice depends on sputum culture If colonised with persistent bacteria, oral macrolide/gentamicin(etc) is given
91
What physiotherapy is used to manage bronchiectasis
ACBT Huffing Autonomous drainage
92
What can be used as anti-inflammatory treatment for bronchiectasis
Low dose macrolides
93
What are examples of special cases of bronchiectasis (2)
primary ciliary dyskinesia Cystic fibrosis
94
What type of hypersensitivity is TB associated with
type four (granulomas and necrosis)
95
Describe Pathophysiology of TB (3)
pathogen is phagocytosed in alveoli and carried to hilar lymph nodes Immune activation occurs A granulomatous response occurs in lymph nodes
96
What are the pulmonary symptoms of TB (3)
cough Haemoptysis (not every case) Dyspnoea
97
what is the main diagnostic test for TB
PCR
98
How does TB present on a CXR (5)
shadows Lesions Consolidation Bilateral hilar lymphadenopathy Miliary shadowing
99
Describe the histology of TB
granulomata with centra caseous necrosis
100
What treatment is used for active TB
rifampicin+isoniazid+pyrazinamide+ethambutol for 2 months Rifampicin+isoniazid for 4 months
101
How is latent TB treated
Rifampicin+isoniazid for 3 months Or Isoniazid for 6 months
102
Which immune response is activated in Pathophysiology of TB
Th1-biased adaptive immunity (CMI) Involves enhanced effector mechanisms
103
What are examples of non-tuberculosis mycobacterium (2)
MAC M.abscessus
104
How are NTMs diagnosed (4)
respiratory symptoms Positive sputum culture PCR Radiology: bronchiectasis in anterior lung
105
How is non severe MAC managed
Rifampicin, ethambutol, and azithromycin 3x a week
106
How is severe MAC managed
Rifampicin, ethambutol, and azithromycin daily
107
How is macrolide resistant MAC treated
Rifampicin, ethambutol, and isoniazid daily
108
Where are NTM found
infected soil and water
109
What bacteria is associated with birds
chlamydia psittaci
110
What bacteria is associated with alcoholism
Klebsiella
111
Which bacteria causes rust-coloured sputum
streptococcus pneumoniae
112
Which bacteria causes green sputum (2)
pseudomonas and haemophilus
113
Which bacteria causes red jelly sputum
Klebsiella
114
Which bacteria cause foul smelling sputum
anaerobes
115

Medicine year 1 (35 decks)

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