Respiratory tract infection Flashcards
(44 cards)
Give 4 conditions of the upper tact
Common cold - coryza
Sore throat - pharyngitis
Sinusitis
Epiglottitis
Give 4 conditions that can affect the lower respiratory tract
Acute bronchitis
Acute exacerbations of chronic bronchitis
Pneumonia
Influenza
What is the coryza
Common cold
Acute viral infection of the nasal passages
Spread by droplets and fomites
It is self-limiting
What is acute sinusitis?
Preceded by a common cold
Purulent nasal discharge
Usually self-limiting, some need antibiotics
What is acute bronchitis?
Cold ‘that goes to the chest’
Inflammation of mucus membrane of bronchial tubes
Preceeded by the common cold
What are clinical features of acute bronchitis?
Productive cough May have a fever (minority) Normal chest examination Normal CXR May have a transient wheeze
What is the treatment for acute bronchitis?
Usually self-limiting
Antibiotics only given if the patient has underlying lung disease
What are the clinical features of acute exacerbation of chronic bronchitis?
Follows upper respiratory tract infection
Worsening of sputum production which is now purulent
More wheezy
Breathless
What would be seen on examination of a patient with an acute exacerbation of chronic bronchitis?
Breathless Wheeze Coarse crackles May be cyanosed In advanced disease - ankle oedema
What management would a patient with an acute exacerbation of chronic bronchitis receive in primary care?
Antibiotic e.g. doxycycline or amoxicillin
Bronchodilator inhaler
In some cases, a short course of steroids
What additional management would a patient with an acute exacerbation of chronic bronchitis receive in hospital?
Measure arterial blood gases
CXR to check for additional diseases
Give oxygen if there is respiratory failure
What are the symptoms of pneumonia? (15)
Malaise, anorexia, sweats, rigors, arthralgia, headaches, confusion, cough, haemoptysis, dyspnoea, preceeding URT, abdominal pain and diarrhoea
What are the signs of pneumonia? (8)
Fever, rigors, herpes labialis, tachypnoea, crackles, rub, cyanosis and hypotension
What investigations would be carried out for pneumonia?
Blood culture, serology, arterial blood gases, full blood count, urea, liver function and CXR
What is the CURB 65 score for pneumonia?
C - new onset of confusion U - urea >7 R - respiratory rate >30/min B - blood pressure systolic <61 65 - age 65 or older Score 1 point for each of the above Mortality increases as CURB65 increases
What is the most common bacteria to cause pneumonia?
Streptococcus pneumoniae (pneumococcus)
What treatment would be given for community acquired pneumonia?
Antibiotics - doxycycline or amoxicillin Oxygen - SaO2 94-98% Fluids Bed rest No smoking
What are 3 special cases of pneumonia?
Hospital acquired
Aspiration pneumonia
Legionella
What can be done to prevent pneumonia?
Influenza and pneumococcal vaccinations
Who is entitled to influenza and pneumococcal vaccinations?
Over 65yo Chronic chest or cardiac disease Diabetes Immunocompromised Health care workers (just influenza)
What is the clinical presentation for influenza?
Fever - high and abrupt onset Malaise Myalgia Headache Cough Prostration (weak)
What is the cause of classical ‘flu?
Influenza A virus and influenza B virus
How is ‘flu transmitted?
Droplets or direct contact with respiratory secretions from an infected individual
What is an epidemic?
A widespread occurrence of an infectious disease in a community at a particular time
