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Flashcards in Respiratory Infection Deck (32)
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1
Q

What are the clinical features of TB?

A

Sub acute general onset
Weight loss, night sweats, malaise, headache, drowsy
Cough, haemoptysis

2
Q

How is TB diagnosed?

A

ZN stain = pink
PCR = Look for resistance
Histology = Caseating granuloma

3
Q

What is the common CXR finding for TB?

A

Upper lobe predominant
Cavities
Tissue deterioration
Scarring and shrinkage

4
Q

What is the treatment for TB?

A
2 months = 
Rifampicin 
Isoniazid 
Pyrazinamide 
Ethambutol 

4 months =
Rifampicin and Isoniazid

5
Q

How is latent TB diagnosed?

A

Mantoux test

Interferon gamma testing

6
Q

What should you ALWAYS test for in anyone with suspected TB?

A

HIV

7
Q

What is pleural infection?

A

Active infection in the pleural space

8
Q

What usually precedes a pleural infection?

A

Pneumonia

9
Q

What is the progression of a pleural infection

A

Simple parapneumonic effusion
Complicated parapneumonic effusion
Empyema

10
Q

What is a makes a simple parapneumonic effusion complicated?

A

+ve gram stain, acidic pH, low glucose, septations, locutions

11
Q

What is an empyema?

A

Pus

12
Q

What is the management for pleural infection?

A
Antibiotics for several weeks
Drainage 
Early discussion with surgeons if persist sepsis 
Nutrition 
VTE prophylaxis 
CONSTANT REASSESMENT
13
Q

What is coryza?

A

Common cold

14
Q

What are the symptoms of coryza?

A

Acute viral infection of nasal passages
Sore throat
Mild fever

15
Q

How is coryza spread?

A

Droplets and fomites

16
Q

What usually precedes acute sinusitis?

A

Common cold

17
Q

What are the symptoms of acute sinusitis?

A

Purulent nasal discharge

18
Q

What is the management for acute sinusitis?

A

Usually self limiting
10 days
SOME need antibiotics

19
Q

What are the features of diphtheria?

A

Pseudomembranes form at the back of the throat

Life threatening due to toxin production

20
Q

Why is acute epiglottitis life threatening in children?

A

Swelling causes airway obstruction

Children have small airways, so even a small amount of swelling can cause obstruction

21
Q

What is acute bronchitis?

A

Preceded by common cold

Inflammation spreads to the chest

22
Q

What are the clinical features of acute bronchitis?

A
Productive cough
Fever in minority of cases
Normal chest exam 
Normal CXR 
Possible transient wheeze
23
Q

What is the treatment of acute bronchitis?

A

Normal people = Usually self limiting, and antibiotics not indicated
Can lead to significant morbidity in patients with chronic lung disease

24
Q

What are the risk factors for developing chronic pulmonary infection?

A

Immunodeficiency
Immunosuppression
Abnormal innate host defence
Repeated insult

25
Q

Which immunodeficiency problems can increase risk of chronic pulmonary infection?

A

Immunoglobulin deficiency = IgA deficiency
Hypogammaglobulinaemia
CVID
Specific Polysaccharide Antibody Deficiency

Hypo-splenism
Immune paresis (usually caused by malignancy)
HIV

26
Q

What kinds of immunosuppression can increase risk of chronic pulmonary infection?

A
Steroids
Chemotherapy 
Monoclonal antibodies 
Methotrexate 
Azathioprine
Cyclophosphamide
27
Q

What defects to the innate host defence can increase risk of chronic pulmonary infection?

A

Damaged bronchial mucosa: smoking, pneumonia, malignancy
Abnormal cilia: Katenager’s, Youngs
Abnormal secretions: CF, channelopathies

28
Q

What kinds of repeated insults can increase risk of chronic pulmonary infection?

A

Recurrent aspiration: NG feeding, poor swallow, pharyngeal pouch
Indwelling material: inhaled object, chest drain

29
Q

What are the forms of chronic infection?

A
Intrapulmonary abscess 
Empyema 
Chronic bronchial sepsis 
Bronchiectasis 
CF
30
Q

What pathogens can commonly cause an intrapulmonary abscess?

A

Streptococci, Staphylococci, E.Coli, Gram negatives

Aspergillus

31
Q

What pathogens commonly cause empyema?

A

Strep Milleri, Staph Aureus

E.coli, Pseudomonas, Haemophilus Influenzae, Klebsiella

32
Q

Which antibiotics are given to treat empyema?

A

IV amoxicillin and metronidazole initially

Oral specific to culture for 14 days