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Flashcards in Respiratory Infection. Deck (49):
1

What are some example of opportunistic fungal diseases?

Aspergillus, candida and pneumocystis.

2

How do we diagnose opportunistic infections?

Have a high index of suspicion, multidisciplinary team, bronchospasm alveolar lavage and biopsy.

3

What are some upper respiratory tract infections?

Corzya, pharyngitis, sinusitis and epiglottisis.

4

What are some lower respiratory tract infections?

Acute bronchitis, acute exacerbation of chronic bronchitis, pneumonia and influenza.

5

What is corzya? What are the symptoms?

Common cold. Acute viral infection of the nasal passages, often accompanied by sore throat and mild fever.

6

How is corzya spread?

By droplets and fomites.

7

What are complications of corzya?

Sinusitis and acute bronchitis. Acute sinusitis is preceded by the common cold and produces purulent nasal discharge.

8

What happens in diphtheria?

Life threatening due to toxin production. Characteristic pseudo membrane. Not usually seen in the UK due to vaccination.

9

What is seasonal flu?

Happens every year, small number of cases amongst the population with background immunity.

10

What is pandemic flu?

Not very often. Large numbers of cases with rapid spread in a population with minimal immunity.

11

What is bird flu?

Rare. Caused by migration of avian flu to poultry workers. there is a very high mortality but little man to man transmission.

12

How long does flu incubate?

1-4 days.

13

What are the symptoms of flu?

Abrupt onset, fever, chills, headache, sore throat, myalgia, malaise, anorexia, dry cough. Clear nasal discharge and signs of complications. Prostration and headache.

14

What is the recovery time for flu?

In bed 3-4 days, 5-6 days recovery, back to work in two weeks.

15

What are the complications of flu?

Small chance of death, primary viral pneumonia, secondary bacterial pneumonia, myositis, encephalitis and depression. Can also cause bronchitis, otitis media. Flu during pregnancy can cause perinatal mortality, prematurity and smaller birth weights etc.

16

What happens in primary viral pneumonia?

Dry cough, bloody sputum and respiratory failure within 24 hours onset of onset of fever.

17

What are the two neuraminidase inhibitor anti viral drugs we commonly use?

Zanamavir disc inhaler
Oseltamivir (Tamiflu) oral.

18

What viruses usually cause classical flu?

Influenza a and b.

19

What can cause flu like illnesses?

Parainfluenza and many others.

20

What link does haemophilus influenza have with flu?

It's a bacteria so isn't a primary cause of flu, but may be a secondary invader.

21

What happens in secondary bacterial pneumonia?

Usually get a new fever on day 7. It is more common in the elderly, infants and debilitated, pre existing disease and pregnant women. It causes mortality in all epidemics. It is the most common cause of death in fatal influenza.

22

What is the therapy for flu?

Bed rest, fluids and paracetamol.
Possibly an antiviral.

23

Whit is antigenic drift/shift?

Minor mutations in the surface proteins of a virus allowing epidemics.

24

What flu causes pandemics?

Influenza A.

25

What are some future threats of flu pandemics?

Avian flu H5N1
Bird to human transmission, not readily transmitted from human to human but high mortality rate.
Also reports of H7N9 in China.

26

How do we confirm flu in the lab?

PCR from nasopharyngeal or throat swabs transported in a virus transport medium.
Other places use antigen detection and virus culture.

27

How is a killed flu virus made?

Virus grown in hens eggs or cell culture, then inactivated and combined with an adjuvant. Contains mixture of influenza viruses.

28

What populations of people are flu jabs given to?

Patients at risk of complications e.g.
Those over age of 65
Those with chronic respiratory, heart or renal disease.
Immunisuppressed.
DM
Long stay residential care
health care workers and children 6 months to 2 years.

29

What two types of flu vaccines are there and which is more effective?

Live attenuated or killed virus jab. Live attenuated is more effective.

30

How is live attenuated flu vaccine administered?

Intra nasally.

31

What is pertussis?

Whooping cough.

32

What are the clinical signs and symptoms of pertussis?

Acute tracheobronchitis with cold like symptoms for two weeks. Paroxysmal coughing, violent exhalations with sever inspiratory whoop. Vomiting is common and a residual cough for a month or more.

33

How do we diagnose whooping cough?

Nasal swab, PCR in the first three weeks and serology after that. By the stage of paroxysmal coughing organism numbers are reduced.

34

When is treatment effective for pertussis?

In the first 10 days. It also reduces spread to susceptible contacts.

35

What is the problem with vaccinations for pertussis?

They are waning which could cause a resurgence.

36

What are the symptoms of legionnaires disease?

Flu like illness which may progress to severe pneumonia, with mental confusion, acute renal failure and GI symptoms.

37

How do we normally contract legionella?

Often associated with travel, usually with water. Not transmitted between people. Can be from shower vapours taken into the lungs. This way of contraction is usually fatal.

38

How do we diagnose legionella?

Urinary antigen/serology. Special culture is required and is slow growing. A PCR test on sputum is also available.

39

What is the treatment for legionella?

Erythromycin. Clarithromycin. Fluoroquinilones e.g. Levofloxacin.

40

What is another name for PCP?

Pneumocystis jiroveci.

41

What patients tend to get PCP and where in the lungs does it exist?

Patients with AIDS. Lives right down at the bottom of the lungs.

42

How do we diagnose PCP?

Bronchioalveolar lavage or induced sputum and identification of cysts.

43

What is the treatment for PCP?

Cotrimoxazole and pentamidine.

44

What is aspergillus fumigatus and what does it cause?

Fungus which causes pneumonia or systemic infection in the severely immunocompromised. Can also cause aspergilloma.

45

How do we diagnose an aspergillus infection?

Culture.

46

What is the treatment of aspergillus infection?

IV amphotereicin B.

47

What different ways can we identify bacteria in the lungs?

Sputum, blood cultures, serology and PCR.

48

What is bronchiectasis?

Abnormal fixed dilation of the bronchi. Usually due to fibrous scarring following infection but also seen with a chronic obstruction such as a tumour. The dilated airways accumulate purulent secretions.

49

What kind of infections is the immunocompromised host open to?

Virulent infections with common organisms.
Infections with opportunistic pathogens e.g.viruses, bacteria, fungi and Protozoa.