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Respiratory Tract Infection Flashcards

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1
Q

Name 4 conditions that affect the lower respiratory tract i.e. below the vocal cords?

A
  1. Acute bronchitis
  2. Acute exacerbation of chronic bronchitis
  3. Pneumonia
  4. Influenza
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2
Q

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?

A

Common cold - coryza

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3
Q

What condition is preceded by a common cold and involves purulent nasal discharge?

A

Acute sinusitis

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4
Q

Name 3 special respiratory tract conditions?

A

Acute tonsillitis and quinsy
Diphtheria
Acute epiglottitis in children

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5
Q

Which special condition is life threatening due to toxin production, characteristic pseudo-membrane and is not seen in the UK due to vaccination?

A

Diphtheria

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6
Q

What is acute bronchitis preceded by?

A

The common cold

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7
Q

What is the term for “the cold which goes to the chest”?

A

Acute bronchitis

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8
Q

Give 5 clinical features of the common cold?

A
  1. Productive cough
  2. Fever - minority of cases
  3. Normal chest examination
  4. Normal CXR
  5. May have transient wheeze
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9
Q

Are antibiotics used to treat acute bronchitis?

A

No

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10
Q

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?

A

Acute exacerbation of chronic bronchitis

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11
Q

What is a sign of right heart failure?

A

Ankle oedema

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12
Q

In acute exacerbation of chronic bronchitis - what 5 features may you find on examination?

A
  1. Breathless
  2. Wheeze
  3. Coarse crackles
  4. May be cyanosed
  5. In advanced disease - ankle oedema
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13
Q

What are the three management methods of an acute exacerbation of chronic bronchitis in primary care?

A

Antibiotic e.g. deoxycycline or amoxicillin
Bronchodilator inhalers
Short course of steroids in some cases

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14
Q

How would you manage a patient with acute exacerbation of chronic bronchitis in hospital?

A

Measure arterial blood gases
CXR to look for other diseases

Give oxygen if has respiratory failure

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15
Q

What are cough, pleurisy, haemoptysis, dyspnoea, preceding URTI, abdominal pain and diarrhoea all a symptoms of?

A

Pneumonia

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16
Q

What are these clinical signs of - fever, rigors, herpes iabialis, tachypnoea, crackles, rub, cyanosis and hypotension?

A

Pneumonia

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17
Q

What are two investigaitons you would do for pneumonia?

A

Blood culture

Serology

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18
Q

What are 5 other tests you would do other than blood culture and serology for pneumonia?

A 
Arterial gases
FBC
Urea
Liver function
CXR
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19
Q

What is the scoring system used for pneumonia?

A

CURB65

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20
Q

Explain the CURB65 score?

A

C - New onset of confusion
U - Urea > 7
R - Respiratory rate >30/min
B - Blood pressure (systolic

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21
Q

What are 4 other severity markers for pneumonia?

A

Temperature 40
Cyanosis PaO2 30
Multi-lobar involvement

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22
Q

Name the top pathogen in pneumonia?

A

Strep pneumoniae (pneumococcus)

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23
Q

Name 7 other pathogens in pneumonia, other than Strep pneumoniae (pneumococcus)

A 
H. Influenzae
Mycoplasma pneumoniae
Influenza
Chicken pox - in adult smokers
Legionella
Coxiella burnetti
Chlamydia psittaci
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24
Q

What are the 5 management steps for community aquired pneumonia?

A
  1. Antibiotics
  2. Oxygen maintain SaO2 94-98%
  3. Fluids
  4. Bed rest
  5. No smoking
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25
Give 4 complications of pneumonia
1. Respiratory failure 2. Pleural effusion 3. Empyema 4. Death
26
What can be noted on a CXR for empyema?
D-shaped pleural opacity
27
What do you need for hospital aquired pneumonia?
Extended gram negative cover
28
What do you need for aspiration pneumonia?
Anaerobic cover
29
What can bacterial pneumonia be one of the presenting features of?
HIV
30
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?
Influenza
31
What are 5 complications of influenza, excluding death?
``` Primary viral pneumonia Secondary bacterial pneumonia Myositis (skeletal and cardiac) Encephalitis Depression ```
32
What are the clinical features of primary viral pneumonia?
Dry cough, bloody sputum and respiratory failure within 24 hours of onset of initial fever
33
Name a class of anti-viral drugs
Neuraminidase inhibitors
34
Name 2 neuraminidase inhibitors
Zanamavir (Relenza) disc haler | Oseltamivir (Tamiflu) oral
35
What are these benefits of - reduced duration of symptoms by one day, reduced use of antibiotics, might reduce infectivity, no data on mortality?
Oseltamivir
36
Name 4 conditions that affect the upper respiratory tract i.e. above the vocal cords
1. Common cold - coryza 2. Sore throat - pharyngitis 3. Sinusitis 4. Epiglottitis
37
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?
Influenza
38
What are the two causes of classical flu?
Influenza A virus | Influenza B virus
39
How is influenza transmitted?
By droplets, or through direct contact with respiratory secretions of someone with the infection
40
What are 4 complications of flu?
1. Primary influenzal pneumonia 2. Secondary bacterial pneumonia 3. Bronchitis 4. Otitis media
41
Name a highly pathogenic avian flu that is a future threat?
Influenza A H5N1
42
How is lab confirmation of influenza done?
Direct detection of virus - PCR
43
How are samples of influenza virus taken?
Nasopharyngeal swabs
44
What type of vaccine is given to healthcare workers to prevent flu?
Killed vaccine
45
What vaccine for prevention of flu is more effective in children agen 2-17?
Live attenuated vaccine
46
Name 3 other causes of CAP?
Mycoplasma pneumoniae Coxiella burnetii Chlamydia
47
What do mycoplasma, coxiella and chlamydophila psittaci all respond to?
Tetracycline and macrolides
48
What two methods are used for lab confirmation of mycoplasma, coxiella and chlamydophila psittaci?
By serology | By virus detection - PCR
49
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?
Mycoplasma pneumoniae
50
What does coxiella burnetii cause?
Q fever
51
Which bacteria is uncommon, sporadic zoonosis, sheep and goats and has a complication of culture negative endocarditis?
Coxiella burnetii
52
What does Chlamydophila psittaci cause?
Psittacosis
53
What bacteria is uncommon, sporadic zoonosis, caught from pet birds and the disease presents as pneumonia?
Chlamydophila psittaci
54
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?
Bronchiolitis
55
What are >90% of cases of bronchiolitis due to?
Respiratory Syncytial Virus
56
How do you lab confirm bronchiolitis?
PCR on throat or pernasal swabs
57
What are most children antibody positive by age 5 for?
Metapneumovirus
58
What may be second only to RSV in bronchiolitis?
Metapneumovirus
59
How do you laboratory confirm metapneumovirus?
PCR
60
What is Chlamydia trachomatis?
An STI which can cause infantile pneumonia
61
How is Chlamydia trachomatis diagnosed?
By PCR on urine of mother or pernasal
62
How is Chlamydophila pneumoniae transmitted?
Person to person

Resp JL (27 decks)

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