Flashcards in Respiratory Tract Infection Deck (62):
Name 4 conditions that affect the lower respiratory tract i.e. below the vocal cords?
1. Acute bronchitis
2. Acute exacerbation of chronic bronchitis
What condition is an acute viral infection of the nasal passages, often accompanied by sore throat, sometimes a mild fever, spread by droplets and fomites and complications can include sinusitis or acute bronchitis?
Common cold - coryza
What condition is preceded by a common cold and involves purulent nasal discharge?
Name 3 special respiratory tract conditions?
Acute tonsillitis and quinsy
Acute epiglottitis in children
Which special condition is life threatening due to toxin production, characteristic pseudo-membrane and is not seen in the UK due to vaccination?
What is acute bronchitis preceded by?
The common cold
What is the term for "the cold which goes to the chest"?
Give 5 clinical features of the common cold?
1. Productive cough
2. Fever - minority of cases
3. Normal chest examination
4. Normal CXR
5. May have transient wheeze
Are antibiotics used to treat acute bronchitis?
What are these clinical features a sign of: usually preceded by upper respiratory tract infection, worsening of sputum production which is now purulent, more wheezy and breathless?
Acute exacerbation of chronic bronchitis
What is a sign of right heart failure?
In acute exacerbation of chronic bronchitis - what 5 features may you find on examination?
3. Coarse crackles
4. May be cyanosed
4. In advanced disease - ankle oedema
What are the three management methods of an acute exacerbation of chronic bronchitis in primary care?
Antibiotic e.g. deoxycycline or amoxicillin
Short course of steroids in some cases
How would you manage a patient with acute exacerbation of chronic bronchitis in hospital?
Measure arterial blood gases
CXR to look for other diseases
Give oxygen if has respiratory failure
What are cough, pleurisy, haemoptysis, dyspnoea, preceding URTI, abdominal pain and diarrhoea all a symptoms of?
What are these clinical signs of - fever, rigors, herpes iabialis, tachypnoea, crackles, rub, cyanosis and hypotension?
What are two investigaitons you would do for pneumonia?
What are 5 other tests you would do other than blood culture and serology for pneumonia?
What is the scoring system used for pneumonia?
Explain the CURB65 score?
C - New onset of confusion
U - Urea > 7
R - Respiratory rate >30/min
B - Blood pressure (systolic
What are 4 other severity markers for pneumonia?
Cyanosis PaO2 30
Name the top pathogen in pneumonia?
Strep pneumoniae (pneumococcus)
Name 7 other pathogens in pneumonia, other than Strep pneumoniae (pneumococcus)
Chicken pox - in adult smokers
What are the 5 management steps for community aquired pneumonia?
2. Oxygen maintain SaO2 94-98%
4. Bed rest
5. No smoking
Give 4 complications of pneumonia
1. Respiratory failure
2. Pleural effusion
What can be noted on a CXR for empyema?
D-shaped pleural opacity
What do you need for hospital aquired pneumonia?
Extended gram negative cover
What do you need for aspiration pneumonia?
What can bacterial pneumonia be one of the presenting features of?
What are these clinical features a sign of - incubation 1-4 days, abrupt onset fever, chills, headache, sore throat, myalgia, malaise, anorexia, dry cough, clear nasal discharge and signs of complications?
What are 5 complications of influenza, excluding death?
Primary viral pneumonia
Secondary bacterial pneumonia
Myositis (skeletal and cardiac)
What are the clinical features of primary viral pneumonia?
Dry cough, bloody sputum and respiratory failure within 24 hours of onset of initial fever
Name a class of anti-viral drugs
Name 2 neuraminidase inhibitors
Zanamavir (Relenza) disc haler
Oseltamivir (Tamiflu) oral
What are these benefits of - reduced duration of symptoms by one day, reduced use of antibiotics, might reduce infectivity, no data on mortality?
Name 4 conditions that affect the upper respiratory tract i.e. above the vocal cords
1. Common cold - coryza
2. Sore throat - pharyngitis
What are these clinical symptoms of - fever (high, abrupt onset), malaise, myalgia, headache, cough (initially dry and painful, becomes productive and less painful) and prostration?
What are the two causes of classical flu?
Influenza A virus
Influenza B virus
How is influenza transmitted?
By droplets, or through direct contact with respiratory secretions of someone with the infection
What are 4 complications of flu?
1. Primary influenzal pneumonia
2. Secondary bacterial pneumonia
4. Otitis media
Name a highly pathogenic avian flu that is a future threat?
Influenza A H5N1
How is lab confirmation of influenza done?
Direct detection of virus - PCR
How are samples of influenza virus taken?
What type of vaccine is given to healthcare workers to prevent flu?
What vaccine for prevention of flu is more effective in children agen 2-17?
Live attenuated vaccine
Name 3 other causes of CAP?
What do mycoplasma, coxiella and chlamydophila psittaci all respond to?
Tetracycline and macrolides
What two methods are used for lab confirmation of mycoplasma, coxiella and chlamydophila psittaci?
By virus detection - PCR
Name an atypical cause of pneumonia which is a common cause of CAP in older children and young adults, also with person to person spread?
What does coxiella burnetii cause?
Which bacteria is uncommon, sporadic zoonosis, sheep and goats and has a complication of culture negative endocarditis?
What does Chlamydophila psittaci cause?
What bacteria is uncommon, sporadic zoonosis, caught from pet birds and the disease presents as pneumonia?
What condition occurs in 1st or 2nd year of life, fever, coryza, cough and wheeze? In severe cases grunting, decreased PaO2 and intercostal/sternal indrawing?
What are >90% of cases of bronchiolitis due to?
Respiratory Syncytial Virus
How do you lab confirm bronchiolitis?
PCR on throat or pernasal swabs
What are most children antibody positive by age 5 for?
What may be second only to RSV in bronchiolitis?
How do you laboratory confirm metapneumovirus?
What is Chlamydia trachomatis?
An STI which can cause infantile pneumonia
How is Chlamydia trachomatis diagnosed?
By PCR on urine of mother or pernasal